State to receive $750M to boost health care coverage [The Press-Republican, Plattsburgh, N.Y.]

Nov. 18—PLATTSBURGH — New federal funding coming to New York State aims to help more people have access to affordable health care coverage.

Last week, Gov. Kathy Hochul announced that $750 million in American Rescue Plan Act funds administered through the U.S. Centers for Medicare and Medicaid Services would go to the state's Essential Plan.

Joyce Porter, director of the EASE (Enrollment Assistance Services and Education) program at Adirondack Health Institute, explained that the funding now makes the program free and tacks on vision and dental coverage.

"From my experience it's just really encouraging to see the level of commitment," she told the Press-Republican. "We still see people that do not have health insurance and so it's really important for us that the message gets out there that it's there, it's affordable and they're making enhancements to the program all the time.

"We're excited to see that we're going to be able to help lots more people with this."

PRAISED BY OFFICIALS

Hochul said in a statement that ensuring all New Yorkers have access to affordable, reliable health care cover was necessary in order to put an end to the COVID-19 pandemic.

"The additional $750 million in federal funding to support our Essential Plan will help us further boost coverage in New York and bring us closer to our goal of achieving health equity."

According to a press release from U.S. Sen. Kirsten Gillibrand's (D-N.Y.) office, the funding will support the Essential Plan for 2022 and retroactively for 2020 and 2021.

"This crucial funding for New York's Basic Health Program will provide high-quality health care for one million low-to-middle income New Yorkers facing growing health challenges and economic hardship in the wake of the pandemic," Gillibrand said.

ONE OF TWO STATES

Porter explained that, when the Affordable Care Act first went into effect in 2013, there was no Essential Plan, so people's options were to qualify for Medicaid or a qualified health plan.

"People that made a dollar above the Medicaid threshold didn't qualify for Medicaid, and the only other option was a $200 or $300 monthly premium to get covered."

Quite a few of AHI's clients walked away from appointments without coverage, she continued. But she credited the state with looking for feedback on how the ACA was going from the beginning.

"We were able to tell them that there's a serious gap here for New Yorkers and they listened and by 2015 they had launched the Essential Plan," Porter said.

"We ended up calling our clients back that originally said they couldn't afford it and they were thrilled to be able to come back in and finally get the coverage that they needed."

According to a press release from Hochul's office, New York and Minnesota were the only two states who took advantage of an ACA provision that gave them the ability to create Basic Health Programs, which "were designed to offer affordable health care coverage to individuals and families with low to moderate income who did not qualify for other programs."

The release said New York's uninsured rate has decreased from 10% to 5% since 2013.

WIN FOR EVERYBODY

Up until this year, Porter said, the Essential Plan covered the 10 essential benefits all plans should cover — including doctor visits, emergency hospitalizations and prescriptions — and were $20 a month.

That the new American Rescue Plan funding now makes it free and include vision and dental is "just a win for everybody," she said.

According to New York State of Health data, as of October, 925,588 New Yorkers were enrolled in the Essential Plan, with 1,716 in Clinton County, 891 in Essex County and 989 in Franklin County.

This year, AHI Enrolled more than 3,400 people in Medicaid, the Essential Plan and qualified health plans, Porter said.

HOW TO ENROLL

Though AHI is not currently doing in-person appointments, assistors still look for the best match for their clients, Porter said.

"We try and, even over the phone, really get to what does this person need? Are they currently under care? Do they need a specialist? Are they on particular drugs that need to be covered?

"We really try and drill into what exactly they need right now and try and find a plan that best fits their needs."

Porter said each county usually has at least three New York State of Health marketplace plans to chose from.

People interested in enrolling in Medicaid, the Essential Plan or a qualified health plan can call AHI at 1-866-872-3740 or visit the New York State of Health website at nystateofhealth.ny.gov/ to find a navigator.

Email Cara Chapman:

[email protected]

Twitter: @PPR_carachapman

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