The state legislative session wrapped up in June, which was arguably one of the state’s most active sessions in decades.
The November Election Impact
Following the midterm elections last year, Democrats gained one-party control over Albany, including the Governor’s Mansion, Senate, Assembly, Attorney General’s office, and State Comptroller’s office – giving them control of the executive, legislative, prosecutorial, and financial levers of government. Republicans held the State Senate for most of the last 40 years which resulted in compromises or blocked legislation, but with the Republicans out of power, Democrats were able to move forward many of their policy priorities.
The NYS Legislative Session
Unlike Congress, which is in session throughout the year, the New York State Legislature is in session only from mid-January through late June. Since the state fiscal year ends on March 31, the state budget dominates the first half of the session and includes policy proposals that the Governor wants to advance and also have budgetary implications. Once a budget is passed, the Legislature turns to bills that reflect its priorities.
What was passed?
A total of 915 bills were passed by both the Assembly and State Senate – compared to 641 in 2018 – that address a myriad of issues. The significant health care bills that passed include:
Passed in the budget and signed into law:
- Invitro fertilization coverage for large groups; fertility preservation for all group sizes (S.1507/A.2007; Part L) – effective 1/1/2020. This law requires that large group plans to cover at least three cycles of invitro fertilization (IVF), and all plans will have to cover fertility preservation services when infertility is related to illness caused by medical treatment. Effective 1/1/2020.
- Expansion of inpatient substance use disorder (SUD) treatment (S.1507/A.2007; Part BB) – effective 1/1/2020. The mandate expands inpatient, outpatient and pharmacy benefits for substance use disorders.
- Affordable Care Act (ACA) codification (S.1507/A.2007; Part J) – effective immediately, applies to policies 1/1/2020. This law codifies the ACA into state statute (NYS Budget 2019-20), which ensures the state’s marketplace would continue to exist if changes happen at the federal level.
- Contraception guarantees (S.1507/A.2007; Part M) – effective 1/1/2020. All plans will have to cover, without cost-sharing, all FDA-approved contraceptive drugs, devices and other products, except for male condoms. Where there is more than one equivalent drug, device or product, health plans must only cover one. Coverage must also include emergency contraception, allow for the dispensing of up to 12 months’ worth of contraception at one time, and include counseling and any follow-up care. Voluntary sterilization is included only for women.
Bills passed awaiting the Governor’s signature
Among the many bills waiting for Governor’s signature, two notable ones are related to drug formularies and surprise medical bills.
- Restriction of mid-year formulary changes (S.2849/A.2969) – effective 60 days after being signed. This law prohibits health plans from making mid-year formulary changes, such as removing drugs from their formularies or moving a covered medication to a tier with a higher cost share. When new generics come to market, plans are allowed to move the brand to the higher tier or off formulary upon 30-day notice to members. When a brand name drug becomes available as a generic drug, tier placement of the brand name drug may move or be removed from the formulary.
- Expansion of surprise billing protections to include inpatient ER stays (S.3171/A.264) – This bill would become law effective immediately once signed. The current law does not protect against inpatient hospital stays that were related to emergency treatment.
Notable legislation not passed:
- The New York Health Act – Neither chamber voted on the New York Health Act, legislation that would eliminate private insurance and enact a single payer system in the state. This is unusual, since the Assembly has passed it for the past four years. Nonetheless, the bill’s sponsors are going to continue to hold hearings throughout the state this year to build support and educate around the issue. The biggest sticking points for lawmakers are how much it would cost – an estimated $139 billion in the first year and $230 billion by 2031 – and who is going to pay for it. The discussion about single payer is likely to be caught in the shadow of the larger national debate about Medicare for All as the 2020 campaign heats up.