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Unions Back de Blasio Health Plan, But Details Vague

January 15, 2019

By Steve Wishnia

NEW YORK, N.Y.—Mayor Bill de Blasio’s plan to bring the estimated 600,000 New Yorkers without health insurance into the city’s public health-care system has won praise from two unions—one representing city hospital workers, the other workers with low and often inconsistent incomes.

NYC Mayor Bill de Blasio.

Mayor Bill de Blasio.

The plan will put the New York City Health and Hospitals system “on the cutting edge of comprehensive health-care delivery,” District Council 37 leader Henry Garrido, whose union represents more than 18,000 HHC workers, said in a statement after the plan was announced Jan. 8. “The approach announced by the Mayor ultimately makes the system more efficient, cost-effective, and most importantly, will result in a healthier city.”

“Most of New York City’s professional drivers already rely on Health and Hospitals clinics and hospitals for primary care and emergency services,” Bhairavi Desai, executive director of the New York Taxi Workers Alliance, said in a statement released by the mayor’s office. “This initiative can fill voids that still exist in access to care and will be a lifeline for New Yorkers who, like many of our members, don’t qualify for Medicaid but still can’t afford premiums. And it will finally allow our undocumented neighbors access to much-needed health-care services.”

The mayor’s plan has two parts: recruiting more people for the city’s MetroPlus public-option insurance, and setting up a new program called NYC Care to connect those who can’t afford insurance—or can’t get it because they’re undocumented—to the city’s network of 11 hospitals and 70 clinics. They would pay on a sliding scale.

While city public hospitals and clinics already treat the uninsured, “there’s no real follow-up, no real connection” when it comes to ensuring that patients have a regular primary-care physician and access to specialists and pharmacies,” Marcy Miranda, a spokesperson for the mayor’s office, told LaborPress. “We’re trying to make it more cohesive.” The mayor’s plan will also cover mental-health and addiction-recovery services. 

NYC Care will begin in the Bronx this summer and be available in all five boroughs in 2021, the mayor’s office says. It estimates the plan would cost $100 million a year. It would not need City Council approval, Miranda said.

Like Obamacare, however, the plan may promise more affordability than it can deliver. The 20-odd plans MetroPlus offers are priced similarly to those available through Obamacare. Its Essential Plan, like the state’s, costs up to $20 a month and is available to people who make too much for Medicaid, but less than $24,280 a year for a single person and $50,200 for a family of four.

 A BronzePlus plan, which costs about $450 a month before the Obamacare tax-credit subsidy, has a deductible of $4,000 for individuals and $8,000 for families, with a maximum out-of-pocket expenditures of $7,150 for individuals and $14,300 for families. About $700 a month before subsidies will buy a GoldPrime plan with a much lower deductible: $650 for individuals and $1,300 for families, with three free visits to a primary-care physician and somewhat lower out-of-pocket maximums. The PlatinumPlus plan, about $850 a month before subsidies, has no deductible and out-of-pocket maximums of $2,000 for individuals and $4,000 for families.

The mayor’s office has not released details about who exactly would be eligible for NYC Care or what services would cost. The one group obviously eligible would be undocumented immigrants. The city has not disclosed how it would judge who would be eligible on the grounds that they can’t afford insurance: The Obamacare system might, for example, deem a single person making $30,000 a year capable of paying $150 a month for a bronze plan, but that person might disagree if they’re spending $1,200 a month on rent and would have to spend more than $7,000 a year on medical bills before the plan covers anything.

“The ultimate solution is single-payer health insurance for this whole country or Medicare for All,” de Blasio said Jan. 8. But if Washington or Albany won’t act, he added, “our people need health care right now, and we can get it to them.”

January 15, 2019

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