Reject CDPAP & Other Medicaid Cuts in NYS 24-25 Budget - + Other Consumer Budget Priorities

NYLAG Calls on the Governor and Legislature to protect Medicaid Home Care and Health Care Access in the NY 24-25 Budget:

1. REJECT CDPAP Cuts Proposed by Gov Hochul in her proposed budget and in the 30-day Amendment - described here  We thank the Senate & Assembly for rejecting these cuts in their one-house bills, and urge them to stand strong and protect CDPAP in the final budget.  Read NYLAG's Statement Opposing the CDPAP Cuts

   • REJECT CUT in  hourly wages by eliminating the "prevailing wage" increase in New York City, Long Island, and Westchester. 

   • REJECT  limiting CDPAP  to people who can "direct" their own care.  This would disqualify all people who have Alzheimer's disease or other types of dementia or cognitive impairments, those with Traumatic Brain Injuries and Intellectual and Developmental Disabilities.   Children under 18 would also be disqualified from CDPAP - even though those with severe disabilities rely on this service to remain at home and avoid institutionalization.  This change would violate federal Medicaid "comparability" requirements and the ADA.  

   • REJECT proposals to replace all CDPAP agencies (called Fiscal Intermediaries FI) with just ONE central agency.   Many CDPAP agencies are run by local local non-profit Independent Living Centers that specialize in the needs of people with disabilities in their communities, and provide enhanced support for consumers and caregivers alike.  

2. Instead of scapegoating CDPAP for problems inherent in the MLTC model,  NYLAG Supports the Home Care Savings & Reinvestment Act  (S8700/A8470)(Rivera/Paulin) that would repeal the Managed Long Term Care program and replace it with a Managed Fee for Service program. 

   • Read NYLAG's memorandum in support of this bill.  NYLAG's support is based on 12 years of advocacy, both on behalf of individual consumers and in class action litigation, and NYLAG's study of data in its MLTC Data Transparency Project and Report, 

   • Watch this powerful 3-minute film called #CareNOTProfits about the bill proposing to replace MLTC.  Learn more at https://www.nycaringmajority.org/carenotprofits.

   • Paul Francis, who served under four New York Governors in roles including Budget Director and Director of Agency Redesign and later the Deputy Secretary for Health and Human Services under  Gov. Cuomo when the MLTC program launched in 2011, now heads a think tank that issued a critical review of MLTC, agreeing that the Home Care Savings & Reinvestment Act  (S8700/A8470)(Rivera/Paulin) replacing the MLTC program with a new system will save money and should be strongly considered.   Read the Step Two Project  report here.  

   • See FACT SHEET on the Home Care Savings & Reinvestment Act

3. REPEAL Cuts Enacted in 2020 with Medicaid Redesign Team II - that were put on hold because of COVID   - See Coalition Statement Asking to:

   • Repeal the 30-Month Lookback & Transfer Penalty that will  Delay and Deny Vital Home Care Services.  We thank the Senate for including Repeal of the Lookback in its One House Bill - incorporating repeal bill S.6414/A.9278  (Skoufis/Paulin). Will be implemented in 2025 if not repealed. 

     • See NYLAG's memo supporting Lookback repeal bill.  

   • Repeal the 3-ADL Requirement that will deny Medicaid home care illegally to Those With Vision Impairments, Intellectual & Developmental disabilities, Traumatic Brain Injuries, and many other disabilities. Will be implemented by Fall 2024 if not repealed.

     • See NYLAG's Memo Supporting  a bill S.328/A.6346 (Rivera/Paulin) to repeal the ADL thresholds . 

4. THANKS to BOTH the SENATE & ASSEMBLY for rejecting other cuts proposed by Gov. Hochul:

• Prescription Drugs – Rejecting elimination of “prescriber prevails” and rejecting the State's authority to  stop covering  certain Over the Counter drugs with no public notice (Part I);

• ADULT HOMES – Rejecting proposed elimination of funding for and repeal of the EQUAL program (Part L)

5. We Support These Proposals by Governot Hochul - and thank the legislature for supporting them in their one-house bills:

• Expanding Continuous Medicaid coverage from birth to age 6 - See Coalition Statement in support
• Eliminating co-pays for insulin (TED Part EE)
• Subsidies for Qualified Health Plans (QHPs) for those who buy insurance coverage under the Affordable Care Act, whose incomes are too high for Medicaid (Part J)

We Support These Proposals from the Legislature that were not in the Governor's Budget 

1. Coverage4All - Expand the Essential Plan coverage for people who are undocumented.   this will build on last year's expansion of coverage for people age 65+ that went into effect Jan. 1, 2024  -- now it's time to close the coverage gap for all.  Thanks to both the Assembly and Senate for supporting this expansion in their one-house bills.  See examples of NYLAG clients who need this coverage in our 2024-25  Budget Priorities. 

2. Create the Medicaid Investment Fund to reserve revenue derived from a new tax on managed care plans -- which would stave off the pressure of imposing many of the proposed cuts, as proposed by both the Senate & Assembly.

3. Repeal the global cap (S.4861) - we support Senate's proposal in the one-house bill and rejection of unallocated cuts

4. Phase out the asset limit for older adults and people with disabilities by increasing it next year and then repealing it (new Part NN) (A.5940-A/S.4881-A)-  Read our coalition memo to see why we strongly support this Senate proposal in the one-house bill 

5. Personal Needs Allowance in Nursing Homes – We applaud  the Senate’s proposed increase in the Personal Needs Allowance for residents of nursing homes and other medical facilities  be included in the final budget - and urge that this be included in the final budget.  The $50 monthly allowance has not increased since 1981.  Residents need this allowance to pay for clothing,  haircuts,  a meal or ice cream treat outside the facility,  newspapers, magazines or books, or a greeting card for loved ones   (New Part YY – S. 7786).

6. Permanently carve out school-based health centers  of Medicaid Managed Care, remaining in Medicaid Fee for Service, which the Assembly added in its one-house bill.

7. Increase the Medical Loss Ratio (MLR) for all managed care plans from 89% to 91% as proposed by the Assembly in their one-house 

See More Resources on NYS Budget -

• NYLAG NYS 2024-25 Budget Priorities here  and more here  

• Empire Justice Center Testimony on Health issues in Proposed FY 2024-25 State Budget 

• Medicaid Matters NY Annual Consumer Budget Checklist

• Medicaid Matters NY Testimony to Legislature on Health Issues in FY 2024-25 State budget 

• See Consumer Directed Action of NY Priorities for Budget  and more  on CDANY website 

• NY Caring Majority website

For information contact vbogart@nylag.org or  eflrp@nylag.org