Proposal Presented for the Master Plan for Aging (#47)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Increase and expand a variety of existing benefit programs. This proposal aims to increase the number of enrollees in and improve the access to critical health programs.
Justification
Increasing and expanding a variety of existing benefit programs that help older adults maintain good health, for example providing vision, hearing and dental services, may improve access to preventative health services. In addition to improving the lives of many New Yorkers, improving access to preventive health services may decrease long-term costs for more acute healthcare needs, potentially mitigating some of the heightened costs associated with expanding access to benefits.
Full Proposal
Increase or expand a variety of existing state benefit programs:
- Revisit Medicaid eligibility criteria (e.g., income limits, asset tests, lookback periods) to ensure the State’s resources are going to support those New Yorkers most in need of services.
- Increase State Supplement Program (SSP) amounts with an annual Cost of Living Adjustment (COLA) increase and streamline eligibility requirements. Consider shifting back to Social Security Administration for oversight.
- Utilize public-private partnerships to increase the number of mobile-dental clinics and encourage pathways for Federally Qualified Health Centers (FQHC) to provide dental care for older adults, require private dental plans to be subject to a dental medical loss ratio to ensure dental plans are more valuable for customers, and increase the number of reimbursable dental cleanings in the Medicaid dental program.
- Require dental plans to be subject to an 83% dental medical loss ratio to make dental plans more valuable for customers.
- Cover a higher frequency replacement of broken or lost dentures.
- Increase the number of reimbursable dental cleanings (dental prophylaxis) to four times per year for adults over age 65 with 16 or more teeth and/or problems directly impacting the health of the gums, including evidence of periodontal disease and/or poor home oral hygiene due to inability to properly care for oneself. Dental cleanings for these vulnerable adults should also include oral hygiene education and instructions.
- Support accessibility to obtaining hearing aids through the provision of an up-front subsidy for a portion of the cost of the hearing aid or create a voucher program to provide up-front payment for medically necessary and prior approved hearing aids through Medicaid hearing coverage.
- Reduce the amount of time for the coverage of replacement glasses under the Medicaid vision program and expand vision assessment coverage under the Medicaid vision program to cover adults 65 years of age and older.
Advocate to increase or expand certain federal benefits:
- Increase SNAP minimum benefits and ease enrollment requirements; implement the federal SNAP standard medical deduction pilot program.
- Encourage the federal government to extend Medicare coverage to all expert-recommended vaccinations and encourage all NYS health insurance plans to extend coverage to all expert-recommended vaccinations. Improve provider education and best practices for vaccines and use public-private partnerships to expand Local Health Department immunization programs and drives.
This proposal is focused on primary and secondary prevention.
MPA Council Commentary
This proposal is categorized as long-term. The State’s capacity to expand these benefits may be evaluated in the context of the annual budget process and would be subject to the availability of resources. Portions of this proposal would have substantial costs to the State’s Medicaid program. The Departments of Health and Financial Service should continue to review research on the potential impacts of these recommendations, such as changes to existing dental medical loss ratio requirements and expansion of hearing and vision benefits. New York State would have to discuss any changes to federal policy, including as related to SNAP and Medicare, with the appropriate federal officials.