In Western New York, there are approximately more than 32,000 Vietnam-era veterans. Statewide, there are more than 240,000 of them.

A 2016 National Academies report found suggestive evidence that bladder cancer and hypothyroidism were associated with veterans’ service, as well as clarified that veterans with “Parkinson-like symptoms” (Parkinsonism) should be considered eligible under the presumption that Parkinson's disease and the veterans' service are connected.

Following this report, former VA Secretary David Shulkin announced that he would add these conditions to the Agent Orange presumptive conditions list in the near future, which would allow Vietnam War-era veterans stricken by these illnesses to receive additional health care benefits, disability compensation, and care benefits to surviving spouses and dependent children and parents.

But that announcement never came after OMB blocked the move.

In addition to the failure to include bladder cancer, hypothyroidism, and Parkinsonism on the Agent Orange presumptive conditions list, the VA has also yet to act on a 2018 National Academies report that found sufficient evidence of association between exposure to herbicides and hypertension.

Even though Schumer secured a provision in the recently passed budget deal requiring the VA to issue a report to Congress in consultation with OMB on the delay in adding these conditions to the presumptive conditions list, he said this is not nearly enough. He urged the agencies to take the necessary steps to ensure that the over 240,000 New York veterans, who risked their lives to defend their country, receive the health care and benefits they need and deserve.

Just last week, Schumer called recently confirmed OIRA Administrator Paul Ray directly and implored him, as the chief overlooking all federal government regulations, to immediately prioritize our veterans’ healthcare, take a personal interest in expanding their health benefits and add these conditions to the Agent Orange Presumptive Conditions List.

“It’s unfathomable that the administration is refusing to do right by our nation’s veterans, including the more than 240,000 New York veterans that bravely served during the Vietnam era, and has unilaterally blocked the VA from expanding healthcare benefits to those exposed to Agent Orange,” Senator Schumer said.

The Right Thing to Do

“After years and years of kicking the can down the road, it is high time for the federal government to accept the substantial proof linking bladder cancer, hypertension, hypothyroidism, and Parkinsonism to Agent Orange exposure, and add these conditions to the Agent Orange presumptive conditions list.

"It is absolutely incumbent on the administration to do everything within its power to clear a path for the VA, add these conditions to the list of Agent Orange illnesses, and finally allow veterans who are currently suffering access to the healthcare and benefits they rightly deserve; it’s not just the right thing to do, but it’s the very least we owe the brave New Yorkers who served and defended our country.”

In March of last year, Dr. Richard Stone, the executive in charge of the Veterans Health Administration, testified before the Senate Veterans Affairs Committee that the recommended new presumptive conditions would be added within 90 days, which also never happened.

Furthermore, this past October, email communications between the VA and the White House revealed that the delays were at the behest of the OMB Director Mick Mulvaney and White House advisors, who were reportedly concerned about the potential cost of adding diseases to the Agent Orange presumptive conditions list.

Emails explaining the decision to hold off on adding the conditions to the presumptive conditions list can be found here.

Exposure to Herbicide 'Agent Orange' Inflicts 'Presumed Diseases'

Schumer explained that per the Agent Orange Act of 1991, the VA automatically accepts that if a Vietnam Veteran physically served in Vietnam between January 1962 and May 1975, it is probable that the veteran was exposed to an herbicide agent like Agent Orange.

Furthermore, the Act established a list of “presumed” diseases that the VA stipulates are caused by Agent Orange exposure. Therefore, if a veteran served in Vietnam at any time between 1962-1975 and is diagnosed with one or more of the diseases VA recognizes as service connected, the VA will compensate the veteran and his or her family.

However, even though there is scientific evidence linking Parkinsonism, bladder cancer, hypertension and hypothyroidism to Agent Orange exposure, they are not currently on the VA’s list of recognized conditions.

Schumer said that is absolutely crucial that the roughly 240,000 Vietnam-era veterans in New York State receive the healthcare benefits they need and deserve.

“Adding these diseases to the Agent Orange Presumption List would only benefit the brave service members who were exposed to this chemical during the Vietnam War and are suffering from its harmful effects,” Veterans Outreach Center Executive Director and Army veteran Laura Stradley said. “Veterans Outreach Center stands with our veterans, and we support the laws that allow our brothers and sisters to access much-needed healthcare, services and support.”

VA Western New York Healthcare System’s Batavia site will host a car show and veterans enrollment event from 11 a.m. to 3 p.m. on Saturday, Sept. 14..

Veterans will have the opportunity to enroll in the VA health care system and have access to information to apply for other Veteran benefits.

To streamline applications and determine eligibility, veterans are highly encouraged to bring their DD-214 discharge papers and tax return from 2018.

