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Cuomo Budget: Called “Out of Whack” on Out-of-Network Coverage

PHOTO: Andrew Cuomo by Pat Arnow
PHOTO: Andrew Cuomo by Pat Arnow
March 18, 2013

NEW YORK - New York lawmakers are scrambling to meet this week's deadline to approve the state budget, but health and disability advocates say a change is needed to protect the health of thousands of New Yorkers. Heidi Siegfried, director of New Yorkers for Accessible Health Coverage, said the problem is that Gov. Cuomo's executive budget does away with New York's current requirement that insurers offer consumers a "rider" that allows them to get vital out-of-network health services.

"We're really confused about why the governor wants to remove this important consumer health protection," she said. "It doesn't save any money, and it really endangers people's lives."

The problem is that a given network of providers does not always include every needed service, such as specialized treatment for cancers and some rare conditions. Siegfried said Cuomo may be unaware of just how drastic the consequences of this change would be, and she hopes lawmakers will restore the rider.

The change Cuomo wants will not only affect New Yorkers in the years ahead, she warned, but it will also sever existing coverage for thousands, many of whom battle life-threatening illnesses.

"In addition, he has allowed the insurance companies to cancel the policies of 5,000 people with various illnesses and disabilities who are depending on being able to see out-of-network providers in order to survive," she said.

Without the state requirement, many local health groups are concerned that the out-of-network coverage could disappear for New Yorkers seeking coverage on the individual market, she explained.

"The Hemophilia Association, HIV organizations, those who serve people with lupus - all are calling upon the governor to not remove this important protection," she said.

While the state health care exchange will allow 1 million additional New Yorkers to get coverage, she urged the governor and the state to also ensure that the out-of-network option is available for those who need it for life-sustaining coverage.

The governor's press office had no comment.



Mike Clifford, Public News Service - NY