Governor Hochul Announces Initiatives to Transform and Strengthen Health Care Throughout New York State

As part of a comprehensive approach to improving the health and well-being of New Yorkers, Governor Kathy Hochul today announced initiatives to stabilize and transform the health care delivery system, expand access to affordable insurance, enhance primary and preventive health care, and protect New Yorkers against ballooning medical debt.

“Every New Yorker deserves access to high-quality, affordable health care,” Governor Hochul said. “Our nation-leading investments and bold policy choices will protect public health and ensure all New Yorkers can access the care they need to live full, healthy lives.”

Over the last two years, Governor Hochul has made multi-billion-dollar investments in safety-net hospitals, passed the largest Medicaid rate increases in more than a decade, and announced $2.6 billion in capital transformation funding to help transform and modernize New York’s health care facilities. Additionally, Governor Hochul’s signed legislation to prevent medical debt from negatively impacting New Yorkers’ access to credit in 2023. The 2024 State of the State unveils a bold statewide health care agenda that builds on these vital investments.

New York State Health Commissioner Dr. James McDonald said, “Under Governor Hochul’s leadership, New York State has made nation-leading investments to significantly enhance health care. When we invest in social needs for Medicaid members and health care safety net transformation programs, strengthen hospital cybersecurity, and address the ongoing opioid crisis, we improve health care facilities and patient care.”

Make Nation-Leading Investment in Health-Related Social Needs for Medicaid Members
Today, New York State received approval from the federal government on a groundbreaking Medicaid 1115 waiver amendment to enhance New York’s health care system. As part of this waiver, New York will significantly expand coverage for health-related social needs for Medicaid beneficiaries, through the largest Medicaid health-related social needs investment in the country.

Services covered for eligible program recipients will include housing supports (such as medical respite and tenancy sustaining services), food and nutrition (such as nutrition counseling and home delivered meals), and transportation required to connect members with social services.

Combating Opioid Overdose Crisis and Supporting New Yorkers Struggling with Addiction

Governor Hochul is leading the nation in terms of both the amount of – and speed at which – funds have been made available through settlements reached with opioid manufacturers making $192 Million available to address the opioid overdose crisis in communities most affected. Throughout 2023, New York State, led by the Office of Addiction Services and Supports (OASAS), has distributed hundreds of millions of dollars to support a full continuum of prevention, treatment, harm reduction, and recovery services designed to support individuals statewide. At Governor Hochul’s direction, New York State will lead the country in disbursing over $200 million more in opioid settlement dollars to bolster and support the workforce of addiction treatment professionals, grow street outreach efforts, and distribute more naloxone and millions more life-saving xylazine and fentanyl test strips.

In addition to deploying settlement funds, Governor Hochul will take other actions to continue her an all-hands-on-deck approach to addressing this crisis:

• Continue commitment to triple the number of Certified Community Behavioral Health Centers statewide by 2024.
• Propose legislation to update the state’s controlled substances schedule to include new fentanyl analogs and xylazine, as well as permit health care providers in emergency rooms to dispense up to a three-day supply of life-saving buprenorphine.
• Direct Health Department to synthesize data across multiple information systems to strengthen surveillance, and the Governor will propose legislation to increase the retention period for which patient data is stored in the prescription drug monitoring program.

Launch the Healthcare Safety Net Transformation Program

New York is home to some of the leading health care institutions in the world, yet due to various factors too many New Yorkers lack access to high-quality care. Under Governor Hochul’s leadership, New York State will transform the health care delivery system to improve access, equity, quality, and patient outcomes, while also increasing financial sustainability. As an initial step, New York State will launch the Healthcare Safety Net Transformation Program. Through this program, New York will encourage partnerships that improve the resilience of safety-net institutions.

The 1115 waiver amendment approval also secured billions of dollars of multi-year funding to support New York’s safety-net hospitals, and encourage them to transform in ways that will improve care and financial sustainability.

Strengthen Hospital Cyber Security

The number of cyberattacks in New York State increased by 53% between 2016 and 2022. Cyberattacks have an immediate impact on hospitals, from creating patient diversions and procedure cancellations, to a transfer from electronic to paper records that can slow down critical services. In November 2023, Governor Hochul announced nation-leading cybersecurity regulations for New York’s hospitals, backed by $500 million in FY2024 funding would support hospitals and health care facilities upgrading their technology systems.

