New York Medicaid Cuts: Legislators Fight Back to Save $3 Billion

In New York’s fiscal year 2025 budget proposal, Governor Kathy Hochul has contemplated cutting $1.2 billion from programs derived from Medicaid, an idea that has already generated bitter debates, concerns on the part of state legislators and other elected leaders, who hone various “weapons” to combat that possibility in the weeks ahead.

Among other things, that cut would mean further limiting long-term care, home care and other services that older New Yorkers depend on, because the Medicaid budget, as state government spokespeople have acknowledged, is about to burst. , because it has grown 40% in the last three years.

While the state government intends to remove funds from that budget line, some legislators, led by the president of the Senate Health Committee, Senator Gustavo Rivera, have already “rolled up their sleeves” to seek support in the Democratic caucus, to approve the “Home Care Reinvestment and Savings Law.”

“This is not the time to talk about cuts. It is time to talk about the stabilization of this system, and we have options available that we can take advantage of”highlighted the Bronx legislator.

According to the proposal led by the Puerto Rican senator, approval would save approximately $3 billion to state coffers. This would be accomplished by paying directly for home care services, rather than charging a fixed monthly fee per member. to the insurance companies that coordinate these services.

And the most notable thing is that this could translate into better salaries for this workforce.

The central argument of this proposal, presented last December, is to completely exclude private insurance companies from the long-term care business, whose funds come from the federal Medicaid program.

Senator Gustavo Rivera of the Bronx assures that the formula of using insurance companies as intermediaries has already been exhausted. (Photo: F. Martínez El Diario)

“Pay caregivers directly”

Since this private intermediation scheme emerged a decade ago, the state of New York has paid $52 billion in bonuses to private corporations to administer this benefitaccording to an analysis by the 111SEIU union, one of the union organizations that will join the fight for this reform in the coming weeks.

Managed long-term care is the product of a state Medicaid redesign launched by former Governor Andrew Cuomo. to address rising program costs.

“New York did not always outsource the management of home care. Previously, the State paid for these services directly through a fee-for-service model. But in 2011, control of the Medicaid-funded home care program was handed over to insurance companies, arguing that privatization would improve care through the promise of care management and coordination. And it has not been like that”Rivera argues.

The reasoning of the drafters of the draft bill, which is expected to be pushed for approval in the coming weeks and signed by Governor Hochul, is that these plans administered by insurers, They spend millions on administrative costs, while the home care workforce, He receives a salary described from every point of view as “miserable.”

“Privatizing health care has not saved our state money, nor improved care for New Yorkers. Instead, it enriches private health insurance companies,” explained to The newspaper Bronx state senator Gustavo Rivera who is sponsoring the bill, along with Assemblywoman Amy Paulin.

The legislative idea alone makes it clear that a battle will come with the 24 intermediary companies, which in the last 3 years, have received at least $5.5 billionof which $3.1 billion has been for administrative costs and $2.4 billion in net benefits, based on balances released by the NY Caring Majority organization.

Only in 2021, the last full year for which data is available, did private insurance companies earn 722 million dollars in profitsthis profit margin of 5.5% was double the national average.

“Let’s find solutions”

In the executive budget proposed by the state president of $233 billion dollarsthe state-funded Medicaid program will total $35.5 billion.

One proposal would suspend “pay parity” for a program that provides services to those who need help with daily activities. Cut the supplemental payment benefit or home care aids, could save the State $200 million dollars.

“Medicaid is a really important program for many New Yorkers. However, its demand is growing quite rapidly. We all have to reflect, including legislators, on how this program It will be sustainable”explained the commissioner of the New York State Department of Health, James McDonald.

“Its inhuman”

In the streets, rumors about the decrease in Medicaid funds, It is a point of rumors and discomfort for elderly people, who benefit directly or indirectly from this federal program. Or they just think they might need it at some point.

For example, the Puerto Rican Alexa Cruz, 70, assures that it is “inhuman and beyond all logic” that older people who have worked all their lives and who have the right to a retirement and health and care plans, They must be hearing about cuts.

“For days I have been hearing that it is cutting here and there for the oldest New Yorkers. Honestly, I don’t understand what our rulers have in their heads, when at the same time they advertise millions and millions to make life easy for thousands of newcomers. While we, who are also vulnerable, may the devil take us,” the islander concluded angrily.

In emergency:

• 85% of agencies that offer home care services in NY, can barely operate. Exponentially, they are suffering a dramatic staff shortage.
• 50% of home care aides They depend on public benefits to care for their own families.
• 25% of patient families requiring home care in 2021, reported they could not find home health aides, according to a report from the New York Home Care Association.

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2024-03-05 12:43:00
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