As part of the fiscal year 2025 state executive budget agreement, Gov. Kathy Hochul signed legislation to eliminate insulin cost-sharing for any New Yorker on a state-regulated health insurance plan. This initiative is being touted as “the most expansive prohibition against insulin cost-sharing in the country.”
In addition to the cost elimination for eligible New Yorkers who use insulin, Hochul signed a $37 billion Medicaid investment plan to support the state’s healthcare system. Other health-related initiatives included in Hochul’s executive budget include new policies to protect pregnant moms and low-income individuals seeking medical care.
“No one should ever have to fear seeking care because of the costs it will impose or time missed from work,” Hochul said. “From supporting pregnant moms to reducing insulin costs, we are taking action to ensure New Yorkers can access the care they need.”
The new legislation regarding insulin costs aims to provide financial relief to New Yorkers and improve adherence to life-saving medications, Hochul said. With 1.58 million New Yorkers diagnosed with diabetes, the proposal is estimated to save New Yorkers an estimated $14 million in 2025 alone, according to Hochul’s office. People with diabetes often have medical expenses that are 2.3 times higher than people who do not have the disease and the impact is even larger for communities of color, which face disproportionately high diagnosis rates, according to the American Diabetes Association.
INVESTMENTS IN MEDICAID
The budget provides “record funding” to keep New Yorkers healthy, while also setting the Medicaid program on “sustainable long-term fiscal footing,” Hochul office said. A total of $37 billion will be made to improve Medicaid, including support for the state’s recently approved Medicaid 1115 Waiver amendment that will invest $7.5 billion in federal and state funding to promote health equity across the state.
IMPROVING MATERAL CARE
The healthcare investment in the budget also gives pregnant women the right to receive an additional 20 hours of paid sick leave for prenatal care in addition to existing sick leave. The budget also includes financial incentives for hospitals to reduce the number of unnecessary C-sections, and eliminates cost-sharing for certain pregnancy-related expenses, such as prenatal and postpartum visits, for Essential Plan and Qualified Health Plan enrollees.
COMBATTING MEDICAL DEBT
The budget includes new legislation to protect low-income New Yorkers from medical debt lawsuits by banning hospitals from suing patients earning less than 400% of the federal poverty level, or $120,000 for a family of four. The legislation also expands hospital financial assistance programs for low-income New Yorkers, limits the size of monthly payments and interest charged for medical debt, implements other protections to improve access to financial assistance, and mitigates the effects of medical debt on New Yorkers. According to Hochul’s office, more than 700,000 New Yorkers have medical debt in collections.
“Individuals with medical debt are less likely to seek necessary medical care and report being forced to cut back on critical social determinants of health, including food, heat, and rent. As a result, substantial debt levels threaten not only the financial stability of many individuals and families, but also undermine the State’s commitment to improving health equity and health outcomes,” said Hochul’s office in a written statement.
