New York Is Giving Billions to Insurance Company Middlemen. It’s Time to Invest in Care.
The current Managed Long-Term Care system sends Medicaid dollars to largely for-profit insurance companies that increase costs without improving care.
The Home Care Savings & Reinvestment Act [A2018A / S2332A] would stop this, and free up an estimated $3.5 billion a year for investment in fair wages, increased staffing and better working conditions for home care workers.
$722M
In MLTC insurer profits in a single year, double the national average
$3.5B
Estimated annual savings from switching to managed fee-for-service
1.47M
Projected shortage of New York home care workers by 2035 unless proper investment
THE CASE FOR REFORM:
FOUR REASONS TO ACT NOW
The MLTC experiment has failed New York’s most vulnerable residents and wasted billions in taxpayer dollars. Here is the evidence:
Billions Wasted on Middlemen
The MLTC system funnels Medicaid dollars through insurance company pass-throughs that add administrative costs and profit margins without improving care. Switching to managed fee-for-service could save the state an estimated $35 billion over ten years.
Care Denied to Those Who Need It Most
For-profit MLTC plans stay profitable by denying care to the most vulnerable New Yorkers and recruiting lower-need enrollees. This system rewards cost-cutting over quality, leaving seniors and people with disabilities without the services they rely on to live safely at home.
No Transparency, No Accountability
Under the current structure, the state lacks reliable information about which agencies provide services, how much workers are paid, and where Medicaid dollars ultimately go. This absence of oversight has enabled wage theft, consumer steering, and widespread abuse of the system, all while insurers pocket hundreds of millions in profit.
New York Is Running Out of Time
Federal cuts to Medicaid are threatening critical health services across the state. To protect residents, New York must act now to end wasteful pass-throughs and find responsible savings that can be reinvested to meet the growing demand for home care.
VOICES OF SUPPORT:
What Legislators and Advocates Are Saying
FOR YOUR OFFICE
This one-page briefing summarizes the case for the Home Care Savings & Reinvestment Act, including key data points and bill provisions. Share it with colleagues and staff.