The "Cruising for Veterans" car show will be staged behind Building 5 of the Jack Wisby Jr. Post-Traumatic Stress Disorder (PTSD) Building.

Merchandise and food will be available for sale starting at 10 a.m. through the Batavia Medical Center’s Veteran Canteen Service located on the ground floor of Building 1.

In the event of rain, the car show’s makeup date is the following day, Sunday, Sept. 15. The public is encouraged to attend.

The Batavia VA Medical Center is located at 222 Richmond Ave. in the City of Batavia.

United Memorial Medical Center (UMMC) has received the American Heart Association/American Stroke Association’s Get With The Guidelines^® -- Stroke Silver Plus Quality Achievement Award.

The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

UMMC earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period.

These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients.

Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

“We are dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines-Stroke initiative,” said UMMC Stroke Director, Dr. Sara Connolly. 

“The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines developed to improve patient outcomes.”

According to the American Heart Association/American Stroke Association, stroke is the number five cause of death and a leading cause of adult disability in the United States. On average, someone in the United States suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

It's caused a six-month delay in the project though Reaves believes it will soon be resolved, he told members of the Human Services Committee at a meeting Monday.

"The hang-up is really a bizarre thing," Reaves said. "New York State, in its wisdom, in order to draw the maximum amount of dollars for this project, passed it through a managed care company. Well, they passed it through a managed care company as a premium. If it’s an insurance company, you have to pay out premiums based on services. It can’t be paid as a project."

And this, Reaves said, is a project.

If the federal government were later to question reimbursements, the question is: Who will pay back the federal government if required?

At first, there was an effort to make the counties responsible for any such return of funds.

"Our attorney basically said, 'That’s not going to happen,'" Reaves said. "'Once we’ve received the money in good faith for the project and we’ve met our deliverables, you’re not getting anything because we’ve met our deliverables.'"

Reaves said in a sense the project is in a state of limbo. There are still operational tasks to be completed to get the new company up and running.

None of this, he says, has affected patient care.

"We think the state is going to agree with the managed care companies and indemnify them from any future potential loss, so we hope it’s going to resolve itself soon," Reaves said.

Previously: County Mental Health Services planning to enter coalition with five other counties to form new nonprofit

With a projected 18 percent growth in job opportunities in the next five years, it is an exciting time to be in or entering the medical profession. To meet the workforce demand, The BEST Center at Genesee Community College is offering three exciting professional training opportunities with tuition scholarships available! With registration deadlines just two weeks away, interested applicants should apply today! 

Patient Access & Registration Professional -- This 90-hour comprehensive program prepares students for patient intake and healthcare experience coordination including patient confidentiality, medical ethics and law, medical terminology, insurance billing and coding basics, appointment scheduling, medical records management and much more! This course costs $1,950 which includes required textbooks. Registration deadline is Feb. 26 and the course runs Mondays and Wednesdays, March 5 through May 14!

Clinical Medical Assistant -- This 140-hour course includes an optional 160-hour clinical externship. During the course, students will train to assist physicians by preparing patients for exams and treatments, routine laboratory procedures and diagnostic testing. Students will review technical aspects of phlebotomy, pharmacology, the proper use and administration of medications, taking and documenting vital signs, cardiology including proper lead placements and the legal aspects of healthcare. This course costs $2,599 which includes required textbooks. The optional externship costs an additional $350 which includes CPR Certification, background check, immunizations, drug screening, uniforms and more. Registration deadline is February 26, 2018, and the course runs March 5 through June 11, 2018!

Phlebotomy Technician -- This 90-hour hands-on program prepares students to collect blood specimens for laboratory analysis. Classroom and lab work includes coverage of medical terminology, anatomy and physiology, blood collection procedures, and skills and techniques for performing puncture methods. This course costs $1,799 which includes required textbooks. Registration deadline is Feb. 27 and the course runs Tuesdays and Thursdays, March 6 through May 6!

All of these training programs take place at GCC's Batavia Campus located at One College Road in Batavia. Registration for these programs requires a high school diploma, GED, or equivalent.

Additional information on each of these programs is available at www.genesee.edu/cms/best/development/certificate-programs/healthcare-certificate-programs/. All participants can register under "View our classes now" at www.genesee.edu/best. 

Those who are underemployed, unemployed and under skilled may be eligible for tuition scholarships through NY INSPIRE. GCC is part of the statewide program that focuses on training qualified candidates for high demand growing industries in the areas healthcare, advanced manufacturing and information technology.

The $20,000 grant to GCC will help offset tuition costs qualified recipients in this year's healthcare training programs. Scholarships are designated for those who are over 17 years of age and do not exceed the income threshold of $40,000 per year.

