Governor Cuomo Takes Important Steps to Protect Healthcare Coverage and Equity in New York

Emergency Regulations Mandate Insurers Cover Substance Use Disorder Services and other Essential Health Benefits

June 7, 2017 – New York, NY: The Legal Action Center applauds Governor Andrew Cuomo for taking important steps to protect the health care of New Yorkers in the context of uncertainty about the future of federal health reform. The Governor’s actions will help ensure that New York does not return to a time when insurers could discriminate against people on the basis of race, gender or previous heath conditions.

The emergency regulations issued yesterday by Governor Cuomo require that all insurers participating in the New York Health Exchange, Medicaid and Children’s Health Insurance Programs retain core consumer protections included in the Affordable Care Act.  These protections are stripped away under the version of the American Health Care Act (AHCA) passed by the House of Representatives on May 4th, which is currently being considered in the Senate.

The current version of the AHCA proposes to remove or relax consumer protections, including the requirement that insurers cover ten ‘essential health benefits’ in all plans. These essential health benefits include coverage for certain services that were previously excluded from many health plans, including substance use and mental health treatment. The legislation would also allow plans to deny coverage to individuals with pre-existing or complex health conditions.

Paul Samuels President and Director of the Legal Action Center says, “These protections are particularly critical to ensuring coverage for vulnerable New Yorkers, especially those with substance use disorders or other complex health needs.” He adds, “As we continue to face an unprecedented epidemic of opioid addiction and overdose deaths in New York and across the nation, protecting access to treatment is absolutely critical to saving lives and addressing this public health crisis.”

Prior to the Affordable Care Act, many insurers excluded coverage of substance use disorder treatment. The recently released Congressional Budget Office report on the AHCA predicts that plans would return to this practice if coverage of substance use disorders is not mandated as an essential health benefit, resulting in tens of millions of Americans losing access to addiction treatment.

Sebastian Solomon Director of New York State Policy at the Legal Action Center says, “We thank Governor Cuomo for taking action to protect the important gains that New York has made over the past decade to expand healthcare access to millions of New Yorkers, and to improve the quality and equity of coverage.”

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