The Future of Healthcare Coverage Worries New Yorkers

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Neela Doodnauth hurried out of her house at 12:30 p.m. on a recent week day, the usual time she leaves for work at Young World, a retail store on Jamaica Ave in Queens, but this time it wasn’t to get to her job on time. Doodnauth’s brother had called just minutes before to say their mother needed to go to the hospital.

Although Doodnauth and her mother both live in Jamaica, Queens, she was 20 minutes away from coming to her mother’s rescue. Her mother had slipped on a rug and fell while she was trying to go to the bathroom. The result of this incident caused a fractured arm and a worried family.

“It’s scary to see my mom like this. I don’t know what would have happened if she didn’t have Medicare. I can’t afford to pay for her healthcare,” Doodnauth said.

Many people in New York cannot afford to pay for their healthcare. According to the Health Plan Marketplace for the New York State of Health, nearly 2.7 million New Yorkers under the age 65 do not have a health plan. This is about 16 percent of people in New York State, recorded by the Health Plan Marketplace. With the uncertainty of how healthcare will become more available in the future with president-elect Donald Trump’s plan to repeal and replace Obamacare, New Yorkers are scared that the changes to the already available federal healthcare programs will do more harm than good.

Healthcare on the Ground in Queens from Ashley Somwaru on Vimeo.

Tamesh Sankar, a health education specialist for Aids Healthcare Foundation, works in Woodside, Queens where the foundation offers free HIV screenings, STD screenings, and free programs for prevention of reproduction to people of any age and gender. He noticed that many people who came in did not have healthcare to cover their visits or could not use their healthcare at all.

“Some people have healthcare but there are people who don’t. A lot of people come in undocumented because they are underage and don’t want anyone to find out or they’re coming in because they’re off the books,” Sankar said.

Sankar also noticed that many people who needed help at his location were from black and Latino communities who had low incomes. The need to help people who didn’t have healthcare coverage caused Sankar, who managed grants that was given to the foundation by New York State, to make sure that the programs funded by the state would have enough money to offer certain amount of services to reach certain demographics.

“If programs were being underfunded, we had to find money from other programs to take out and put it into the program that had patients that required more help,” Sankar said.

New Yorkers get help from New York State for healthcare coverage but there are also many people who heavily depend on federal government programs like Medicare, Medicaid, and the Affordable Care Act, also known as Obamacare. According to healthinsurance.org, 6,395,894 people were covered by Medicaid in New York as of June 2016. The Kaiser Family Foundation reported that 3,343,349 New Yorkers benefitted from Medicare in 2015 and the U.S. department of health and human services reported that 408,841 consumers in New York selected or were automatically re-enrolled in affordable health insurance coverage.

Yet with the new president-elect wanting to repeal Obamacare and reform healthcare, many are concerned that they won’t be able to afford healthcare.

Steven Newmark, the Senior Health Policy Advisor for mayor Bill de Blasio, believes that Obamacare should not be repealed but rather worked on and improved.

“The vague details of the replacement plan don’t ensure that Americans will have better Healthcare. There’s a better way. Fix Obamacare; 80% of it works, we need to work to close the rest of the gap,” Newmark said.

However, if Obamacare were to be repealed, Newmark pointed out that the premium support system that Donald Trump wants to implement is similar to Obamacare. Premium support for Medicare would allow beneficiaries to choose a private health plan that the federal government would pay a predetermined contribution for. The enrollees of this plan would be given a voucher in which to buy the plan they want, which is also what Obamacare does. Yet Newmark does not think this plan would be effective if people have to buy new healthcare plans every fall.

“I can’t imagine how this plan would get through. Everyone likes Medicare; it’s a system that works. I don’t see how anyone would want to change it. People who are elderly would have to do their research and find out which plan they want every fall. I don’t see this plan working,” Newmark said.

The main goal that Obamacare aimed for was to make healthcare more affordable for people who were qualified by the federal poverty level to get cost assistance by the Federal or State Health Insurance Marketplace. But to get healthcare insurance companies to willingly participate there needed to be more incentive, like making sure out of the 10 people who were given healthcare coverage, half of the people had to be young adults, not the elderly/frail/sick people who actually need healthcare coverage. This led to the carrot and the stick method, as Newmark calls it.

“If you don’t have healthcare, the government charges you a fee. This influences more people to get healthcare and keeps the exchange program with healthcare insurances going. You can’t have an exchange pool if the only people who need healthcare coverage gets it, it screws the market,” Newmark said.

New York is a progressive state that helps pay the difference that the government does not fund for healthcare. If Medicaid were to face spending cuts or if the government couldn’t fund the people who could make 100% of the federal poverty line, Newmark estimated that New York would have to put up $4.6 billion to help provide healthcare to unprivileged people, which Newmark commented was “extremely costly.”

It is still uncertain if Obamacare will be repealed or if Medicare and Medicaid will be facing changes but some people hope that it doesn’t vastly affect the way they are covered at the moment. Doodnauth realizes that Medicare has done a lot to help her 86-year-old mother by covering checkups, medication, and her recent hospital bill.

“I’m lucky that Medicare covers everything for my mom. If it didn’t, she wouldn’t be with us today.”

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