NYS, US Budgets Face Stop-Gap Measures; NYS Health Insurer 2018 Rate Setting Stymied

NYAPRS Note: State and federal political stalemates stymie budget agreements.
In NY, many of the issues have been resolved except for Raise the Age and others noted below. Despite the atmosphere of uncertainty, funding to increase wages for direct care workers are expected to be included in the final agreement, Senator Rob Ortt said last Friday. Reportedly, the health budget has been resolved. NYAPRS continues to push for a rejection of Senate proposals to cut health home/outreach funding and is working with MHANYS to keep $125 million in Capital Infrastructure funding for the health/behavioral health sector and to expand its reach to include recovery focused HCBS services.

Congress will apparently pass a stopgap spending measure to keep federal funds flowing past April 28.

The uncertainty around federal healthcare and Medicaid policy is putting health plans under great pressure, since they have to submit their proposed premium rate hikes to DFS by May 10.

With No Deal, Cuomo Will Ask for Emergency Budget Measures
By Jesse McKinley New York Times APRIL 2, 2017

ALBANY — Faced with a recalcitrant Legislature and a failed negotiating strategy, Gov. Andrew M. Cuomo said late Sunday that he would introduce emergency legislation to keep the state government in operation after efforts to pass a state budget for the 2017-18 fiscal year faltered during weekend-long talks.

The fiscal year began at the stroke of midnight on Friday with no deal in place, though the governor requested that lawmakers stay in Albany over the weekend, extending the workweek in the hope that the extra time would result in a flurry of deals. He called it a “grace period.”

By Sunday evening, however, that hope had not blossomed into a budget. And with lawmakers seeming to be at odds over a rotating roster of issues, Mr. Cuomo said he would introduce a so-called extender bill, which effectively freezes spending at last year’s level, in order “to keep government fully functioning.”

…“These are difficult and unusual times for our state and country,” Mr. Cuomo said. “An ultraconservative Congress poses an unsettling attack on individuals’ rights and American values.”

But the bill was also the byproduct of a strategy of incorporating major policy debates inside the state budget, a longstanding — and continually contentious — tactic that Mr. Cuomo has used in the past. In this case, it is the question of raising the age of criminal responsibility that has consistently been mentioned as the stumbling block to a deal, something acknowledged by the governor in his statement, as he referred to “political and ideological differences between the Senate and Assembly.”

…With the initial deadline having been missed on Friday, lawmakers had spent the weekend in the capital, even as leaders on both sides of the aisle continually expressed confidence about a looming deal. But the list of contested policies continued to percolate, including a renewal for 421-a, a lapsed tax-cut program for developers; support for charter schools; changes to the workers’ compensation system; and education aid. Each of those issues had been said to be near a final deal in recent days, without any actual legislation materializing.
Another Federal Government Shutdown Scare
According to Politico: “Congress kicked the can in December by clearing a stopgap spending bill that keeps the government temporarily operating, and now the day of reckoning is here. With federal cash set to run out on April 28, the big question this month is whether lawmakers can reach a deal to fund federal operations through the end of September and avert a government shutdown. Complicating matters: Congress, which is on recess from April 10 to 21, is expected to be in session for just eight legislative days this month.

…The latest round of spending negotiations are complicated by the Trump administration's insistence on an initial $1.4 billion to jump start construction of a wall along the U.S.-Mexico border and the Pentagon's request for supplemental defense spending.

And meanwhile, even with funding for the current fiscal year still hanging over their heads, lawmakers are simultaneously beginning to shape funding levels for the next budget year: fiscal 2018. Trying to reconcile President Donald Trump's "skinny budget" wishes with current budget realities, GOP leaders have already said it will be nearly impossible to fulfill the White House's request for a $54 billion increase in military spending without bucking the president's promise not to revamp entitlement programs such as Social Security and Medicare. The idea of offsetting that defense spending by decimating many non-defense agencies — as Trump has proposed — has not gone over well on Capitol Hill…

Uncertain Federal Environment Thwarts NYS Health Plans

According to Crain’s, uncertainties about federal health care policy bedevil New York's actuaries and insurance executives, who have to plan for what they can't possibly predict. And that could impact the prices individuals and small groups pay for insurance.

By May 10 health insurers must advise the state Department of Financial Services how much they expect to raise premiums for plans sold to individuals and small groups next year. That leaves little time to sort through the chaos in Washington, D.C., where Republicans are still talking about reviving reform, while Trump has tweeted that Obamacare will "explode."

…Insurers must consider how much costs will rise for medical care and prescription drugs; how government actions may affect consumers shopping for coverage, whether young or old, sick or poor; and what the future of Obamacare-created taxes on premiums will be.

….One of the many unknowns…is a pending federal appeals court case,House v. Price, which could determine the fate of Obamacare's cost-sharing reductions.

Federal payments to insurers are supposed to help them make deductibles and coinsurance more affordable for lower-income consumers. The Obama administration had appealed the original court ruling that the payments were unconstitutional because they weren't authorized by Congress.

But Trump could simply decide to drop the appeal and strike a fatal blow to the program, which is expected to yield U.S. insurers about $7.35 billion this year. An end to the subsidies—with plans still on the hook to lower costs for members—could lead to financial losses.

In New York, most of the people who qualify for cost-sharing reductions are enrolled in the state's Essential Plan. That product serves more than 665,000 residents who earn up to 200% of the federal poverty level—$48,600 for a family of four. They currently pay monthly premiums of $20 or less per person.