NYAPRS Note: The following provides details about one of the Cuomo Administration’s 11 regional forums held this past week. NYS Assistant Secretary for Health Megan Baldwin opened with the attached presentation, which was followed by presentations by panelists representing a cross section of advocates and experts and local stakeholder discussion. All expressed very grave concerns about the potential impact of the Senate GOP healthcare proposal on Medicaid recipients, including cancer survivors, seniors and individuals with mental health and substance use related conditions.
Thanks to the group from NYAPRS member agency MHA of Essex County, who made offered compelling comments both during this discussion and to the media.
Republicans in the U.S. Senate temporarily shelved a healthcare bill yesterday that they say would repeal and replace Obamacare. The Republican measure came under fire after officials with the Congressional Budget Office released an analysis showing it would mean more than 20 million Americans losing health insurance.
The bill includes deep cuts to Medicaid, which would affect hospitals, nursing homes and patients across the North Country.
The Cuomo administration has been lobbying hard against the measure. In an event organized last night in Plattsburgh by the governor's office, Darlene Imondi talked about her struggle with tongue cancer.
She says much of her healthcare was paid for by Medicaid. "If it wasn’t for Medicaid, I wouldn’t be sitting here right now. And if it wasn’t for Medicaid, I would not have seen my daughter or my songraduate," Imondi said.
One change to the healthcare system Republicans hope to make would end the requirement that counties contribute to the cost of the Medicaid program. Republicans say that reform would help reduce property taxes. But at last night's meeting, Megan Baldwin with the governor's office said it would also mean even deeper cuts to funding for local hospitals and nursing homes.
"In the North Country alone," Baldwin said, "there would be $29.8 million in cuts for 26 nursing homes in the North Country, and $20.2 million in cuts for 15 hospitals."
No one at last night's meeting spoke in favor of the Republican measure. David Curry works at CVPH hospital in Plattsburgh and spoke for the New York State Nurses Association.
"This is not a healthcare bill; it’s a tax cut bill, and it is designed to take moneys that were invested in our healthcare system and give those moneys back to largely the top one tenth of one percent of Americans," Curry said.
In all, the Congressional Budget Office says some 15 million Americans would likely lose Medicaid coverage if the current bill is signed into law. The CBO also found that wealthy Americans would see roughly $560 billion in tax cuts over the next ten years.
Brian Mann spoke yesterday with New York's Lt. Governor Kathy Hochul, who was part of the lobbying effort against the Republican bill.
Lt. Gov. Kathy Hochul: Sixty-four percent of nursing home patients receive Medicaid, and if that’s cut, where are these people supposed to go? So I would say, I agree with President Trump that it is actually a very mean and mean-spirited piece of legislation. And, yes, there are ways we can fix and improve health care in this country. We’re doing it at the state level; we’ve cut costs dramatically; we’ve expanded access. But we’re talking about society’s most vulnerable: our children, pregnant women looking for maternity care, our seniors. We can’t do this. And even the Catholic Conference of Bishops said this is something that is not appropriate in this day and age; we ought to be more caring of this, and I think we can do a lot more. We can fix it, but not throw it out.
Brian Mann: Here in the North Country and in a lot of rural New York, there are a lot of nursing homes that are hanging on by a thread now. If these cuts go forward and a lot of these nursing home residents are effected, what does that do to the retirement home network in New York State, especially in those small towns?
KH: It has potential to literally wipe them out. We’re talking about over $400-million cuts to these nursing homes. As you are correct in stating, they are hanging on by the threads, particularly rural hospitals and nursing homes. And in these areas - for example, my old congressional district was a very rural area - people had to travel great distance to receive care and when you have an elderly parent or grandparent who’s finally settled into a nursing home and you have to pull them out of there because they don’t have enough coverage anymore, that is cruel and heartless. And we’re better than that in the state of New York, and that’s why we’re fighting so hard to protect these individuals. But also, on the other end of the spectrum, they’re talking about severely curtailing money for substance abuse treatment. When I travel all over upstate New York, North Country to Western New York, this is one of the largest problems; it’s literally killing our young people. The number one cause of death for young people in our state today is addiction to heroin and opioids. So at a time when we’re at a peak crisis time with this epidemic, to say we’re now cutting treatment, I can’t understand the logic behind that. How can people be so cruel?
North Country Congresswoman Elise Stefanik, a Republican, voted in favor of the House version of this measure. In a statement yesterday, her spokesman Tom Flanagin said the Senate measure is still being debated and improved. “We anticipate there will be changes made to the Senate bill before it moves to the floor for a vote," Flanagin said in an email to North Country Public Radio.
Megan Baldwin with the state, John Rugge with Adirondack Health Institute, and Harvey Rosenthal with the NY Association of Psychiatric Rehabilitation Services were among the panelists at the Plattsburgh forum (left)
Darlene Imondi talked about her struggle with tongue cancer. "If it wasn't for Medicaid, I wouldn't be sitting here right now," she said. (right)
Kelly Trombley and Devon Wallace said they came to learn how they'd be impacted by the GOP's health care plan. (middle)
Experts Warn Against Health-Care Bills
By Ashleigh Livingston Plattsburgh Press-Republican June 29, 2017
Two years ago, Darlene Imondi was diagnosed with cancer, but she has lived to tell her story thanks to numerous treatments and therapies — all covered by Medicaid.
