NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8054A REVISED MEMO 04/30/2018
SPONSOR: Gottfried
 
TITLE OF BILL: An act to amend the public health law, in relation to
extending eligibility for the child health insurance plan to young
adults
 
PURPOSE OR GENERAL IDEA OF BILL:
To extend the age of eligibility for Child Health Plus to young adults
insurance coverage due to their immigration status.'
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends subdivision 4 of section 2510 of the public health law
to add the phrase "eligible young adult" and adds a new subdivision 4-a
to define "eligible young adult" as a person 19 years of age or older
but less than the age of 30.
Section 2 amends paragraph (d) of subdivision 9 of section 2510 of the
public health law to add the phrase "under the age of nineteen" to
subparagraphs (i), (ii), (iii), (iv), (v)and (vi); and adds subpara-
graphs (vii), (viii), (ix) and (x) defining eligibility based on incomes
and associated premium payment levels.
Section 3 states the effective date as April 1, 2018.
 
JUSTIFICATION:
Over the past few years, New York has drastically cut its uninsured
rate. However, many immigrant New Yorkers have not benefited from new
coverage options or public coverage through the New York State of Health
Marketplace because of exclusions based on their immigration status.
Numerous studies have found that people without coverage are more likely
to delay seeking preventive care for serious and chronic health condi-
tions, avoid seeking care for fear of costs, and are at higher risk of
incurring medical debt or bankruptcy. Recent studies have shown that
those who have gained coverage have reduced mortality and morbidity.
Finally, lack of coverage for significant numbers of New Yorkers incurs
problems 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 threatens the financial
sustainability of many safety net hospitals and clinics.
This bill would provide young 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 Essential
Plan or through Qualified Health Plans offered through the New York
State of Health Marketplace. The bill extends coverage through New
York's Child Health Plus program to young adult immigrants between the
ages of 19 through 29, averting the health insurance cliff many young
immigrants now face when they turn 19 after years of state investment in
their health.
This program builds upon New York's strong commitment to young people
evidenced by both our universally available Child Health Plus program
and our commercial young adult coverage law which requires employers and
insurance carriers to offer young adults the opportunity to stay on
their parents' health plan through the age of 29.
This bill seeks to provide coverage to immigrant young adults that
mirrors the coverage offered to their young adult citizen and qualified
immigrant counterparts.
By expanding coverage, this bill makes New York health care providers
more financially sound and better able to provide continuous, high-qual-
ity care to 1 this population.
 
PRIOR LEGISLATIVE HISTORY:
New Bill
 
FISCAL IMPLICATIONS FOR STATE & LOCAL GOVERNMENTS:
According to a 2016 report by the Community Service Society of New York,
How Can New York Provide Health Insurance Coverage to its Uninsured
Immigrant Residents?, there are approximately 90,100 young adult immi-
grants who would be eligible, but only 27,900 of those who are eligible
are likely to enroll. Members would pay premiums on a sliding fee scale,
based on the young adult's income. The total cost to the state would be
approximately $78 million in 2016. Adjusting for medical inflation, the
cost in 2018 would be $81 million.
There would be no fiscal impact on local governments.
 
