New York

State Government Profile

Governor: Andrew Cuomo (D)

Lt. Governor: Robert Duffy (D)

Attorney General: Eric Schneiderman (D)

Legislature: Senate (Republican control 32-30), House (Democratic control 100-48)

Legislative Leaders: Senate President Pro-Tem Dean Skelos (R); Speaker of the House Sheldon Silver (D)

2012 Legislative Session: Begins Jan. 4 (full time legislature)

Key Health Officials: Superintendent of Insurance James Wrynn; Commissioner of Health Dr. Richard Daines; Medicaid Director & Deputy Commissioner Office of Health Insurance Programs Jason Helgerson

State Links

Demographic Highlights

State Population: 19,378,102 (2010 US Census data)

Medicaid Enrollment: 4,740,518 (July 2010, CMS)

Percent Enrolled in Managed Care: 68.07% (July 2010, CMS)

Uninsured Rate: 14.% (three-year average, 2008-10, US Census Bureau)

Health Reform Projections: 305,945 – 820,623 (total new Medicaid enrollees, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)

0.0 – 1.2% (change in state Medicaid spending, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)

Budget Overview

State Fiscal Year (SFY) 2011 Budget Appropriations: $53.533 billion (state general funds)

SFY2012 Projected Budget Shortfall: $9.0 billion (state general funds)

SFY2008 Medicaid Expenditures: $8.568 billion (state general funds)

Federal Medical Assistance Percentage (FMAP) Rates:

53.20% (January – March 2011)
51.20% (April – June 2011)
50.00% (July – September 2011)
50.00% (October 2011 – September 2012)

Health Reform Implementation Activities and Developments

Health Reform Implementation Structure:

In May 2010, Governor Paterson created the Governor’s Health Care Reform Cabinet. The Cabinet is responsible for providing the Governor with advice and recommendations on all aspects of federal health care reform and strategic planning for implementation of the ACA. The Cabinet is chaired by the Director of State Operations with the Deputy Secretary for Health, Medicaid and Oversight and the Deputy Secretary for Labor and Financial Regulation serving as vice-chairs.

The Governor also established a Health Care Reform Advisory Committee consisting of 37 stakeholder organizations, to provide input on implementation to the Health Reform Cabinet. The Advisory Committee will also form issue specific workgroups to focus the expertise of members and conduct a public forum series around the state to obtain additional input.

The Health Care Reform Advisory Committee held its first meeting on September 16. The committee was briefed on implementation efforts to date and on plans for next steps.

SID presentation to Advisory Committee on Insurance Reforms and the Exchange

Office of Insurance Programs presentation to Adv. Committee on HCR Implications for NY

Exchange:

The state applied for and was awarded an Exchange Planning and Establishment Grant.

Amount Awarded: $1,000,000

Administrator: New York Department of Insurance

Initial Planning Activities:

  • Determine whether its current insurance regulations that go beyond the protections of the Affordable Care Act should be maintained or whether they need to be modified to limit adverse risk selection in the Exchanges.
  • Compile and evaluate background research from current research platforms and private funding by January 2011.
  • Engage stakeholders in the evaluation, planning and development process throughout the one-year planning period.
  • Evaluate the extent to which New York can or should integrate and build on existing programs, as appropriate.
  • Identify and utilize existing resources and capabilities, as appropriate, throughout the one-year planning period and determine the need for additional resources.
  • Design Exchange governance structure and draft legislation, if required.
  • Evaluate financial accounting, auditing, and reporting requirements and potential pathways to securing compliance.
  • Identify existing technical infrastructure resources and needs.
  • Create business operations plan and policies for Exchange.
  • Identify legislation and regulations needed to create, promote, and regulate the Exchange.

New York response to U.S. Department of Health and Human Services request for comments on state health insurance exchanges

High Risk Pool:

State-Run. The state established a temporary high risk pool program called the NY Bridge Plan, operated by Global Health Incorporated, an EmblemHealth Company.

Additional Grants and Funding:

Other State Actions, Indicators, and Health Reform Resources:

White House Information on Health Reform’s Impact in New York