MEMO IN OPPOSITION

S.3296 (Rath)
A.4676 (Schimminger)

The New York State Chapter of the National Association of Social Workers (NASW-NYS) opposes S.3296 / A.4676.  This legislation would require additional Medicaid recipients (dually eligible Medicaid/Medicare enrollees, people covered through SSI, people with HIV/AIDS and people with serious mental illness) throughout the State to participate in managed care plans. 

More than 10 years ago New York started enrolling Medicaid beneficiaries into HMOs and the above categories of individuals did not have to enroll.  There is still no conclusive data suggesting that HMOs are ready to serve people with significant health care needs.  People with mental illness already struggle to coordinate their physical health care services and their mental health needs, relying on networks of care that they have personally developed.  People with HIV/AIDS are more likely to suffer from multiple chronic illnesses, more likely to need access to mental health care and substance use treatment, and more likely to benefit from case management than the majority of the Medicaid population.  Dually eligible persons, who are elderly or disabled, have intensive health care needs, and experience great difficulty navigating the health care delivery system.  New Yorkers on SSI are among those with the most complex health conditions, yet they often have the fewest resources. 

New York’s fee-for-service Medicaid program has guaranteed these beneficiaries flexibility and access to a wide range of providers and services.  Managed care plans have not yet demonstrated their capacity or readiness to serve people with complex health care needs.  NASW-NYS urges the State to move slowly in developing a plan for increased enrollment in Managed Care, assuring stakeholder involvement in the planning, and maintaining a voluntary approach.

NASW-NYS opposes S.3296 / A.4676 which would undermine the health care access needs of thousands of the most vulnerable Medicaid beneficiaries including the mentally ill men, women and children, people with HIV/AIDS, dually eligible and enrollees covered through SSI.  Forcing these people into a care model not prepared to meet their health care needs will create potential health care disasters and fail to generate significant savings for the State.