Don't delay! Contact The BEST Center at (585) 343-6868 or visit www.genesee.edu/best to find out if you are eligible!

President Trump at a meeting with Chris Collins, right, and other members of Congress.
Photo: Getty Images. Copyright 2017. Published with permission.

The future of health care coverage for some Americans has become uncertain. If your employer provides health coverage through an HMO or PPO, you're probably OK. If you're on Medicare or Medicaid, you're probably OK. But if you're one of the 51 million of U.S. residents who must buy your own coverage, you might be watching the news coming out of Washington with concern.

After seven years of promising to repeal and replace the Affordable Care Act, the Republicans in Congress have been unable to do either. Now, President Trump is threatening to defund the CSRs (cost sharing reductions) that help insurance companies contain coverage costs. He may not be able to do that, at least in New York, but there are other actions Trump can take to hamper the health care exchanges. The funding reductions and uncertainty are creating turmoil for insurers and consumers alike.

There are a reported 5,074 Genesee County residents who purchased their health insurance through the New York exchange for 2017.

A month ago, The Batavian spoke with Rep. Chris Collins at length about his views on health care, with a follow-up interview last week, and learned that Collins doesn't think anybody needs worry about their coverage. When the House repeal and replace bill, the American Health Care Act was still alive (at the time of our first talk), he was confident that bill would be better for New Yorkers. Last week, when the so-called "skinny repeal" was still on the table (it since failed in the Senate), he thought whether it passed or not, New Yorkers would still have no trouble getting the coverage and care they needed.

The Congressional Budget Office has issued reports saying from 15 million to 25 million Americans could lose health benefits if either of those bills passed, but when pressed, Collins maintained there remained viable ways for anybody who needed coverage to get coverage.

Collins believes we have the best health care in the world, that Medicaid should be the same in all 50 states, that Republicans will never support universal health care, and he plans to continue the push to shift the cost of Medicaid from county taxpayers to the state.

"My buddy just had two grandchildren that were born twins two and a half pounds each," Collins said. "They finally just came home at six pounds. In days gone by the outlook for those kids would not have been good. The advances are tremendous in this country. I think we stand alone in this country with many of those and there's a cost that goes with it. We can get better everywhere. We have to go step by step but we've got to get rid of Obamacare (the Affordable Care Act). That's imploded."

That implosion, Collins said, is not because of anything the Republicans did -- eliminating support for risk corridors, creating uncertainty about the future of funding for individual market insurance, blocking the expansion of Medicaid, and not working on amendments to the original language of the act; rather, Collins said, it is because the ACA was doomed to fail.

"It was a house of cards that was never realistic," Collins said. "I called it out for what it was on day one."

On risk corridors, that was a flawed plan from the beginning, he said.

"I'm saying they (insurance companies) gamed the system," Collins said. "They priced the product low when they knew they would be reimbursed by the government. That all turned to mask how bad Obamacare was. It was masked for three years through this risk corridor reimbursement. Well, now the emperor's got no clothes and we see him standing there naked. That's what ended up happening when we stopped (the risk corridors). Now they have three years of actuarial data to know where it's got to be priced and sure enough, Blue Cross Blue Shield just announced a 47-percent price increase."

There are reports that the insurance companies are owed an more than $5.8 billion. Collins said they are owed nothing.

"They got their money," Collins said. "They got their money and now they have three years of actuarial data. They should be on their own."

Provisions in the Affordable Care Act such as risk corridors were meant, according to groups such as the Kaiser Foundation, to provide safe guards for insurance companies against taking on a wave of people with pre-existing conditions.

Remember, before the ACA, those $51 million Americans in the individual pool could be denied coverage if they didn't already have insurance or changed insurance -- such as going from an employer-based plan to an individual plan -- if they had a pre-existing condition, or that condition might not be covered. The ACA, which became law in 2009 and took effect in 2014, made that practice illegal. Risk corridors were intended to recognize a period of instability while insurance companies took on millions of people who had been denied coverage because of pre-existing conditions all in a short period of time.

The risk corridors were not directly funded by the Federal government. It was expected that some insurers would under estimate and some would over estimate their costs. The risk corridors set a range of acceptable variance and then used profits from above that range to reimburse insurers who fell below that range.

Collins contends no insurance companies were profitable in the first three years of the ACA, or profitable enough to fund the risk corridors. 

"The young and healthy did not sign up," Collins said. "They are not signing up. Therefore the people in these plans are sicker. Those are the ones who flocked to them. There was never any money on the surplus side to give to the companies who all, in a race for the most patience, I would say negligently, priced their products knowing their losses would be covered by the federal government for a period of time. That was the house of cards. Set to fail. And it has failed. It was not anything the Republicans did."

