The big news coming out of Mayor de Blasio’s proposed executive budget is the dire condition of the city’s municipal hospital system and what can be done to shore it up so it remains a vital lifeline for needy New Yorkers. As a result of expected cuts in safety-net funding, NYC Health + Hospitals (formerly the New York City Health and Hospitals Corporation) stands to lose $800 million dollars in federal funds starting in FY2018.
For years Health + Hospitals has been losing revenues as the market consolidates and competition for patients increases between it and the other large hospitals. The mayor is proposing a series of transformational changes to stabilize finances and position the hospital system to be more competitive. This includes expanding community-based models of care, emphasizing preventative care, encouraging uninsured New Yorkers to sign up for health coverage, and repurposing vacant and underutilized Health + Hospitals land.
But the real challenge for the de Blasio Administration is convincing state and federal officials to spare the city from shouldering the entire burden of cuts in safety-net funds.
We have to address the coverage gap left by the Affordable Care Act (ACA) that leaves many of our most vulnerable residents without adequate health care. Earlier this year CSS issued a report examining the costs, eligibility and coverage options related to providing cost-effective, affordable and high-quality health insurance to nearly half a million unauthorized immigrants living in New York who are presently uninsurable due to their immigration status.
Our report outlines practical options for addressing the health needs of immigrant residents. This includes using the $645 million a year the state is saving from shifting New York’s lawful immigrants from Medicaid into the new Essential Plan to help cover New York’s remaining immigrant residents who have been left behind by the ACA. The state should also prioritize the allocation of safety-net funds (Federal Disproportionate Share Hospital funds) for hospital systems that serve the largest number of uninsured.
Our municipal hospital system serves more than a million New Yorkers every year. Maintaining it as a viable source of health care for needy New Yorkers should be one of our highest priorities.