Growing up on Long Island, I was fortunate to receive care from some of the country’s best doctors. Around the dinner table, many healthcare discussions also took place among relatives who were medical providers: an aunt with her own primary care practice in Baldwin; an uncle who led a neurology practice in Northport; and my mother who served as a nurse administrator at Long Beach Medical Center.
Fast forward to today, Governor Kathy Hochul’s Executive Budget Proposal this year included a particular provision in Part E of the Health and Mental Hygiene (HMH) Article VII legislation concerning Medicaid Managed Care (MMC) plans. If ultimately agreed to by the state legislature in final budget negotiations, it would be disastrous for New York’s patients and providers alike. This specific proposal, supported by the health insurance industry, calls for eliminating the state’s independent dispute resolution (IDR) process for MMC plans. By stripping providers’ access to the state’s IDR process for these plans, this provision would jeopardize emergency services for more than 4.4 million New Yorkers enrolled in MMC.
Thankfully after their own discussions, both the Senate and Assembly stood with nearly a quarter of the state’s population by rejecting this portion of Part E in their one-house budgets. For the second straight year, legislators have shown common-sense leadership by removing this dangerous proposal. They should be commended for siding with patients and their physicians over the private health insurance companies that administer New York’s MMC plans while, at the same, are generating record profits.
Yet as budget negotiations in Albany continue—possibly now into May—proponents of quietly reinserting this provision back into the final budget are using potential Medicaid budget cuts from Washington as a straw man. Legislators must not acquiesce to this folly in the home stretch of negotiations.
Financially speaking, Medicaid represents $1 out of every $5 spent on healthcare in the U.S., according to Johns Hopkins’ Bloomberg School of Public Health. One might then think that President Trump’s supporters and his allies in Congress would see federal Medicaid cuts as a tempting offset for the GOP budget plan. Looking past the bluster, the political calculus does not add up.
First, there are currently more than 83 million Americans who rely on Medicaid. What’s more, according to KFF News, “In half of all Republican congressional districts, 21% or more of the population is enrolled in Medicaid.” Cutting Medicaid would amount to hara-kiri for Congressional Republicans in the upcoming midterm elections. Adding to that, ahead of House Republicans passing their budget resolution on April 10, U.S. House Speaker Mike Johnson vowed that Republicans will be protecting “essential programs” like Medicaid. Perhaps most telling is a new national poll on Medicaid attitudes from Fabrizio Ward, the president’s top pollster. It finds not only that “[l]arge majorities of Trump voters and Swing voters…have favorable views of Medicaid,” but also “there is no appetite across the political spectrum for cutting Medicaid to pay for tax cuts.”
The biggest threat to MMC beneficiaries will continue to emanate from the halls of Albany, not Washington. As Governor Hochul rightfully stated recently regarding the potential of federal cuts, “We don’t have a crystal ball that tells us the scale of cuts, if any.” What we do know is that, for miniscule, proposed savings in a $252 billion-plus budget—the largest in state history—eliminating the state’s IDR process for MMC would have serious and adverse impacts on patients’ access to skilled specialty physician care, including access to needed and often immediate surgical care in hospitals across New York.
It is therefore vital that legislators hold firm and not let this ruinous proposal targeting the state’s most vulnerable patients creep back into the final budget.