According to a study by Common Wealth Fund, some insurers lost their shirts under the ACA while others raked in record premiums. Then, in the first quarter of this year, health insurance providers had their most profitable quarter ever. The volatility over the past three years in the health care exchanges is exactly what you would expect to find in a newly created market, according to a paper co-authored by conservative economist Craig Garthwaite.

The loss of risk corridor protection isn't the only shoal in the storm weathered by the Affordable Care Act.

There were more than 100 lawsuits filed against the ACA, some of them backed by Republicans. The fact that some of those challenges prevailed is evidence, Collins suggested, that the health care insurance law was bound to fail.

"This was a fundamentally flawed plan trying to get universal health care," Collins said. "The biggest issue was the Supreme Court struck down the exchanges being mandated across the country. That was the beginning of the end. That was not the Republicans. That was the Supreme Court ruling on an unconstitutional aspect of Obamacare. This thing was bound to fail."

The Affordable Care Act was meant to help lower the cost of health insurance for the approximately 51 million Americans (in a nation of 302 million adults, or 17 percent of the population) who are not covered by employer-provided health insurance or already receiving Medicaid or Medicare. Most of these Americans, prior to the ACA, did not have health coverage.  Since passage of the ACA, an additional 20 million people in the United States now have health insurance.

The ACA expanded Medicaid (though some states rejected the expansion) to include low-income workers (that's about six million of the 20 million mentioned above). There are also more people covered under their parents' plans because the law extended required coverage for children up to age 26.

A key provision of the ACA -- and one most reviled by conservatives -- is the individual mandate. The mandate was intended to push healthy young people toward signing up for insurance so their premiums (because on average they wouldn't require care resulting in claims) would help keep costs down for people with more health concerns.  People in the individual market who don't buy insurance can be assessed a tax penalty. 

The bill also required companies with more than 50 employees to provide insurance. Like the individual mandate, this provision has been unpopular and one report said as many as 22 percent of small businesses are hiring few workers as a result.

One thing Collins believes about the ACA is that the bill was really a trick to institute universal health care in the United States.

"The Democrats want universal health care," Collins said. "No if ands, or buts. Hillary Clinton wanted that. Barack Obama wanted that. They never could get there and that's when we ended up with the abomination that I call Obamacare."

At the time the ACA passed, the Democrats controlled the House and the Senate, with enough votes in the Senate (58 Democrats and two Democrat-leaning independents) for Obama to get through just about any legislation he wanted, including single-payer, Medicare-for-all, or any other universal system.

The ACA seems to be largely based on proposals first put forward by the conservative think tank, the Heritage Foundation. That that is not an indisputable fact. Stuart Butler, a Heritage director, says it's not true but there are documents out there that show Heritage and Butler pushing coverage for all Americans with an individual mandate.

At the time Butler was offering any kind of proposal for health care, Bill Clinton was president and Hillary Clinton was heading a commission aimed and creating universal health care for the nation. To counter the Clinton plan, Republicans were proposing alternatives, including the Heritage plan.

Republicans remain steadfastly opposed to universal health care, Collins said, even though Trump has seemingly promised just that during his campaign for president.

“We’re going to have insurance for everybody,” Trump said on Jan. 11. “We’re going to have a healthcare that is far less expensive and far better.” 

In an interview with 60 Minutes in September 2015, he said, “I am going to take care of everybody. Everybody’s going to be taken care of much better than they’re taken care of now.”

Collins deflected questions about Trump's promises.

"I don't speak for the president," Collins said. "I would say on the campaign trail he talked about a lot of different topics."

And in response to a follow-up question, Collins said, "The life I live is here now, and Republicans will never support universal health."

Interestingly, not all conservatives agree. The American Conservative has recently published two columns suggesting that within five years Republicans will embrace universal health care and that universal catastrophic coverage is what is best for the nation.

Collins is opposed to universal health care, he said, because he believes it's inferior to what we have now.

"(I) would point to the situation in Europe certainly the situation in Canada where we have Canadians pouring over the border to get health care that's just not available within their universal health care system," Collins said. "You look to Europe; the elderly are denied health care. The ROI is not there, whether it's a new hip for it or something else -- how old are you? What's your life expectancy? Some of the life-saving cancer drugs are not available in Europe from a cost perspective because those nations budget health care." 

