nysbpclc@gmail.

com

BPCLC

New York State

October 24, 2011

The Honorable Kathleen Sebelius Department of Health and Human Services Commissioner Donald Berwick Centers for Medicare & Medicaid Services Attention: CMS9989P P.O. Box 8010 Baltimore, MD 212448010 Re: CMS9989-P; Proposed Rules for Establishment of Exchanges and Qualified Health Plans Under the Patient Protection and Affordable Care Act

Dear Secretary Sebelius and Commissioner Berwick: We are writing to strongly encourage you to implement the Affordable Care Act in a way that meets the needs of the citizens of New York. Improving access to quality, affordable health care remains one of our top priorities for the members of the New York State Bipartisan Pro-Choice Legislative Caucus. Specifically, a principal concern in New York is ensuring that our residents have both the opportunity to purchase the health insurance coverage they need, and access to available local health care providers. In order for expansions in health insurance coverage to work, newly insured Americans must have access to an available and local network of health care providers. This is especially important for Americans who are low-income and live in medically underserved communities. Recognizing this, Congress included Section 1311(c)(1)(C) in the health care reform law. This provision requires health plans sold through state-based health insurance Exchanges to include essential community providers in their networks. Essential community providers are crucial to New Yorks health care delivery system because communities across the state rely on them for primary and preventive health care. In the economic downturn, more women and men are turning to these providers for basic health care. In implementing section 1311(c)(1)(C), it is vital that HHS place special emphasis on addressing the unique health care access issues that women face. For example, while wait
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times increased for many types of providers after Massachusetts enacted its health care reform, it was most problematic for womens health care providers. Wait times for OB/GYN services increased dramatically to 70 days in the Boston area. It is critical that HHS put protections in place to ensure women do not face similar access problems around the country. To achieve true health care access for womens primary and preventive care, the final rule on state-based health insurance Exchanges must follow Congress intent by requiring Exchange-participating health plans to contract with all womens health centers and family planning clinics in their region. It is also important that health plans be required to contract with these providers for all of the covered health services they provide. It is equally important that HHS establish a solid benchmark to ensure adequate reimbursement for essential community providers. These protections are fundamental to creating a meaningful essential community provider standard and would go a long way towards ensuring continuity and coordination of care top priorities for the state of New York. On the separate issue of health insurance coverage, we also encourage the final rule to include policies that ensure people can continue to purchase the comprehensive health insurance coverage they have today. As such, we urge HHS to implement Section 1303 of the Affordable Care Act in a way that is in line with insurance industry practices. We look forward to working with you to make our nations health care system work better for Americans across the country. Please feel free to follow up with the NYS Bipartisan Pro-Choice Caucus via the office of State Senator Liz Krueger at (212) 490-9535 or at the address listed below. Thank you for your consideration. Sincerely,

Senator Eric Adams

Assemblymember Thomas J. Abinanti

Senator Tony Avella

Assemblymember James F. Brennan

Senator Neil D. Breslin

Assemblymember Harry B. Bronson

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Assemblymember Kevin A. Cahill

Senator David Carlucci

Senator Martin Malav Dilan

Assemblymember Jeffrey Dinowitz

Senator Thomas K. Duane

Assemblymember Steve Englebright

Senator Adriano Espaillat

Assemblymember Sandy Galef

Assemblymember Deborah J. Glick

Assemblymember Richard N. Gottfried

Senator Ruth Hassell-Thompson

Assemblymember Andrew Hevesi

Assemblywoman Rhoda S. Jacobs

Assemblymember Ellen Jaffee

Assemblymember Brian Kavanagh

Assemblymember Micah Kellner

Senator Jeffrey D. Klein

Senator Liz Krueger

Assemblymember Rory I. Lancman

Assemblymember George S. Latimer

Assemblymember Charles D. Lavine

Assemblymember Barbara Lifton

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Assemblymember Donna A. Lupardo

Assemblymember Alan Maisel

Assemblymember Margaret M. Markey

Assemblymember Joel M. Miller

Assemblymember Joan L. Millman

Senator Velmanette Montgomery

Assemblymember Catherine Nolan

Assemblymember Daniel J. ODonnell

Senator Suzi Oppenheimer

Senator Kevin S. Parker

Assemblymember Amy Paulin

Assemblymember Crystal D. Peoples-Stokes

Senator Gustavo Rivera

Assemblymember Linda B. Rosenthal

Assemblywoman Addie J. Russell

Senator John L. Sampson

Senator Diane J. Savino

Assemblymember Teresa R. Sayward

Assemblymember William Scarborough

Assemblymember Michelle Schimel

Senator Jos M. Serrano

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Senator Daniel L. Squadron

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Senator Toby Ann Stavisky

Senator Andrea Stewart-Cousins

Assemblymember Fred W. Thiele, Jr.

Senator David J. Valesky

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