Building on this, New York State will establish a New York Hospital Cybersecurity Roundtable to share best practices across the state’s hospitals– ensuring that health care facilities have not only the mandate and necessary funding, but also the implementation and operational support they need to strengthen their cybersecurity systems.

Expand Access to Primary Care

Although New York State is home to some of the world’s oldest and most distinguished medical health care and research institutions, it currently ranks 28th in the nation for providing prevention and treatment-based health care. In health care “deserts”, which may include rural communities, limited access to primary care leads to over-reliance and overcrowding of emergency rooms, disproportionately affecting Medicaid program participants. As a result, those with Medicaid are less likely to receive routine immunizations, or effectively manage medical issues.

Governor Hochul’s health care agenda includes furthering primary care access to ensure health equity across New York State. New York will increase Medicaid rates for providers participating in the state’s innovative primary care model (Patient-Centered Medical Homes). Additionally, to better integrate and coordinate mental health services with primary care, New York will increase support for Health Department-licensed facilities and private practices treating mental health conditions. To ensure access to care for adults with complex needs, Medicaid will increase reimbursement rates for health care providers serving individuals with physical, intellectual, or developmental disabilities.

Increase the Affordability of NY State of Health Insurance Options

Health insurance plans accessible through the New York State Health Plan Marketplace provide comprehensive benefit packages, including free preventive care (such as routine office visits and recommended screenings), as well as doctor's visits, hospital stays, emergency care, and other key health services.

In 2023, Governor Hochul submitted a request to the federal government to raise the income limit for Essential Plan eligibility from 200 to 250% of the federal poverty line (up to $36,450 income per year for an individual)– once implemented, this is expected to expand affordable coverage in the Essential Plan to an additional 100,000 New Yorkers. That is just step one. New York will offer new health insurance premium subsidies to residents enrolled in Qualified Health Plans, as well as eliminate cost-sharing in both the Essential Plan and Qualified Health Plans for office visits, laboratory work and testing, pharmaceuticals, and other supplies and services to promote better management of chronic conditions. To ensure that Essential Plan and Qualified Health Plan members have access to the health care providers they need, the Department of Health and the Department of Financial Services will revisit and update provider network adequacy standards.

Increase Access to Mental Health Care

Governor Hochul announced that the Department of Financial Services (DFS) and the Department of Health (DOH) have proposed regulations to expand access to mental health and addiction services by establishing network adequacy standards for behavioral health insurers. When timely appointments are not available for in-network coverage, New Yorkers will be able to go out-of-network for mental health and addiction services at in-network rates.

End Preventable Epidemics

Since 2014, New York State has laid the groundwork for ending preventable epidemics through the Ending the Epidemic (ETE) initiative– a plan to end the AIDS epidemic and achieve the first-ever decrease in people living with HIV. In 2023, Governor Hochul took action to prevent a rise in Congenital Syphilis by requiring third trimester screenings during pregnancy, and introduced legislation to screen more New Yorkers for Hepatitis C (including pregnant persons). However, despite tremendous impact, there are still pronounced disparities specifically among women, Black, and Hispanic populations.

Governor Hochul will take several steps to advance the State’s efforts to end preventable epidemics. Labs will be required to report all negative HIV, Syphilis, Hepatitis B, and Hepatitis C test results to improve targeted interventions and address gaps in testing. The Governor will also propose legislation to make HIV testing a routine part of an annual visit. To make it easier for New Yorkers to access care and prevent further transmission, the Governor will propose legislation to allow pharmacists to administer vaccines, screen and dispense medication for MPOX and PrEP, and expand the role of registered nurses to facilitate Hepatitis B testing. Finally, to address inequities, there will be increased investment in PrEP uptake in communities of color through targeted interventions and innovative delivery models like telehealth and learning collaboratives.

Improving Equity and Outcomes for Maternal and Infant Health Through Data-Driven Interventions

The State is committed to using data-driven approaches to inform efforts to reduce infant and maternal mortality. The Department of Health will establish new reporting requirements for Medicaid managed care plans to give the State better insight into patients’ utilization of critical prenatal and postpartum services to better target interventions. Additionally, the Department of Health will work with birthing hospitals and centers, through the Perinatal Quality Collaborative, to develop racially-sensitive and culturally-competent birth equity improvement plans based on the results and assessment of their Patient Reported Experience Measure (PREM) surveys. Finally, the Department of Health will convene regional stakeholder groups to develop recommendations to better target efforts to reduce infant mortality.