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Older adult issues for New York's 2020 legislative session: Medicaid cuts, drug prices, caregiving

WBFO file photo
Assemblymember Monica Wallace speaks at Garden Gate nursing home in October about New York state's Medicaid recalculation. Medicaid cuts will be a major issue for the upcoming state legislative session.

Issues impacting older adults — including lowering prescription drug prices, tax relief for caregivers and large Medicaid cuts — will be some of the major issues during New York state’s 2020 legislative session. 


State lawmakers head back to Albany next month facing a $6 billion dollar budget gap due mostly to the rising costs of Medicaid, which covers low-income individuals, including some low-income seniors in long-term care facilities.


Officials are considering cutting $1.8 billion in Medicaid spending and delaying $2.2 billion dollars in Medicaid payments, which could hurt nursing homes and assisted living facilities.


Assemblymember Monica Wallace, who sits on the Assembly’s Committee on Aging, said the Legislature has to close the budget gap without lessening quality of care.


“It’s really a matter of taking a look at what are some of the ways we can increase efficiencies in the way care is being delivered, trying to cut some costs that may be duplicative,” said Wallace, D-Lancaster. “It is really going to be a huge challenge to try to address that issue going forward.” 


The AARP is also concerned about looming Medicaid cuts. Randy Hoak, AARP state associate director, said the special interest group will advocate strongly for securing Medicaid funding.


However, the AARP also supports non-Medicaid funding that can help older adults age in place and avoid going into a nursing home altogether. It helped secure a $15 million increase in last year’s state budget for non-Medicaid services like delivered meals and transportation.


“So we are going to certainly advocate for Medicaid funding … but we also are going to continue our advocacy to support home and community-based services for non-Medicaid individuals, keeping folks home and healthy in their communities, which is where they’d prefer to be,” Hoak said.


This year the state Department of Health changed the case-mix index, which determines Medicaid reimbursements for nursing homes. The facilities argued it would cost them $246 million and a state supreme court justice last month put an injunction on the measure. 


“(This) will hopefully entice all of the parties to get back to the table and to try to come up with some resolution that works for all the stakeholders, to hear from the Department of Health and to come up with a resolution that will work for everyone,” Wallace said.


Lowering prescription drug prices are part of Gov. Andrew Cuomo’s 2020 budget proposal. Cuomo’sthree-part plan is capping insulin copayments at $100 a month; giving the state power to investigate and fine drug manufacturers for price hikes; and creating a commission to study importing drugs from Canada.


Hoak said the AARP feels Cuomo’s proposals are good first steps, but noted it is disappointed the governor recently vetoed a bill that would stop insurance companies from changing medication coverage rates during the middle of the year.


“Consumers of insurance products have to commit to an insurance plan and formulary once a year during open enrollment. Insurance companies can then change the formulary, which will impact the financial situation of those individuals,” Hoak said. “The governor vetoed that. We’re going to take another look at that in 2020.”


Critics of the mid-year formulary bill argue it would harm insurance companies because pharmaceutical companies could still raise drug prices.


Lawmakers this session will also consider a bill meant to help those who care for an aging or disabled loved one. The legislation would provide middle-class family caregivers up to a $3,500 saving on their tax bill, or up to half of their caregiving expenses. 


The state has more than 2.5 million unpaid family caregivers who on average spend $7,000 a year providing care to a loved one, according to the AARP.


“It’s not a budget ask in terms of an expenditure of state dollars. It’s a tax credit so certainly there’s a fiscal impact,” Hoak said. “However, we know that when caregivers are supported in a way they can effectively care for their loved ones, those loved ones are going to be in better shape and they’re going to be able to remain in their communities, in their homes.” 


Lawmakers could also address the state’s ombudsman shortage. The state Comptroller’s Office reported in October that less than half of the state’s 1,500 long-term care facilities have an assigned volunteer ombudsman, who investigate complaints from nursing home residents. 


Wallace said she plans to advocate for increased funding for the ombudsman program.


“I think last year we allocated about $1.2 million, and that’s about half of what other states allocate with similar size beds and facilities,” she said. “So we definitely need to look at increasing funding for that program and finding ways to attract more volunteers, streamline the volunteer process so it’s something people want to continue doing.”


One in six New York state residents are 65 and older, which is about a 26% increase from a decade ago, according to a report by the AARP and Center for an Urban Future.


This means caring for older adults has to be a major priority for the state, Wallace said.


“At the end of the day, the New York state budget is a reflection of what we consider to be priorities in New York state,” she added, “and I think caring for some of our most vulnerable individuals — the elderly and disabled — is something we should make a priority in our state.” 


The legislative session begins Jan. 8. 

Tom Dinki joined WBFO in August 2019 to cover issues affecting older adults.