Safety Net Providers Demand Repeal of Medicaid Pharmacy Carve-Out

Harlem United client Anthony Randolf speaks at a rally at Governor Hochul’s Manhattan office on March 1, 2022

For Immediate Release
March 1, 2022
Contact: Liz Benjamin,

Safety-Net Providers Mark 2-Year Anniversary of NYC’s First Confirmed COVID-19 Case, Demand Governor Hochul Protect Vulnerable Patients by Permanently Repealing Medicaid Drug Carve-Out

Local Health Centers That Provided Essential, Life-Saving Care, Vaccines To At-Risk New Yorkers Will Lose Critical Funding, Endangering Patients, If Carve-Out Is Implemented

New York, NY (March 1, 2022) – A statewide coalition of safety-net clinics, community organizations, advocates, and patients today highlighted how vulnerable patients who were disproportionately impacted by the coronavirus pandemic will lose access to life-saving services and care if a proposed Medicaid pharmacy benefit carve-out is implemented in Albany.

Participants demonstrated outside Governor Hochul’s Midtown Manhattan office on the 2nd anniversary of New York City’s first confirmed COVID-19 case to demand that the Governor permanently repeal the carve-out, which pre-dates the pandemic and was championed by her scandal-scarred predecessor.

If the carve-out is implemented on schedule, safety-net facilities across the City and State would lose a critical recurring revenue stream, forcing them to curtail services, cut jobs, and in some cases, close altogether.

“The pandemic brought to the surface what we already knew: There is injustice in the availability and access to health care, and Black and Brown communities were most impacted due to pre-existing social determinates,” said Dr. Pierre Richard Arty, Chief Psychiatric Officer for Housing Works. “People will suffer both physical and psychiatric issues having to do with the pandemic long after it is declared over. We are asking the governor to be a champion of social justice and medical justice by permanently eliminating this carve-out, which threatens to pull the rug out from under the feet of the most vulnerable New Yorkers.”

Coalition members noted that California has already implemented the same changes to the Medicaid pharmacy benefit that New York is now considering, and the results have been disastrous for patients, some of whom are going without medications and are left on hold for hours while trying to clear up administrative barriers to filling life-saving prescriptions.

Anthony Randolph, a U.S. Army veteran and Bronx resident, said the potential loss of the ability of pharmacists to connect in real-time with members of his medical team would be a life-or-death crisis.

“One time, I was sick, my body was in pain, and there was nothing left in me; I went to pick up my prescription, but the pharmacy said it was already filled. I didn’t know what to do,” Randolph recalled. “My health plan provider called my doctor and they worked with the pharmacist to resolve the problem. If I had to call a 1-800 number and my request got kicked upstairs and brought back down, I wouldn’t have needed medication. I wouldn’t have needed anything. We have to have the safety net because the safety net saves lives like mine. Governor, Save lives, don’t save money.”

“Our agency provides care for low-income families, people living with chronic illnesses and HIV, and in the 800 clients living with HIV, the virus has become undetectable, which means they are contributing members of society; they good workers,” said Samuel Rodriguez, assistant manager for Treatment Adherence Services at Alliance for Positive Change. “We need to make sure this governor understands that the carve-out hurts everybody – not just our clients, but the entire community. We need to let this governor, and all the governors that come along how important this program is. We cannot lose this battle.”

Save New York’s Safety Net is a statewide coalition of community health clinics, community-based organizations and specialized HIV health plans committed to serving vulnerable New Yorkers across the state, ending the epidemic, and saving the Medicaid drug discount program.