New York lawmakers will push to deregulation of home care from private insurers

In New York’s fiscal year 2025 budget proposal, Governor Kathy Hochul has put forward $1.2 billion cut from programs considered derived from Medicaid, an idea that has already generated bitter debate, concerns from state legislators and other elected leaders, who wield various “weapons.” To deal with that possibility in the coming weeks.

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

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

“This is not the time to talk about cuts. Now it’s time to talk about the stabilization of this system, And we have options available that we can take advantage of.”Highlighting the Bronx legislator.

According to the proposal led by a Puerto Rican senator, the approval would save approx. $3 billion To the state treasury. 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 remarkable thing is that it can be translated Better pay for this workforce.

The central argument of this proposal, presented last December, is to get private insurance companies out of the long-term care business entirely, Whose funding comes from the federal Medicaid program.

“Pay caregivers directly”

Since this private arbitration plan emerged a decade ago, New York State has paid $52 billion bonus to private corporations to administer this benefitAccording to an analysis by 111SEIU union, it is one of the union organizations that will join the fight for this reform in the coming weeks.

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

“New York did not always outsource the management of home care. Previously, the state paid directly for these services 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 will improve care through the promise of care management and coordination. And that hasn’t happened.”Rivera argues.

The rationale of the drafters of the draft bill, which will be put forward for approval in the coming weeks and is expected to be signed by Governor Hochul, is that these plans are administered by insurers, They spend millions on administrative costs, While the home care workforce, He gets a “sad” salary by all accounts.

“Privatizing health care has neither saved our state money nor improved care for New Yorkers. Instead, it enriches private health insurance companies.” explained to Newspaper Bronx State Senator Gustavo Rivera Joe is sponsoring the bill with Assemblywoman Amy Palin.

The legislative idea itself makes it clear that a fight will come 24 arbitrage companies that have received at least $5.5 billion in the last 3 yearsof which $3.1 billion is for administrative costs and $2.4 billion is for net profit, based on Balance issued by NY Caring Majority organization.

In 2021 alone, the last full year for which data is available, private insurers earned $722 million profitThis profit margin of 5.5% was double the national average.

“Let’s find a solution”

The budget proposed by the state president in the executive $233 billion dollarsThe state-funded Medicaid program would total $35.5 billion.

One proposal would suspend “pay parity” for programs that provide services to people who need assistance with daily activities. Cut supplemental payment benefits or home care assistance, The state could save $200 million.

“Medicaid is a really important program for many New Yorkers. However, its demand is increasing very fast. We all, including the MLAs, will have to consider what this program should be like. “It will be sustainable.”Commissioner explained New York State Department of Health, James McDonald.

“This is inhumane”

Rumors of Medicaid funding cuts on the streets, It is a subject of rumors and trouble 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, Puerto Rican Alexa Cruz, 70, Asserts that it is “inhumane and beyond all reason” that older people who have worked all their lives and who have the right to retirement and health and care plans, They may be hearing about the cuts.

“I’ve been hearing for days that it’s making cuts here and there for the oldest New Yorkers. To be honest, I don’t understand what is going on in the minds of our rulers, When at the same time they spend millions and millions of advertisements to make the lives of thousands of newcomers easier, While we, who are also weak, let the devil get hold of us,” the islander concluded angrily.

in emergency:

• 85% agencies Those who provide home care services in NY can barely function. Increasingly, they are suffering a dramatic staff reduction,
• 50% home care assistant They rely on public benefits to support their families.
• 25% patient family People requiring home care in 2021 reported that they could not find home health aides, according to a report by New York Home Care Association.