Yesterday I sat for an interview with David Lombardo, host of The Capitol Pressroom, a daily radio show produced by WCNY and carried across the state on many public radio stations, with veteran journalist and political reporter David Lombardo.  The show is another ‘must listen’ for state leaders and other key decision makers here in Albany and across the state.  The topic was our request for a carve out of most MH and SUD community-based services from the state’s Medicaid managed care program.

This is top billing on the first day of the legislative session (today)! 

Listen in at 11:00 today (links below) or anytime using the archive feature on the show’s Website – also linked below.  

Listen & Follow

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STATE BUDGET

Last night we sent you a link to a NY Times article stating that the Trump admin is pulling back $10B from 5 blue states across the country, based on recent allegations that the state of Minnesota has allegedly defrauded the federal government of TANF child care subsidies and cash support programs available to ‘noncitizen’ low income families.   NY is one of 5 ‘blue states’ targeted by the Trump Admin. in this matter.  We noted that this is likely to have a significant impact on state budget negotiations due to a potential of significant reductions in federal assistance.  Today’s Crain’s Health Pulse includes a story indicating that Governor Hochul intends to sue the federal government if funds are withheld (as discussed above) from NYS.  

Fallout from federal cuts is expected to drive the health care agenda in Albany

ALBANY, New York — As the new legislative session kicks off, lawmakers, health care lobbyists and advocates are keeping an eye on action at the federal level as they craft their lists of priorities.

Gov. Kathy Hochul — who is facing a tough reelection bid next year — and Democratic lawmakers will be forced to balance competing demands to backfill federal funding cuts that far exceed what the state can afford.

And New York’s health care industry is just starting to feel the impact of massive federal cuts to Medicaid and the Affordable Care Act. Hundreds of thousands of New Yorkers this year will become ineligible for the state’s Essential Plan or lose enhanced subsidies for ACA coverage due to policy moves by President Donald Trump and congressional Republicans.

Assembly Health Committee Chair Amy Paulin told POLITICO she feels “nervous and worried” about the upcoming legislative session.

“We’re going to see people without insurance, we’re going to see people deprived, and if we take [state] money to supplement the cuts from the federal government — which we might have to do to protect people’s health care — it’s going to mean taking it away from somewhere else,” Paulin said.

Senate Majority Leader Andrea Stewart-Cousins said the state will have to prioritize addressing federal funding cuts and policy changes in an interview with the Times Union Tuesday.

“With the cut that is happening because of H.R.1 already to the Essential Plan, [it] erodes our ability to cover so many of the people that we were able to cover; it’s a $3 billion hit,” Stewart Cousins said. “And then, with the expiration of the extra tax credits from the Affordable Care Act, at least 140,000 New Yorkers will see their insurance rates go up 40 percent.

“I’m sure that everybody would like a great solution, that is multifaceted, that handles all these different areas, but most of us realize that we have to push everywhere and educate people as we are doing it,” she added.

Trump-proofing

Some lawmakers are introducing legislation that could neutralize cuts or restrictions imposed by the Trump administration, Paulin said.

“We are putting all the options on the table, and hopefully they do nothing, so we can keep our options the way they are,” she added.

The Healthcare Association of New York State said it is looking to see the state create a plan that will address the future impact of the administration’s One Big Beautiful Bill Act, which passed in July.

“I call it the snowball effect. We hope [state leaders] will engage with us in a conversation that begins to help them understand that we need to do something this year to mitigate the impact of H.R. 1,” HANYS President Bea Grause said to POLITICO. “It’s all about preserving access to care and trying to bend the cost curve — not just for our members — but for the state of New York.”

Scope-of-practice changes

To address workforce shortages, some health care advocates are hoping the Legislature will back scope-of-practice changes that have long been a nonstarter primarily due to union opposition. These pieces of legislation would authorize select health care practitioners to perform a wider array of tasks under their current licenses from the state Education Department.

During a November conference convened by the Primary Care Development Corp., which provides capital financing to expand primary care access, Sen. Gustavo Rivera said federal health care cuts will require lawmakers to take bold actions they’ve previously shunned — including scope-of-practice changes.

“The status quo doesn’t work anymore,” said Rivera, who chairs the Senate health committee. “There are third rails that we need to breathe deeply and just grab on to.”

The state Education Department has been a barrier in the past; however, department officials told POLITICO they are working closely with state lawmakers and Health Department officials to pave the way for changes.

Health Commissioner James McDonald confirmed that the agency has been working with the Education Department on changes that could be made this year, if passed by the Legislature. He noted that many of the proposed changes would bring New York in line with what is already the standard of care in other states.

“The Department of Health is simply reflecting what health care providers are asking for. This isn’t my agenda, I’m just telling you what I’m hearing from health care providers as I travel across the state,” McDonald told POLITICO. “We need to look at things differently in New York state; we have to catch up with everyone else.”

Hospital price caps

Hochul’s obsessive focus on affordability — combined with skyrocketing health insurance premiums — could be a boon for a hot-button bill that would cap prices and ban hospital facility fees for dozens of routine outpatient services.

The measure, which was rolled out by state Sen. Liz Krueger and Assemblymember Chantel Jackson, both Democrats, in November 2024, never saw much movement. Notably, the powerful Greater New York Hospital Association fiercely opposes it.

The bill’s supporters say it would save New Yorkers an estimated $1 billion annually by eliminating massive price discrepancies between hospital-owned facilities and doctors’ offices for the same services.

New insurance mandates

The Primary Care Investment Act also may see more momentum this session.

The bill, which was spearheaded by the Primary Care Development Corp., would require at least 12.5 percent of insurers’ health care spending to go to primary care. It passed the Senate last year, but got stuck in the Assembly’s insurance committee.

Democratic Assemblymember David Weprin, who chairs that committee, pledged an “early discussion” on the bill during the Primary Care Development Corp. conference in November. But he has stopped short of promising a committee vote.

“There’s no question that we need to spend more on primary care,” Weprin told POLITICO in a recent interview. “I’ll certainly try and get it on an early agenda.”

Weprin said his priorities also include legislation to reduce the burden of prior authorization on health care practitioners, namely by shortening the required time frame for insurers’ decisions and setting standards for those reviews.

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