According to this op-ed in the Denver Post from 2009, the idea that Canadians come here for routine coverage is a myth, through when Canadians do come to the U.S. for care, for whatever reason, their universal healthcare plan covers their medical expenses. (Colby Cosh, a journalist in Canada, read the Denver Post piece after I sent him a link on Twitter and he said, "Some of its plain nonsense, like 'no waits for urgent care', obviously."

There does seem to be some issue with the elderly being denied care in Great Britain (care rationing), but apparently, that is not how their care should be handled since they can sue if denied care.  

While there is a report in England recently of patients being denied expensive treatment, those same treatments are available elsewhere in Europe, and American pharmaceuticals tend to be substantially less expensive in Europe than the United States.

The idea, however, that drugs make health care more expensive for Americans, is a myth, Collins said.

"There's so much misinformation out there," Collins said. "For instance, if you surveyed the average American they will tell you the biggest cost driver and the biggest problem we have are prescription drugs. That's what they say. But that's not the reality. As I understand that prescription drug coverage is nine percent of health care cost. Ninety-one percent is everything else. So if all these, and they are expensive drugs, and as I just illustrated through my ill-venture down in Australia, nine out of 10 drugs are going to try and fail, there's a huge cost. It's got to be recovered one way or the other but you're simply not going to have new R&D and new drugs to cure the next disease."

Pharmaceutical research, however, is not a totally free-market system. While drug companies fund about $60 billion of the $100 billion spent on R&D each here, about 1/3 of that tab is paid for by taxpayers (with the rest covered by charitable contributions). Many drugs are formulated based on publicly financed research and some drugs are developed through a public-private partnership.

Even so, Collins expressed no interest, when asked, about reforming the current patent law system that gives drug makers monopoly pricing on drugs, though he did say he supports making it easier for patent-expired drugs to enter the generic market.

"None of us would ever suggest that anything's perfect," Collins said.

He said he's especially interested in reducing the approval process around what is called "biosimilar" drugs. Biosimilars are the same in every respect to FDA approved drugs, except for some inactive ingredients. The process for biosimilars was supposed to be reformed under the ACA.

While not addressing the patent issue, he said he would like to see new drugs get to market faster.

"It begins with things that we've done, that I helped with, with the FDA and the 21st Century Cures Act, to get drugs to the market quicker," Collins said. "I sat down with the administrator of the FDA and asked her about her personnel needs and the skill set she needs to get drugs to market quicker, to save lives, to treat illnesses, to treat debilitating diseases because the quicker they get to market the cheaper they'll be. There's a cost. Whatever it does and it takes you eight years to get it to market, and we can get it down to five years, we can save the net cost, and I believe it will be substantially reduced."

Whether the Republicans the Republicans let the ACA die, repeal it outright, repeal and replace it, Collins doesn't believe that people are going to die for lack of health insurance.

The poor, he said, will continue to be covered by Medicaid. As for people not eligible for Medicaid, nobody will face bankruptcy because they can't afford health care.

"We, Republicans, and everything we've said are they don't have to go bankrupt," Collins said. "That's was the old system. The old system said, because it was no safety net whatsoever, you have to go on Medicaid. The only way to get on the Medicaid was to go bankrupt. Well, that's not where we are today. Where we are today -- we don't know where it's going to end but certainly, American Health Care Act said very simply, you can get insurance."

It might be expensive insurance because if you were without insurance when you developed what carriers would consider a pre-existing condition, the insurers could charge you premiums that are 30 percent higher for 12 months.

"You are perhaps in that uncomfortable slice of working poor and your numbers didn't work and you did not have coverage through your employer and you made the decision to not carry that insurance," Collins said. "There were other things that took priority in your life. We're not going to now force you into bankruptcy, which was the old way. What we said is there would be a 30 percent added cost for 12 months then you would go back into the community rate. Personally, I think that is a pretty fair compromise."

The AHCA seems to be dead, at least for now, and Collins defended it at length during our conversation. You can read his comments in the transcript (links to the full interviews below).

Even with the AHCA seemingly consigned to legislative history, Collins said the proposal he backed to provide mandate relief for cash-strapped counties hit with the high costs of supporting Medicaid isn't dead. He will continue to pursue that legislation, he said.

"John Fasso and I are going to continue to pursue our Medicaid language and find something else to attach it to because we have some other must pass stuff," Collins said. "We've got S chip that's got to pass. We've got some extenders that need to pass, so let's just say John Fasso and I are not giving up on the Medicaid piece regardless."

Many economists have raised concerns about the lack of free market mechanisms in health care, a key factor in driving up costs. Employer-provided health insurance distorts the market, creates what economists call the principle-agent problem (the ultimate consumer isn't making the key buying decisions) and information asymmetry (buyers have less information than sellers). Liberal economist Dean Baker has been especially vocal about the American Medical Association, which he labels a "cartel."   The "cartel" he contends, is able to artificially reduce the number of hospitals and doctors in the United States. to constrict supply and drive up costs.

