New York’s rocky overhaul of its Medicaid consumer directed home care program (CDPAP) puts 280,000 elderly and disabled New Yorkers at risk. It also risks the health coverage of 400,000 workers – a consequence of replacing hundreds of fiscal intermediaries (FI) with a single FI. An FI handles the paperwork and payroll for consumers, who select and train their own workers. New York is now paying Georgia-based, private equity-owned PPL approximately $225 million to administer the multi-billion-dollar program.
As the Fiscal Policy Institute revealed, PPL offers insurance options that exploit legal loopholes in the Affordable Care Act (ACA), covering virtually nothing. The ACA penalizes large employers that don’t offer health benefits. But it isn’t clear whether the penalty applies to PPL, which is a joint employer with consumers under labor laws, but not under the ACA. PPL offers lousy insurance that renders many workers ineligible for high-quality affordable coverage they receive now.
PPL offers an optional “Minimum Value” plan to full-time workers, with a $212 monthly premium and $6,350 annual deductible. Realistically, no one earning $32,000 can afford these sky-high costs. Workers will face bankruptcy if they need significant treatment, skip treatment for chronic conditions, or be forced to find another job…