This article first appeared in the February/March 2009 issue of the newsletter "States in Action."
New York Governor David Paterson (D) outlined four key health reform initiatives in his State of the State address on January 7: public coverage expansion, enrollment reforms, private insurance expansion for dependents, and multiple efforts to combat obesity. In other communications, he has proposed reforms to promote access to health care services.
Paterson plans to expand Family Health Plus, New York's coverage program for uninsured low-income adults, to those with incomes up to 200 percent of the federal FPL. With current Family Health Plus eligibility at 100 percent of FPL for childless adults and 150 percent of FPL for parents, the expansion would make more than 400,000 additional residents eligible for coverage. The expansion depends on approval by the federal government to fully fund the expansion, recognizing that New York saved approximately $30 billion over the past 10 years through its Medicaid managed care initiative.
To help enroll the estimated 1 million uninsured New Yorkers who are eligible for publicly funded coverage, Paterson proposes easing certain barriers to enrollment. He would eliminate the requirements for an asset test, finger printing, and face-to-face interview.
Paterson is proposing, subject to approval by the state legislature, allowing parents to claim and pay for dependents up to age 29 as part of their family health care coverage, an increase from the current limit of age 19, or age 22 for full-time students. Based on a similar law in New Jersey, the plan could result in about 80,000 young people insured in the first year, according to the governor's office.
Perhaps the centerpiece of Paterson's health-related discussion in his State of the State address was his comprehensive campaign against obesity. According to his office, one of every four New Yorkers under age 18 is currently obese. Paterson pointed out that obesity is a cost issue as well as a health issue. New York spends $6.1 billion each year to treat obesity-related health problems. Paterson's five-point plan to fight obesity includes:
- a Healthy Food/Healthy Communities Initiative that offers business loans to increase the number of healthy food markets in underserved communities;
- a ban on trans fats in restaurants;
- a requirement to post calories in chain restaurants;
- a ban on the sale of junk food in schools; and
- a tax on sugared beverages. Paterson asserts that an 18 percent tax on soda and other soft drinks would reduce consumption by 5 percent and raise $404 million next year to fund obesity prevention and other programs.
In addition, First Lady Michelle Paige Paterson is rolling out the Healthy Steps to Albany Initiative to encourage children to eat healthfully and exercise. A contest challenges middle school students to walk about four million steps in six weeks.
Finally, Paterson proposes increased funding to enhance access to needed services for uninsured New Yorkers. To promote primary and preventive care, he proposes reducing Medicaid reimbursement rates for hospital inpatient care and reallocating the funds to increase rates for ambulatory care settings. His office released proposals to increase funding for hospitals, community health centers, and mental health clinics serving uninsured patients. He would also promote medical homes by enhancing payments to providers meeting medical home standards such as coordinated care and follow-up. A medical home demonstration project is planned.