The United States has only 3.3 hospital beds per 1,000 people, compared to 3.7 in Canada and 4.2 in the United Kingdom. At 2.2 physicians per 1,000 people, the United States ranks 52nd in the world, though a tad higher than Canada or the United Kingdom. The United States spends more, much more, per capita on health care than any other nation on earth, yet ranks 43rd in life expectancy.

We asked Collins about the underlying causes of high health care costs in the United States and he didn't answer the question directly.

"Well there's one big issue and it's lifestyle," Collins said. "Two-thirds of our country is obese. Through that, all kinds of things happen whether it's diabetes, whether it's joints, whether it's heart, or whether it's cardiovascular. If you want to look up and down in health in the U.S., it's we got a weight problem. So what can we do? We got to talk about it. We've got to remind people of it. Health insurance companies now have fitness plans. Government plays a role and then people play a role. I'm just a firm believer in personal accountability. We make decisions good and bad. Certainly, our health decisions are more under our control, not to say that bad things genetically don't happen but there's an awful lot of the health care world that we do control individually. We're not doing a very good job."

PDF transcripts for full interviews:

• July 5 interview
• July 26 interview

Congressman Chris Collins (NY-27) today hailed the inclusion of his amendment to the House passed American Health Care Act into the Senate version of the bill. The amendment, introduced with Congressman John Faso (NY-19), would require New York State to take over the county portion of Medicaid by 2020 and would provide the largest property tax reduction ever to Western New York.

 

“This was a long fought battle against the injustice in Albany and is a big victory for taxpayers,” Congressman Collins said.

 

Federal law now permits states to share some of their costs with local governments, but New York is the only state that has imposed this level of burden on property taxpayers. Counties currently have no say in how local revenues are spent on Medicaid; they’re simply required to foot part of Albany’s bill. Local state leaders agreed that the inclusion of the amendment is important and welcome news for Western New York residents.

 

"Mandate relief has been talked about in Albany for as long as anyone can remember - it certainly wasn't new when I was talking about it as mayor. It's not a headline-grabbing or attractive issue, so meaningful proposals on mandate relief are generally swept aside. But I can tell you that it's real. It's real for the local governments who deal with tight budgets and it's real for taxpayers who pay some of the highest property taxes in the nation. I applaud Congressman Collins for bringing this issue to the forefront. Ideally, this would have been a serious discussion at the state level, but having failed that, I'm pleased that we could possibly address the crippling burden placed on our local governments as part of larger, federal health care discussions,” said State Senator Ortt.

 

“As a long-time supporter of curbing the costs of Medicaid, which would take a heavy burden off of local governments, I am proud to support Congressman Collins’ amendment. The impact on my assembly district and local taxpayers will be tremendous with estimated tax reductions of 49 percent in Orleans County and 35 percent in Genesee County. It is clear that New York’s outrageous Medicaid spending is one of the driving forces behind property and school tax increases and it is time for government to take that burden off our residents’ backs,” said Assemblyman Steve Hawley.

 

"Western New Yorkers pay some of the highest property taxes in the state. Rep. Collins' amendment fixes this problem and protects upstate taxpayers from Albany’s unfunded mandates. Removing the unfunded county Medicaid mandate is key to reducing local property taxes and growing our economy,” said Assemblyman Ray Walter. 

 

"This amendment is a blessing for upstate families, small businesses, and farms that’ve been crushed by the high taxes and unfunded mandates coming from Albany. The inclusion of this amendment is a win for our towns and villages and I appreciate Rep. Collins efforts to stand up for our taxpayers,” said Assemblyman Joseph Errigo.   

 

"I'm pleased that the Senate has included Rep. Collins's amendment in the healthcare reform bill. This promises real relief for property taxpayers in communities like Niagara County, and holds state government accountable to fund their mandates instead of passing on costs to the local level. Americans deserve access to the best healthcare possible, but it shouldn't fall to just homeowners to fund the system,” said Niagara County Legislature Chairman Wm. Keith McNall.

 

"Congressman Collins' Medicaid proposal will provide historic “real” property tax relief for hardworking local taxpayers. Currently over 30 perfect of the Ontario County property tax levy currently goes towards paying for New York's unfunded Medicaid mandate. I look forward to working with Rep. Collins and the members of the Board of Supervisors as we continue our efforts to reduce the burden on hardworking taxpayers in our community," said Jack Marren, Chairman of the Ontario County Board of Supervisors. 

