Governor Cuomo delivered his annual State of the State address, outlining his legislative and budget aspirations and priorities for the coming year. There was much to cheer about in the address, including the Governor’s exhortation that we resist efforts to divide and pit groups against one another, and commit instead to “pull[ing] each other up” and to always reach higher as a state. Among the specific proposals announced that will strengthen New York families and children was a pledge to implement the First 1,000 Days on Medicaid initiative, aiming to generate better health and well-being outcomes for young children. Another welcome pledge was to increase investment in pre-K, albeit by a modest amount.
There were also some disappointing omissions for New York families. The Governor made no commitment to increasing investment in child welfare. This omission comes on the heels of last year’s devastating cut of $62 million to the State’s foster care block grant, and at a time when county child welfare services are straining to meet rising demand for supports and services as a result of the opioid epidemic. Nor did the Governor commit a single new dollar to expanding access to quality child care, or even to restoring the $7 million cut to child care subsidies last year – a demoralizing omission given that 80% of NY working families earning less than 200% of poverty receive no child care subsidies due to inadequate subsidies.
New York can – and must – do better for its children. Since the Great Recession, New York State has made a steady, albeit slow and uneven, economic recovery. Last year, the State’s economy was ranked among the strongest in the nation (12th).1 Yet, even as New York’s economic indicators have improved, the state still fails to provide many of our children with the basic supports they need to grow, learn and thrive. As a result, more of our children live in poverty, suffer maltreatment, and struggle to succeed in school than in many other states.
New York has the knowledge and tools to do better by our children, and to provide them the stepping stones they need to set them on a path to achieving their potential. What our children need for a strong start is well-understood and non-controversial: strong and economically stable families; healthy bodies and minds; a home and community that shelters them from violence and stress; and a sound education that includes early learning opportunities. Proven ways to provide all our children those stepping stones include robust working family tax credits; quality affordable child care; strong public health systems; access to quality mental, dental and physical health care including developmental screenings and referrals; home visiting and other family strengthening that can prevent children from experiencing toxic stress; and equitable access to quality, culturally responsive education, including early education.
It is time for New York to make our children its number one priority – particularly this year when the state is facing real and significant budget challenges; challenges that will likely be made greater by expected federal cuts to education, health, and safety net programs.
On Tuesday, January 9, we’ll be releasing data on the state of New York children. We will highlight health, child welfare, economic status, and educational achievement indicators for our children, and policies that can pull us up – Excelsior!
As people who believe that communities are stronger when children and families have access to affordable health care, we are profoundly disappointed that the health needs of children and the families that care for them appear to have been forgotten as Congress moves policies designed to radically restructure Medicaid and strip health coverage from millions.
New York’s Medicaid program provides important health coverage for more than two million children – nearly one million under the age of six. Medicaid covers 84% of children living in poverty and 100% of children in foster care. It helps to make sure that our children can get mental, dental and physical health treatment and other vitally important and life-saving care. It promotes healthy development that brings lifelong benefits – to individuals, families and communities. It helps to assure that families do not go bankrupt trying to care for medically fragile children and that children with disabilities can be cared for at home rather than institutionalized.
Medicaid has a great impact for children in both rural and urban New York State. Forty-two percent of rural New York children are covered by Medicaid, with rates higher in certain counties – 50% in Fulton County; 49% in Sullivan County; and 43% in Greene County. Yet many children remain uninsured – 34% in Yates County; 11% in Seneca County; and 11% in Franklin County.
At a time when New York is so close to universal coverage for children – nearly 98% of New York’s children are covered – our elected leaders should be working to close the gap, not moving us back to a time when parents could not afford insurance or basic health care for their children.
The fight is not over. We will continue to press for sound health policies that enhance the lives of children and we thank you for your continued efforts to inform your colleagues and friends and our policymakers about how Medicaid and affordable health coverage benefit the health and well-being of the youngest New Yorkers and the communities that care for them.
Congratulations to all of us on defeating the damaging health bill in the Senate. We defeated this bill because people from across the nation came together and in one voice said “no!” to Medicaid cuts that would hurt children, families, people with disabilities, and seniors. We fended off devastating cuts to Medicaid because consumers, advocates, hospitals, clinics, physicians and long-term care providers worked together. We defeated this bill because schools, child welfare agencies, rural health networks, immigrant rights groups and so many more constituencies stood together. We defeated this bill because, collectively, as a state, we fought hard against this bill which would have severely weakened our health system – one that covers 98% of our children – one we have built together.
But, we can’t let down our guard. Threats persist, although they make take different forms. The budget that the President has proposed contains per capita caps for Medicaid as well as cuts to the Child Health Insurance Program. Stay vigilant. Stay prepared.
We will continue to work with our partners here in New York and beyond to provide you with current information as this fluid situation changes. We are also focused on ensuring that Congress renews funding for Child Health Insurance Program (CHIP) and Maternal, Infant and Early Childhood Home Visiting (MIECHV) before the end of September.
We wanted to take a moment to thank you for your energy and dedication in protecting the health of New York’s children. Celebrate today – but get back to work tomorrow. New York kids are depending on us.
