New HIV Infections in New York State Hit Historic Low, Yet Disparities Continue

 

There's good news from the front lines of Ending the HIV/AIDS Epidemic (ETE) in New York: the New York State Department of Health released new data showing that HIV diagnoses have hit a record low, down 13 percent from 2015 to 2016, according to the ETE Dashboard. Yet racial, gender, and regional disparities continue. Of particular concern is that certain communities--women, transgender and gender non-conforming individuals, people of color, and individuals living in areas of New York State outside of New York City--are seeing less progress in reduced HIV infections. In the 57 counties outside of New York City, HIV diagnoses dropped less than one percent from 2015-2016, while New York City diagnoses dropped 11 percent during the same time frame. New diagnoses among non-Hispanic blacks and Hispanics are 7.6 and 5.1 times higher respectively than the rate for non-Hispanic whites. And the greatest increase in new infections of women continues to be among African American and Latina women. Read more: HIV rates/FY19 Budget press release. 

 

New York must meet the needs of those who are disproportionately impacted by the HIV epidemic by:

Additional recommendations from the New York State Ending the Epidemic Coalition

can be found here.

The Federal Tax Bill

In late December 2017, President Trump signed into law legislation that disproportionately cut taxes and added $1.4 trillion to the federal deficit. The wealthiest Americans and corporations will receive enormous permanent tax cuts, while hard-working Americans will see smaller cuts that expire in a few years. Additionally, by eliminating the individual mandate, which required all Americans to purchase health insurance, the new tax legislation will lead to increases in health insurance premiums.

Federal Inaction Disrupts Health Insurance Coverage

The Trump administration stopped paying Cost Sharing Reductions (CSR) that reduce the cost of health insurance premiums and enable millions of Americans to afford health insurance. To date, Congress has not reinstated the CSR payments despite bipartisan efforts to do so. Additionally, Congress has failed to reinstate funding for the Child Health Insurance Program (CHIP, or Child Health Plus in New York) that helps children access critical care.

New York State Budget Pressures

New York State is projected to have a budget deficit of between $4.5 and $8 billion dollars. While the deficit resulted in part from a loss of state tax revenues, the enormous variation in the deficit projection is greatly impacted by the uncertain federal environment.

Increasing Threats to Medicaid

Medicaid is still intact, and recipients can expect that the program will be safe in the short term .  However, the federal government is increasing pressure to cut funding for safety-net programs such as Medicaid, Medicare, Social Security, and the Ryan White Care Act. The tax bill created a $1.4 trillion federal deficit. Elimination of CSR payments could also increase New York State's costs associated with Medicaid if CSR payments are not reinstated by Congress.

Federal funding supports New York State's  Essential Plan, which provides quality health insurance to lower-income working adults who do not qualify for Medicaid. Without the CSR payments, approximately 325,000 of the 750,000 individuals in the program could move to NYS Medicaid at a cost of around $1 billion. Since NYS Medicaid has capped spending, this large increase would push costs over the spending limit. Under NY law, exceeding the cap authorizes the NYS Health Commissioner to reduce Medicaid spending as they see fit to keep NY under the spending cap.

The Center for Medicaid and Medicare Services (CMS) recently allowed states to submit applications that could change Medicaid to make eligibility for the program contingent on work requirements. Ten states--Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin--submitted applications that include such a request. Kentucky's request was approved; Kentucky now also has approval to charge premiums in Medicaid and stop covering medical expenses for the 90 days prior to the date when a recipient's Medicaid was approved .  New York State Medicaid does not use work requirements as an eligibility criteria to qualify for or stay in the program.

Medicaid work requirements would harm unemployed people instead of helping them.

What can you do to prevent cuts to Medicaid?

Stay involved and be vigilant: Continue to inform your local, stat e, and federal legislators about the valu e of Medicaid to you. Tell your story about how it has helped  you or someone you know. 

 

Call or visit your state legislators ask them to oppose any state cuts to Medicaid services. http://www.mygovnyc.org/

Send a message to Congress telling them to oppose any federal attempt to cut Medicaid or any of the Social Safety Net programs. Learn more at Medicaid is US:  www.medicaidisus.org  

Call your Senator and Member of Congress. Ask them to restore funding for Cost Sharing Reductions that help make health insurance affordable. Contact the U.S. Capitol Switchboard at (202) 224-3121.

Register to vote--and vote! (Stop by the post office for a form or call 311 to learn more in NYC.) Important elections for statewide office and Congress are on the ballot for this year's election. The offices of Governor, Attorney General, State Legislator, and U.S. Senator are all up for election. Your vote can make a difference!

Find out when and how to register to vote: www.elections.ny.gov or call 311.