EFFECTIVE DATE:
This act shall take effect April 1, 2019; provided that the commissioner
of health shall take such actions, including making regulations and
applying for federal financial participation; as are reasonably neces-
sary for implementation of this act on that date.
STATE OF NEW YORK
________________________________________________________________________
8054--A
2017-2018 Regular Sessions
IN ASSEMBLY
May 25, 2017
___________
Introduced by M. of A. GOTTFRIED, SOLAGES, CRESPO, THIELE, SIMON,
LENTOL, BRONSON, DE LA ROSA, MOSLEY, SEPULVEDA, VANEL, ORTIZ, JAFFEE,
D'URSO, WILLIAMS, BLAKE, CARROLL, NIOU, L. ROSENTHAL, DICKENS, RODRI-
GUEZ -- read once and referred to the Committee on Health -- recommit-
ted to the Committee on Health in accordance with Assembly Rule 3,
sec. 2 -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee
AN ACT to amend the public health law, in relation to extending eligi-
bility for the child health insurance plan to young adults
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 4 of section 2510 of the public health law, as
2 amended by chapter 2 of the laws of 1998, is amended, and a new subdivi-
3 sion 4-a is added to read as follows:
4 4. "Eligible child" or "eligible children" means a person or persons
5 [under the age of thirteen years for the period January first, nineteen
6 hundred ninety-one through December thirty-first, nineteen hundred nine-
7 ty-three; born on or after June first, nineteen hundred eighty and under
8 the age of sixteen for a period commencing on or after January first,
9 nineteen hundred ninety-four through December thirty-first, nineteen
10 hundred ninety-six; and for a person or persons enrolled in the program
11 on the day before they are sixteen years of age, under the age of seven-
12 teen for a period commencing on or after June first, nineteen hundred
13 ninety-five through December thirty-first, nineteen hundred ninety-six;
14 and] under the age of nineteen [for periods commencing on or after Janu-
15 ary first, nineteen hundred ninety-seven,] who meets or meet the crite-
16 ria in section two thousand five hundred eleven of this title. Unless
17 the context clearly requires otherwise, "eligible child" includes an
18 eligible young adult.
19 4-a. "Eligible young adult" means a person nineteen years of age or
20 older but less than the age of thirty, who meets the criteria in section
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD11187-02-8
A. 8054--A 2
1 two thousand five hundred eleven of this title and who is not eligible
2 for the basic health program under section three hundred sixty-nine-gg
3 of the social services law or a qualified health plan through the New
4 York state of health marketplace. An eligible young adult shall be
5 deemed to be his or her own legally responsible adult for the purposes
6 of this title.
7 § 2. Paragraph (d) of subdivision 9 of section 2510 of the public
8 health law, as amended by section 29 of part D of chapter 56 of the laws
9 of 2013, is amended to read as follows:
10 (d) for periods on or after July first, two thousand nine, amounts as
11 follows:
12 (i) no payments are required for eligible children under the age of
13 nineteen whose family household income is less than one hundred sixty
14 percent of the non-farm federal poverty level and for eligible children
15 under the age of nineteen who are American Indians or Alaskan Natives,
16 as defined by the U.S. Department of Health and Human Services, whose
17 family household income is less than two hundred fifty-one percent of
18 the non-farm federal poverty level; and
19 (ii) nine dollars per month for each eligible child under the age of
20 nineteen whose family household income is between one hundred sixty
21 percent and two hundred twenty-two percent of the non-farm federal
22 poverty level, but no more than twenty-seven dollars per month per fami-
23 ly; and
24 (iii) fifteen dollars per month for each eligible child under the age
25 of nineteen whose family household income is between two hundred twen-
26 ty-three percent and two hundred fifty percent of the non-farm federal
27 poverty level, but no more than forty-five dollars per month per family;
28 and
29 (iv) thirty dollars per month for each eligible child under the age of
30 nineteen whose family household income is between two hundred fifty-one
31 percent and three hundred percent of the non-farm federal poverty level,
32 but no more than ninety dollars per month per family;
33 (v) forty-five dollars per month for each eligible child under the age
34 of nineteen whose family household income is between three hundred one
35 percent and three hundred fifty percent of the non-farm federal poverty
36 level, but no more than one hundred thirty-five dollars per month per
37 family; [and]
38 (vi) sixty dollars per month for each eligible child under the age of
39 nineteen whose family household income is between three hundred fifty-
40 one percent and four hundred percent of the non-farm federal poverty
41 level, but no more than one hundred eighty dollars per month per fami-
42 ly[.];
43 (vii) no payments are required for eligible young adults whose house-
44 hold income is at or below one hundred fifty percent of the non-farm
45 federal poverty level;
46 (viii) twenty dollars per month for each eligible young adult whose
47 household income is above one hundred fifty-one percent of the non-farm
48 federal poverty level but at or below two hundred percent of the non-
49 farm federal poverty level;
50 (ix) one hundred sixty dollars per month for each eligible young adult
51 whose household income is above two hundred one percent of the non-farm
52 federal poverty level but at or below two hundred fifty percent of the
53 non-farm federal poverty level; and
54 (x) a premium payment equivalent to the second lowest costing silver
55 plan offered in the New York state of health marketplace that would be
56 available to the young adult if eligible for a qualified health plan,
A. 8054--A 3
1 not to exceed the amount of a full monthly premium payment for the child
2 health insurance plan for each eligible young adult whose income is
3 above two hundred fifty-one percent of the non-farm federal poverty
4 level.
5 § 3. This act shall take effect April 1, 2019; provided that the
6 commissioner of health shall take such actions, including making regu-
7 lations and applying for federal financial participation, as are reason-
8 ably necessary for implementation of this act on that date.