The Senate’s delay of the vote on the Better Care Reconciliation Act (BCRA) is a victory. But it is a delay, not the end of the fight. Congress returns to Washington the week of July 10, and could take up this legislation then. Let’s use this delay to keep up the pressure on U.S. Senators and Members of Congress to ensure they do not pass the BCRA or any damaging health care bills. This delay is also an opportunity to get out the word: the American Health Care Act (AHCA) and BRCA would not only repeal and replace the Affordable Care Act (ACA), they would gut Medicaid.
Like many of you, I’ve been carefully tracking proposals unfolding in Washington as Congress attempts to restructure our nation’s health system without hearings, committee meetings or debate. In fact, on Monday the nonpartisan Congressional Budget Office released a report showing that 22 million people lose health care coverage and millions of others will pay more for care and get less coverage under the BCRA.
I spend a lot of time immersed in this topic, so a poll done last week by the Kaiser Family Foundation brought me up short – only 38% of those polled – 4 in 10 – understood that the AHCA passed by the House of Representatives would drastically cut Medicaid. Medicaid is the health insurance program that provides essential coverage for low-income children and families and many of our nation’s people with disabilities and seniors. The AHCA and BCRA both claim to repeal and replace the ACA. So, what has gutting Medicaid have to do with repeal and replace? Not much. These bills cut Medicaid to generate tax cuts for corporations and higher income individuals.
Both the AHCA and BCRA would radically restructure Medicaid financing, with dire consequences for New York. Under a per capita cap, funding would be based on a pre-determined amount per enrollee, locking New York into past spending levels and reduce federal payments over time. Any formula also puts future funding at risk as it can be used as a screw to reduce costs anytime Congress seeks funding for tax cuts or other programs. (For more information on how per capita caps work and the impact on children and families, please see our fact sheet.) This mechanism would remove billions of dollars from New York’s Medicaid program. Billions. No matter how dedicated our State is to covering families and improving services drastic cuts will have to be made.
But the terrible nature of these bills does not stop there – the radical restructuring of Medicaid puts children with special health care needs in jeopardy, threatens EPSDT and services for children in foster care, would gut critical children’s health services in schools, pull health insurance from many low-income parents and harm families in rural areas. And that list doesn’t cover the aspects of Medicaid that would result in cuts to services and coverage for adults (even those requiring mental health and substance abuse services), persons with disabilities, and the elderly.
I realize you have been asked before to take action on these bills and we thank you for your efforts. We are asking you again because stopping these bills must be everyone’s priority this week. All the indications we have from our partners is that we are facing a dire future in children’s health and welfare if the Medicaid program is gutted. Also keep in mind that other programs in the State budget may be in jeopardy if drastic cuts to Medicaid requires resources to be diverted to maintain essential services.
If you have not already reached out to others in your community caring for children and families, please do so today. Contact your hospital, your community health center, and your local pediatric office. Reach out to your schools, your day care centers, your local health department. Seek out those working with other populations – find out who is involved in services for persons with disabilities, nursing homes and home care agencies. Contact your local media and editorial board. Explain to everyone how these Medicaid cuts will impact your local community.
We need to work together to carry this message to New York’s Congressional Delegation: Medicaid is essential to the health and well-being of New York’s children.Gutting Medicaid, as proposed by these bills, will harm children.
We will keep you posted on other actions you can take as events unfold in Washington. But don’t wait. Reach out locally andact now!
Even as advocates and policymakers dive into the details of the President’s first budget, this much is clear: this proposal is devastating for children, families and communities.
The President’s budget makes additional cuts to Medicaid above the deep reductions present in the American Health Care Act (AHCA) passed by the House and being discussed in the Senate. How much would Medicaid be cut between these two plans? $1 trillion over 10 years. On top of that, the President has proposed cuts to the Child Health Insurance Program (CHIP) of 23%. These are massive cuts to programs that provide health insurance coverage to 41% of New York’s children.
Why is this so very important? Well, with the help of Medicaid and Child Health Plus (CHP), New York has achieved near universal health coverage for children—a remarkable 97.5% of children have coverage. Let that sink in—nearly all of New York’s children have coverage. New York has led the way in coverage for children, recognizing what a smart and compassionate investment it is. We should be justifiably proud of our collective efforts—extending over decades—toward ensuring that all children in the Empire State have health insurance. Now that legacy is threatened. There also is significant concern about the impact of significant Medicaid reductions on the stability of our health care safety net, including community health centers, hospitals, and pediatricians.
The President’s budget uses the CHIP block grant and the per capita cap passed in the AHCA to extract savings (above and beyond the House-passed AHCA bill) from these programs. This confirms the suspicions of advocates that federal officials would use these redesigned funding mechanisms as screws to be tightened at any time—including in the middle of a recession or some other time when people are most in need. This would leave states to pull from other essential state programs, cut the number of enrollees, cut benefits, cut provider payments, and/or raise state taxes. Our website has more information on per capita caps and the importance of Medicaid and CHP for children.
And it is not only the threats to health care that will impact children and families. The President’s budget slashes SNAP, TANF, and a whole host of safety net programs. We will endeavor to keep you updated on the events in Washington as we digest emerging information and consult with our state and national partners. Keep watching us for information and action steps over the coming weeks.
Finally, as the budget process shifts to Congress, we pose this question: Which members of Congress are going to come back to their districts and proudly share that they voted to take health care and food away from children?
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