By Allison Hibbs
The dawning year is already seeing some significant changes in the way that New York State organizes and ensures healthcare. Exchanges have become operational, medical marijuana is on the immediate horizon, and Gov. Andrew Cuomo has expressed plans to regionalize healthcare planning and is exploring options to outsource the state organ donor registry.
“The Affordable Care Act has been getting implemented in New York as well as or better than anywhere else,” said Assemblyman Richard Gottfried, the longtime chair of the Assembly Health Committee. “The exchange that Governor Cuomo put together is working delightfully well.”
Gottfried said that while he believed the majority of New Yorkers who have been required to change their plans have wound up with better coverage, in cases where that may not be true, “The state insurance department and the Insurance Committee in the Assembly will be looking at whether these are problems that can be fixed by state law and approach possible remedies from the consumer’s standpoint.”
Sen. Kemp Hannon, chair of the Senate Health Committee, also said that continued monitoring of the new exchanges and their efficacy and compliance with federal law will be important this year.
One unanswered question is whether the state will offer a “basic coverage health plan” through the Affordable Care Act, under which the state would pay the consumers’ share of their premium beyond the subsidies afforded by the ACA. According to Gottfried, such a plan could affect several hundred thousand families in New York State as comparable programs are being phased out.
“Whether or not the governor will propose it in the budget comes down to one fairly arcane point,” Gottfried said. “Under Medicaid, many immigrants are not eligible for federal matching money. In New York, we have provided that money at state expense. Under the basic health program offered under ACA, they would become eligible, and New York would receive federal matching dollars, which could actually make money for the state. For the executive office, it’s a question of whether it will earn or cost the state.”
A more publicized area in which the executive office has taken recent, decisive action is the medicinal use of marijuana. As Cuomo revealed in his State of the State address earlier this month, he will make use of a largely forgotten 1980 law allowing the use of medical marijuana for the purposes of research and “establish a program where qualified eligible participants may seek relief for their symptoms in a safe and legal manner.” While the maneuver essentially bypasses the Legislature, Gottfried hailed it as “a very important interim step,” and said it was his hope the next step would be to formulate comprehensive legislation less restrictive than the 1980 law.
Existing legislation will also be used to allow for the creation of Regional Health Improvement Collaboratives. Similar to the governor’s Regional Economic Councils, these collaboratives are intended to reduce costs and improve care by tailoring services and utilities to regional needs through improved communication between the state Department of Health and regional community members, medical professionals, insurance companies and pharmaceutical providers. Cuomo and Gottfried have both pointed to Rochester and the Finger Lakes region as success stories.
Of course, many of the top healthcare issues will be resolved in the state budget. Gottfried and Hannon agreed that the scope of the legislative health agenda will depend largely on funding.
- Healthcare exchanges and the continued rollout of the Affordable Care Act
- Medical marijuana legislation
- Regionalized healthcare planning