 

"This is an important step forward in our fight to reduce unfunded mandates and protect local taxpayers. This measure will reduce local property taxes and help ensure that our seniors can afford to stay in their homes," said Bob Green, Vice Chairman of the Ontario County Board of Supervisors.

 

“We as a board supported a resolution in support of this measure because protecting property taxpayers is one of our prime concerns. This legislation will reduce an unfunded state mandate and help us deliver real tax relief to local homeowners,” said Eric Gott, Chairman, Livingston County Board of Supervisors.  

 

“We appreciate Rep. Collins efforts to relieve the counties of this extraordinary unfunded mandate. This will be a tremendous relief to local county property taxpayers and will allow us to invest in our infrastructure and other county services,” said Raymond Cianfrini, Chairman, Genesee County Legislature.  

 

“For years counties in New York have decried the use of property taxes to fund New York State’s expansive Medicaid program. We are optimistic that changes at the federal level can result in real, substantive, positive changes to the bottom line for county property taxpayers,” said David B. Callard, Chairman, Orleans County Legislature.

 

The Senate is expected to vote next week on their version of the Obamacare repeal bill.

Congressman Chris Collins (NY-27) today reacted to news of anticipated steep increases in the price of BlueCross BlueShield plans available to New Yorker’s through the New York State Insurance marketplace.

“Not only has Obamacare been a failure for most of America, it is now failing the people of Western New York by making basic healthcare completely unaffordable and inaccessible,” said Congressman Collins.  “I am absolutely appalled a BlueCross BlueShield plan in Western New York would increase by almost fifty percent in the marketplace.”

BlueCross BlueShield pointed to the failed Obamacare policies that have cost insurance companies millions of dollars, driving up costs for Americans.  Regulations put in place under Obamacare have made the insurance marketplace less competitive, thus increasing costs for consumers.

While President Obama promised that premiums under his plan would decrease during these last few years, a May 23, 2017 report from the Department of Health and Human Services showed that Obamacare increased premiums across the country by 105% between 2013 and 2017.

“Obamacare’s chief cheerleader in our state, Governor Andrew Cuomo, owes our community an apology,” added Congressman Collins.  “Cuomo is part and parcel to Obama’s promises that ‘you can keep your plan’ and premiums will be lower.  Those have turned out to be lies.”

Collins said there was help on the way.  The American Health Care Act (AHCA), which passed the House of Representatives on May 4, 2017, repeals and replaces Obamacare and removes more than $800 billion in onerous taxes and fees that have been stifling the economy and eliminating job growth.

“I am working with my colleagues in Congress to implement policies that allow the people of Western New York the opportunity to make their own choice when it comes to healthcare and provide lower premiums.  Americans deserve to be able to pick which plan works best for their family, and I’m urging the senate to take up the American Health Care Act so we can get ourselves out of this mess.”

The American Health Care Act:

·         Eliminates the individual and employer mandate, which forced millions of workers, families, and job creators into government mandated plans that did not work for their needs.

·         For Western New Yorkers, the bill also includes the largest property tax reduction ever to be enacted. The legislation includes an amendment Congressman Collins introduced that would bar federal reimbursements for New York State Medicaid funds raised from local governments.

·         Guarantees protections for individuals with pre-existing conditions by prohibiting insurance companies from denying coverage on the basis of a pre-existing condition, banning insurers from rescinding coverage based on a pre-existing condition, and preventing insurers from raising premiums on individuals with pre-existing conditions who maintain continuous coverage. Additionally, New York state law fully protects individuals with pre-existing conditions.

·         Modernizes and strengthens Medicaid by implementing a “per capita allotment” which provides more flexibility for states and results in the largest entitlement reform in decades.

·         Provides Americans access to affordable care that works for their needs by delivering monthly tax credits of $2,000-$14,000 a year, which individuals and families can use to purchase private insurance of their choice.

·         A provision within the American Health Care Act (AHCA), The Patient and State Stability Fund, would provide solutions to help lower costs and repair insurance markets damaged by Obamacare. CBO estimates this would significantly reduce premiums in the nongroup market and encourage participation by insurers.

The American Health Care Act is with the Senate where it will need to be approved before heading to President Trump’s desk to be signed into law.

Genesee County is joining with five other counties that have service-providing mental health departments to create a new nonprofit that should help improve services and lower costs, Mental Health Director Ellery Reaves told members of the County Legislature yesterday.

The new 501(c)(3) will be called Integrity Partners for Behavioral Health.

It's being formed both because regional mental health leaders see the need and because the state is pushing for more consolidation and more shared services. The state has made available $60 million for such consolidations in mental health services and Integrity Partners is the first of its kind in the state.

