Memorandum in Opposition

For Immediate Release: April 28, 2023

Re:      S.4889 (Rivera) – AN ACT to amend the social services law and the insurance law, in relation to coverage for the treatment of asthma

This legislation, S.4889, while well intentioned, is unnecessary as plans currently provide robust programs for the treatment of asthma. Moreover, creating new health insurance coverage mandates results in increased costs for individuals and employers purchasing health insurance in New York. Accordingly, the New York Health Plan Association (HPA) opposes this bill.

Asthma is a chronic disease of the lungs that affects millions of New Yorkers, including hundreds of thousands of children. When not well-controlled, asthma can greatly limit a person’s quality of life and even result in death. Effective asthma health management programs have the potential to decrease medical services that occur as a result of poor management of the disease and to improve quality of life.

Managed care plans are founded on principles that emphasize primary and preventive care. As part of their comprehensive approach to health care, HPA member plans have long sought to educate their members about the importance of adopting healthy lifestyles, avoiding behaviors that increase the risk of developing chronic problems, and utilizing tools to help manage various types of illnesses and encourage better quality outcomes. Plans provide access to a wide array of health education programs aimed at empowering members to manage chronic conditions — such as asthma — as well as wellness programs aimed at helping members take an active role in improving their overall health and well-being.

Plans continually evaluate and update their education programs and care delivery protocols based on evolving, evidence-based medical information. This includes review of new treatment guidelines and medications used to treat asthma.  Mandating into statute specific treatments or levels of coverage fails to take into account when the science changes or evidence-based guidelines evolve, requiring health plans to cover services that are outdated and, potentially, harmful to patients.

We believe S.4889 is unnecessary and, more importantly, would result in burdensome and costly requirements that ultimately would lead to higher health care premiums. For all these reasons, the New York Health Plan Association urges your opposition to this proposal.