"If it wasn't for Medicaid, I wouldn't be sitting here right now," she said through tears during the recent North Country ACA (American Care Act) Repeal Roundtable at Clinton Community College.
The forum, organized by Gov. Andrew Cuomo's office, was one of a series of events held across the state this week to discuss the impact the U.S. House of Representative's proposed American Health Care Act (AHCA) and the Senate’s proposed Better Care Reconciliation Act would have in the state.
"Both those will put millions of Americans at risk," Megan Baldwin, assistant secretary for health at the State Executive Chamber, told attendees of the roundtable, where she served as host.
COVERED BY MEDICAID
She was joined by several panelists, including Imondi; local nurse practitioner David Curry of the State Nurses Association; Hudson Headwaters CEO Dr. John Rugge; Connie Wille, executive director of Champlain Valley Family Center for Drug Treatment and Youth Services Inc.; Harvey Rosenthal, executive director of New York Association of Psychiatric Rehabilitation Services Inc.; and Gail Meyers of the Statewide Senior Action Council.
If passed, the AHCA would leave 2.7 million New Yorkers without health insurance and cut $7 billion from the state's health-care system, according to data from the state.
These cuts would especially hurt those who rely on Medicaid services, Baldwin said.
In the North Country, she noted, one in three people covered by Medicaid is a child.
And 74 percent of nursing home residents; 24 percent of emergency room/clinic visits and outpatient surgeries; and 40 percent of baby deliveries are currently covered by Medicaid.
'VERY SCARY TIME'
In addition to sharply reducing Medicaid funding, Baldwin continued, both the House and Senate bills would increase the cost of private insurance coverage, reduce financial assistance for lower income New Yorkers and eliminate funding for the Essential Plan, which has made insurance available to 665,000 working-class New Yorkers.
"This is a very scary time for health care," Rugge said.
Hudson Headwaters, he noted, serves about 100,000 people, and of those, 9,000 have health insurance thanks to the ACA.
"These are the people at stake when Sen. (Charles) Schumer, Sen. (Kirsten) Gillibrand and Congresswoman (Elise) Stefanik make their votes in Washington," Rugge said. "They need to hear from us, and they need to know how important it is we have this kind of coverage.”
OPIOID OPT OUT
Additionally, the $2 billion included in the Senate's repeal bill for combating opioid addiction is not nearly enough to address the problem, Baldwin said. And the legislation would allow insurance companies to opt out of providing addiction treatment.
“The opiate epidemic in Clinton County is real ... We've all witnessed the outcomes of untreated addictions," Wille said.
During 2016, she said, 65 percent of clients receiving outpatient addiction treatment services through Champlain Valley Family Center were either Medicaid recipients or covered by Medicaid Managed Care.
And if the Senate bill is passed, about 40 percent of those served by the center would have no health-care coverage, according to Wille.
“Obviously, this has the potential to devastate client services (and) reduce treatment options,” she said.
BEHIND CLOSED DOORS
Both the House and Senate bills would also prohibit federal reimbursement, including Medicaid payment, for services provided at Planned Parenthood, according to Baldwin.
“Folks will tell you they're taking the high moral ground and this is about abortion, but it's not," Curry said. "It's about all the services that Planned Parenthood offers, which includes contraceptive services and men's health and LGBT.
"There's lots of folks who get their care from Planned Parenthood who are not just pregnant woman.
"This attack was done behind closed doors, as we're all aware, by 13 rich white men. No women.”
In addition, Meyers fears the bills, which would make it possible to charge higher premiums based on age and gender, would result in poverty for many senior citizens.
“When we talk about the age tax, that is people who are under Medicare eligibility, so it's people who are under 65, who are not disabled, who do not have Medicare, who are purchasing their insurance on the exchange,” she explained.
And the House and Senate proposals, Meyers said, will make their premiums unaffordable.
"That's bad," she said. "But what's also bad is that when they come into Medicare, when they age into Medicare at 65, they're coming in in worse shape, they're coming in sicker, they're coming in using the health-care system more. ”
"And basically, just to sum it up," Baldwin added, "all of this is being done to provide a massive tax cut to the top 1 percent of the wealthiest Americans."
'CHANGE HEARTS, MINDS'
She encouraged forum attendees to share information with others, contact lawmakers to advocate against the bills and sign Cuomo's "Fight for Quality Health Care" petition.
"We need to change the hearts and minds of folks locally as well," Plattsburgh Town Supervisor Michael Cashman said from the audience during the event's question-and-answer period.
This issue is not about a political party, he said, "this is about the health of our society, our people, our friends, our neighbors, our family."
And it's not an issue that will simply go away, Cashman continued.
“It will come back over and over and over again unless the groundswell of us demands more and better," he said. "That is your responsibility.
"If you do not take it upon yourself to carry this message and your individual message to at least one other person, you have failed.”
To sign Gov. Andrew Cuomo's "Fight for Quality Health Care" petition, visit https://tinyurl.com/y73hxek2.