PRESS RELEASES
Release Date: March 4, 2003
CONTACT: Lenore Neier, CSSNY, 212/614-5425
Survey by the New York City Task Force on Medicaid Managed
Care Reveals that Tens of Thousands of Eligible New Yorkers
are not Getting the Medicaid for Which They are Entitiled
Medicaid Applicants Are Falling Through
The Cracks Due To Barriers In Medicaid Application Process
New York, NY, March 4, 2003 – A new
report by the New York City Task Force on Medicaid Managed
Care, a coalition of nearly 200 individuals and organizations
that includes advocates for children, adolescents, women,
the elderly, the homeless, people with disabilities and
chronic conditions (including those with HIV and mental
illness), and other low income populations, documented the
problems associated with obtaining and keeping health coverage.
Nearly 200 Medicaid applicants were interviewed for a survey
during the summer of 2002 when 350,000 people were transitioning
from Disaster Relief Medicaid (DRM) to Medicaid.
Some of
the findings in Lost
in the Medicaid Maze: Voices From the Frontlines of
New York City’s Public Health Insurance Programs (PDF),
a study by Kirsten L. Aspengren, Denise Soffel, Ph.D.
and David C. Wunsch prepared for the New York City Task
Force on Medicaid Managed care include:
- Forty-one percent of those interviewed reported disease
or health conditions requiring treatment. Many people often
go without needed health care during the application process.
- Nearly one-half of the respondents reported that eligibility
requirements are a principle barrier to transitioning from
DRM and obtaining new or ongoing Medicaid and Family Health
Plus coverage. Problems documenting income and residence
were most commonly cited.
- Counseling about health plan selection is not taking place
and information about Family Health Plus and the ways it
is different from Medicaid, are not being provided.
- The physical environment at Medicaid offices continues
to act as a deterrent to coverage.
Dr. Soffel, an author of the study and a Senior Policy Analyst
at CSS, summarized the survey by stating, “this report
provides needed proof of what has been clear to other health
care advocates
besides CSS for quite some time, the application process
acts as a barrier to those individuals that are eligible
and desperately need health care services.”
Susan
Dooha, Executive Director of the Center for the Independence
of the Disabled in New York and Chair of the New York
City Task Force on Medicaid Managed Care, said, “DRM
proved that the city could effectively process and deliver
health coverage smoothly and painlessly to thousands of
people. It is a shame that we are not replicating a model
that worked so well.”
In response to the need for health
care services after the attacks on the World Trade Center,
and the loss of computers to process the necessary information,
the State initiated the Disaster Relief Medicaid (DRM)
program in late September 2001. Disaster Relief Medicaid
provided four months of immediate health insurance coverage
to low-income New York City residents. Enrollment in Disaster
Relief Medicaid ended on January 31, 2002.
Implications
The survey substantiated existing
studies that demonstrate that being without health insurance
means receiving less preventive care, being diagnosed at
more advanced stages of a disease, and, once diagnosed, receiving
less therapeutic care. For example, according to an analysis
by the New York City Health and Hospitals Corporation, tens
of thousands of DRM patients treated in city hospitals, nearly
one-fifth suffered from chronic conditions, about 1,580 people
were diagnosed and treated for a type of cancer, and over
600 women were pregnant and seeking prenatal care. In summary,
challenges inherent to getting and keeping public coverage
have negative health consequences.
Recommendations to the Human Resource Administration
and the Department of Health of the City and State:
- Provide immediate Medicaid coverage to individuals
while their eligibility is being determined.
- Eliminate unnecessary
documentation requirements that needlessly burden applicants.
- Eliminate procedural confusions and clarify exactly
what is suppose to happen in the application process.
- Immediately
implement staff retraining on the importance of health
plan selection, and differences between Medicaid and
Family Health Plus (FHPlus) for those who may be eligible
for both programs.
- Finally, regular monitoring of all offices
and staff working with applicants is essential in securing
an efficient process and one that secures eligible
New Yorker’s
access to needed health coverage.
Conclusions
As the economy continues to
decline and the number of unemployed continues to rise, the
number of uninsured is also expected to escalate. The promise
of Family Health Plus is illusory if people are unable to
make it through the application maze.
It is the government’s responsibility to preserve
accessible public health insurance programs for eligible
New Yorkers. This is not a question of expanding the coverage,
but rather of facilitating the enrollment of people that
are already eligible and should be enrolled. Research illustrates
that this is both good public health policy and an economically
sound action.
For over 150 years, CSS has pursued a mission that is
aimed at the poor but which benefits all: to identify and
eradicate the problems creating and perpetuating poverty in
New York City. CSS is an independent, nonprofit organization
that assists those in need to defeat the problems of poverty
and more fully participate in productive community life.
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