Provides eligibility for services under the basic health program for individuals whose immigration status renders him or her ineligible for federal financial participation and who meet additional requirements.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5974
SPONSOR: Gottfried TITLE OF BILL:
An act to amend the social services law, in relation to coverage for
health care services under the basic health program for individuals
whose immigration status renders him or her ineligible for federal
financial participation
PURPOSE OR GENERAL IDEA OF BILL:
To expand eligibility for the Essential Plan to individuals who current-
ly face barriers to health care coverage due to their immigration
status.
SUMMARY OF SPECIFIC PROVISIONS:
Section one of the bill adds a new subdivision 3-a to Section 269-gg of
the social services law detailing qualifications for participation in
the state's basic health program, known as the Essential Plan.
Section 2 of the bill amends the title heading of title 11-D of article
5 of the social services law to read "Basic Health Program."
Section 3 of the bill is the effective date.
JUSTIFICATION:
Since the enactment of the Affordable Care Act Marketplace in 2010, New
York has drastically reduced the number of uninsured from 3 million to 1
million people. However, more than 400,000 immigrant New Yorkers have
not benefited from new coverage options or public coverage through the
New York State of Health Marketplace because of their immigration
status. Numerous studies have found that people without coverage are
more likely to delay seeking preventive care for serious and chronic
health conditions, avoid seeking care for fear of costs, and are at
higher risk of incurring medical debt or bankruptcy. Studies have also
shown that those who have gained coverage have reduced mortality and
morbidity.
The lack of coverage for significant numbers of New Yorkers causes prob-
lems for the broader health care system because payers and providers
charge more to the insured population to offset their losses related to
providing care to the uninsured. But even with this cost shifting, the
costs associated with uncompensated care threaten the financial sustain-
ability of many safety net hospitals and clinics. The program will
invest $532 million into the health care system, further stabilizing the
state's health care economy.
This bill will provide adult immigrants with access to health insurance
coverage that is equivalent to the coverage offered to their citizen or
lawfully present counterparts who are eligible for the Essential Plan.
The program builds upon New York's success covering children (including
immigrant children) through the Child Health Plus program. It extends
coverage to eligible adult immigrants ensuring that all New Yorkers have
access to affordable health coverage, averting the health insurance
cliff many young immigrants now face when they turn 19 after years of
state investment in their health.
By expanding eligibility for coverage under the Essential Plan, this
bill makes New York health care providers more financially sound and
better able to provide continuous, high-quality care to this population.
PRIOR LEGISLATIVE HISTORY:
2019: New bill
FISCAL IMPLICATIONS:
The cost to the state to accomplish this goal is estimated to be over
$500 million. The state will be saving close to the same amount in emer-
gency Medicaid spending. Eligible individuals would be paying small
premium amounts to contribute to their coverage.
EFFECTIVE DATE:
This act shall take effect on the one hundred-eightieth day after it
shall have become a law. Effective immediately, the commission of health
shall make regulations and take other actions reasonably necessary to
implement this act on this date.
STATE OF NEW YORK
________________________________________________________________________
5974
2019-2020 Regular Sessions
IN ASSEMBLY
February 22, 2019
___________
Introduced by M. of A. GOTTFRIED -- read once and referred to the
Committee on Health
AN ACT to amend the social services law, in relation to coverage for
health care services under the basic health program for individuals
whose immigration status renders him or her ineligible for federal
financial participation
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 369-gg of the social services law is amended by
2 adding a new subdivision 3-a to read as follows:
3 3-a. Alternate eligibility. A person shall also be eligible to receive
4 coverage for health care services under this title, without regard to
5 federal financial participation, if he or she is a resident of New York
6 state, has household income below two hundred percent of the federal
7 poverty line as defined and annually revised by the United States
8 department of health and human services for a household of the same
9 size, and is ineligible for federal financial participation in the basic
10 health program under 42 U.S.C. section 18051 on the basis of immigration
11 status, but otherwise meets the eligibility requirements in paragraphs
12 (b) and (c) of subdivision three of this section. An applicant who fails
13 to make an applicable premium payment shall lose eligibility to receive
14 coverage for health care services in accordance with time frames and
15 procedures determined by the commissioner.
16 § 2. The title heading of title 11-D of article 5 of the social
17 services law, as added by chapter 1 of the laws of 1999, is amended to
18 read as follows:
19 [FAMILY HEALTH PLUS PROGRAM] BASIC HEALTH PROGRAM
20 § 3. This act shall take effect on the one hundred eightieth day after
21 it shall have become a law. Effective immediately, the commissioner of
22 health shall make regulations and take other actions reasonably neces-
23 sary to implement this act on that date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09899-03-9
