Repealing State’s IDR Process for Medicaid Managed Care Plans Will Destroy Healthcare Benefits for More Than One in Five New Yorkers
Governor Kathy Hochul’s executive budget proposal this year clocks in at $252 billion—the largest in state history. With March now upon us, it’s crunch time for the Senate and Assembly to respond with their one-house budget resolutions. Without a doubt, there are many healthcare provisions in the governor’s proposal to be lauded. However, contained within Part E of the Health and Mental Hygiene (HMH) budget bill, there is one seemingly minor provision that, if not rejected by the legislature, would have disastrous consequences for millions of New Yorkers enrolled in Medicaid Managed Care (MMC).
For the second consecutive year, Governor Hochul has proposed eliminating the state’s independent dispute resolution (IDR) process for MMC plans, leaving for-profit MMC contractors unchecked to increase their record profits. This elimination would also jeopardize emergency services for more than 4.4 million New Yorkers enrolled in MMC, which is nearly a quarter of the state’s population. Legislators rightly rejected this proposal last year—and must do so again.
Over a decade ago, New York pioneered the nation’s first IDR process, establishing a model later adopted by the federal No Surprises Act. These laws have protected tens of millions of patients from receiving a surprise medical bill and ensure access to emergency care when they need it most. This elimination of the state’s IDR process for MMC plans would erode these important patient protections. Make no mistake, if the state neglects its constituents’ health by including this provision in the enacted FY 2026 budget, MMC beneficiaries will lose access to essential on-call emergency department care and immediate surgical care in hospitals across the state.
What would happen next? These MMC patients would then be forced to transfer to public hospitals, many of which are already financially-distressed, safety-net hospitals deeply in debt. This would not only overwhelm the safety-net system, but also create a two-tiered healthcare structure in which MMC patients receive lower-quality care than other New Yorkers.
Additionally, eliminating the state’s IDR process would empower for-profit health insurance companies to further cut rates for medical services. This would lead to a severe decline in patients’ access to care.
From Buffalo to Manhattan and Rochester to Montauk, New Yorkers who are enrolled in MMC plans should be troubled by this proposal. New York has spent years transitioning Medicaid beneficiaries into MMC plans, relying on private health insurance companies such as UnitedHealthcare, Fidelis, and Anthem. Yet this proposal undermines that very system, allowing these health insurers to pocket more taxpayer dollars while offering patients less.
In an era where Albany’s leaders champion health equity, it is unacceptable to revive a proposal that deepens health inequities. Recognizing the damage it would cause, the legislature stood up for patients and rejected this dangerous proposal last year. They must do so again.
Protecting emergency care for millions of vulnerable New Yorkers should not be a budget bargaining chip. New York’s lawmakers must ensure that Part E has no place in the final budget.
Christopher Sheeron is founder and president of Action for Health and the State Care Network
