Updates: Gun Reform, Clinical Scope Bill, & Health Insurance Premiums

June 21, 2022

Gun Reform Package

Today, Congress returns after a three-day weekend. But some senators took the extra time to get closer to an agreement on a bipartisan gun safety package, which Majority Leader Chuck Schumer is hoping to vote on as soon as this week.  It is rumored that the language in the bill may include an expansion of the CCBHC model to states where CCBHCs do not currently exist, and that the language includes a provision making the CCBHC Program a permanent part of the federal Medicaid Program.   

Sens. Chris Murphy (D-Conn.), Kyrsten Sinema (D-Ariz.), Thom Tillis (R-N.C.) and John Cornyn (R-Texas) met Thursday without reaching agreement on final text.  Apparently much of the discussion hinged around the so-called “boyfriend loophole,” which currently allows convicted domestic abusers to buy guns if they aren’t married to their partner. Republicans have raised concerns about how to define a “long-term relationship” among other hang ups, including how to reinstate gun rights for those with misdemeanor convictions.  There have also been controversies over the proposed ‘red flag’ language in the bill, with some Senators stating that individual states should not be forced to implement or intensify red flag laws, and that they should be able to use the funds coming with the bill for other issues.

Senators have four days to introduce and pass the legislation before they break for a two-week recess. But the upper chamber would have to move on the package today to meet that timeline, so it seems more likely that action will slip until after the recess.  (Source:  Roll Call, NYS Council)

Clinical Scope of Practice Bill

The NYS Council continues to communicate with the Administration regarding A6008E/S9449, a scope of practice bill that passed both houses of the legislature before the end of the 2022 legislative session.  We think the bill will address the remaining human resource concerns associated with the sunset of the exemption for our programs and services (and accompanying workforce), but this is largely up to the state agencies that will be required to put guidance on the street that addresses the sunset of the exemption.  The bill is not without its’ challenges.  But legislative leaders were unwilling to extend the exemption again, and so this is what we have.

Last week, advocates met with Commissioner Sullivan and other OMH executive staff to express our support for the bill, to request that OMH immediately weigh in with the Governor’s Office in favor of its’ passage, that OMH correspond with SED and press for swift implementation of a SED portal that will collect required information from practitioners seeking a privilege that is at the heart of the legislation.  Obviously we are pushing for the Governor to sign the bill immediately given the pending sunset on June 24.  We also pushed for OMH to issue immediate guidance to the field that will end any remaining confusion regarding if/how program operations will change after the sunset of the exemption next week.  There has been no formal response from OASAS to our request for a meeting that was sent on May 25.

Health Insurance Premiums(Excerpts from Albany Times Union article)

Health insurers serving individuals and companies in the state are requesting increases as high as 30 percent in some cases, although the weighted average is 18.7 percent for individuals and 16.5 percent for the so-called small group employer market that includes companies under 100 people. The majority of large employers are self-insured, meaning they manage health care costs for their employees directly.

If the full rate increase requests were approved, the average monthly premium for the small group market could rise as much as $100 in 2023.

Although the Department of Financial Services usually approves much smaller rate increases than those requested by insurers, the requests this year are the highest in the last five years. The agency will announce the final rates in August.

Insurance industry executives said Thursday that the cost of health care in the state and across the country is ballooning for several reasons. Some are tied to the pandemic while others are systemic and have been simmering for years now, such as the rising costs of prescription drugs and the cost of care for doctor visits and surgeries.

On top of that, people are finally getting around to addressing medical issues that were put on hold during the pandemic. And government mandates for coverage of certain types of care, along with increased taxes on health insurance, have only increased costs more. And soon, pandemic-related government health care subsidies that had offset medical costs will expire, exacerbating the rate increases.

“Health insurance premiums are directly tied to the underlying cost of care and the continued growth in health care costs further add to premiums,” said Eric Linzer, the CEO of the New York Health Plan Association in Albany.

The exact costs of health insurance for workers can vary by circumstances. Many companies that provide health insurance to their employees share the costs with their employees, so in theory, a business could decide to absorb the 2023 rate increase instead of passing it on to their workers.

Linzer said that with the unemployment rate so low and the job market so tight, that will be a decision that individual companies will have to come to grips with.  

However, the U.S. economy is at a crossroads. With price inflation at a 40-year high, the Federal Reserve Board has been forced to take drastic measures to raise interest rates. The stock market has tanked. And a global recession is on the horizon. If that happens, companies may be forced to start making layoffs again. Those same companies could be forced to pass on health insurance increases to their existing employees if that happens.

Linzer says that both state and federal political leaders need to start addressing the wholesale costs of prescription drugs and health care costs in general if they want to take pressure off insurers, many of whom are nonprofit and have razor-thin margins as it is.

“How are policymakers going to hold drug companies accountable for the prices that they charge?” Linzer said.

For instance, Highmark Western and Northeastern New York, also known as Blue Cross Blue Shield, said in its filing that its premium plan offered to small employers that costs $697.97 per person per month would rise to $803.28, an increase of 15 percent.

Amber Hartmann, a spokesperson for the insurer, said 90 percent of premiums collected go to pay for medical costs directly. 

“On top of anticipated rising hospital, doctor and prescription drug bills, future costs associated with COVID-19 care for our members are factored into this rate request,” Hartmann said. “Additionally, rates include the cost of government mandates, taxes and fees.”

MVP Health Care, another locally based health insurer, encouraged members to submit comments on potential rates to the Department of Financial Services.