"So while other parts of the state are sort of scrambling to get themselves together, we’re literally going to submit our application with all of our providers, affiliate providers, and network providers, and it’s going to cover literally a six-county group so far," Reaves said.

Genesee County's Mental Health Services has a staff of more than 65 people, including doctors, therapists, counselors, and care managers. The service provides care to patients who either come to it through the Genesee County Jail, schools, other agencies, or just walk through the front door. The cost of care is either covered by private insurance or programs such as Medicaid or Medicare.

The goal of Integrity Partners will be to reduce costs through greater efficiency and improve care outcomes by sharing resources and knowledge.

"This model we’re moving to is more of a value-based, performance-based model," Reaves said. "We’re all going to get together and decide on what the matrix is going to be for what’s quality care. Then we as providers are going to try and meet those matrixes and get paid based on the efficacy in keeping folks out of hospital beds and providing service immediately, same-day access."

The six counties participating -- Genesee, Niagara, Cattaraugus, Chautauqua, Livingston, and Orleans -- all have county-run mental health services. The coalition will also include non-government providers within the region.

The partners have retained legal counsel to help set up the tax-exempt, 501(c)(3) corporation, as well as ensure the organization complies with all state laws and the requirements of the state incentives to organize it.

“If we can pull that off then this corporation will literally be on par with some of the larger health entities in the state,” Reaves said.

Lower costs and improved efficiency comes at a time when the county and the region need it, Reaves said.

So far in 2017, mental health services is on pace to serve more clients than in 2016.

Much of the increase is driven by the decreased stigma associated with seeking mental health care, but for children, social media is creating more problems, and opioid use leading to more mental health patients.

Reaves said the opiate crisis locally is "massive." 

"It's beyond what people can comprehend," Reaves said.

He added, "If you look at the stats on drug use, it's going to have a peak and once it peaks then it will start to abate once we can get more services in place. We haven't reached that point yet."

U.S. Representative Chris Collins (NY-27) today voted to repeal Obamacare and replace it with the American Health Care Act, which will improve access, reduce costs, and provide Americans with the health care system they deserve.

“This puts us even closer to ending the Obamacare nightmare that has plagued Americans for the last seven years,” Congressman Collins said. “The legislation passed today increases competition and gives people the power to make their own choices with their own health care. The American Health Care Act is a drastic improvement over the failing health care system Obamacare has left us with.”

For Western New Yorkers, the bill also includes the largest property tax reduction ever to be enacted. The legislation includes an amendment Congressman Collins introduced that would bar federal reimbursements for New York State Medicaid funds raised from local governments.

“My commonsense proposal will fix the finances of counties across New York for decades to come and most importantly keep money in the pockets of hardworking Western New Yorkers,” Congressman Collins said. “This puts a stop to this massive unfunded mandate coming out of Albany once and for all.”

For residents in New York’s 27^th Congressional District, it would result in more than $470 million in property tax savings. The proposal would only apply to the $2.3 billion being raised from counties outside of New York City to pay for the state’s Medicaid share. New York State currently raises $7 billion from its local governments to fund its $27 billion Medicaid liability, which is the largest such mandate in the nation.

Beyond the property tax savings for New Yorkers, the legislation improves access and affordability, and removes more than $800 billion in onerous taxes and fees that have been stifling the economy and eliminating job growth.

Congressman Collins indicated these improvements are absolutely necessary because the current health care system has completely failed. In 2017, 33 percent of counties nationwide only have one insurer on their exchange, and many counties are being left without any insurance providers.

He also noted that Obamacare has unsustainably raised insurance premiums by nearly 40 percent in the last three years. Recently, thousands of New Yorkers experienced the pain of Obamacare when they were kicked off their insurance plans because their provider, Health Republic, collapsed.

The American Health Care Act:

• Eliminates the individual and employer mandate, which forced millions of workers, families, and job creators into government-mandated plans that did not work for their needs;
• Guarantees protections for individuals with pre-existing conditions by prohibiting insurance companies from denying coverage on the basis of a pre-existing condition, banning insurers from rescinding coverage based on a pre-existing condition, and preventing insurers from raising premiums on individuals with pre-existing conditions who maintain continuous coverage. Additionally, New York state law fully protects individuals with pre-existing conditions;
• Modernizes and strengthens Medicaid by implementing a “per capita allotment,” which provides more flexibility for states and results in the largest entitlement reform in decades;
• Provides Americans access to affordable care that works for their needs by delivering monthly tax credits of $2,000-$14,000 a year, which individuals and families can use to purchase private insurance of their choice.

The American Health Care Act now heads to the Senate where it will need to be approved before heading to President Trump’s desk to be signed into law.