Asm. Josh Jensen

Questioned whether OCA had been adequately consulted (noting their stated preference for delay), whether public hearings were held in affected districts, raised concerns about the $9.6 million fiscal cost without appropriation language, and asked about the process for assigning individual judges to new districts.

Expressed concern that most New Yorkers already know hospital policies through existing relationships with providers and facilities. Worried about the onerous reporting burden on hospitals and DOH, and concerned about the possibility that certain providers could be targeted based on services they do not provide, even though that is not the legislation's intent.

Argued the bill is unnecessary because DOH already issued comprehensive guidance in 2023 requiring community notification and public meetings, and that the bill's procedural requirements could jeopardize hospital viability during financial crises.

Argued the bill is unnecessary because DOH already implemented similar requirements through 2023 guidance and expressed concern that procedural delays could jeopardize hospital financial viability. Noted that existing DOH processes protect healthcare access and that the Governor's veto last year was correct.

While supportive of the bill, expressed concerns that eliminating prior authorization removes important health metrics monitoring for PrEP and PEP effectiveness. Also noted the state's Medicaid obligations have expanded far beyond original intent and questioned whether the bill duplicates existing protections already on the books.

Raised concerns about insufficient safeguards against coercion, focusing on practitioner coercion, systemic coercion, and self-coercion. Argued that vulnerable individuals might feel pressured to choose medical aid in dying due to perceived burden on family or concerns about nursing home costs, beyond explicit family pressure.

Argued the bill lacks evidence specific to New York, where the two existing for-profit providers have no fraud allegations. Questioned why the legislature would artificially ban providers when New York has only one hospice provider per 500,000 residents and ranks 50th nationally in access. Advocated for DOH oversight rather than a blanket ban.

Existing processes handle individual deaths; requiring DOH plan review during active emergencies adds confusion and delays crisis response; lack of statutory minimum storage capacity requirements could force facilities into costly capital projects or vendor competition during crises; best-laid plans often fail in actual emergencies.

Began questioning the Chair regarding the MCO tax, characterizing it as a 'legalized money laundering scheme,' though the transcript cuts off before his full remarks.

The bill's prohibition on biomedical uses is overly broad. Horseshoe crab blood is essential for endotoxin testing in vaccines and medicines, extraction methods are safe with best practices, and synthetic alternatives lack widespread FDA approval. An exemption for biomedical research should be included.

Noted the bill applies only to fully insured policies covering 50 percent of the market, questioned its practical impact, and pointed out that federal law and a 2019 Division of Financial Services circular letter already prohibit cost-sharing for preventative care meeting USPSTF standards.

Horseshoe crab blood (LAL) is critical for endotoxin testing in vaccines and medicines; the Atlantic States Marine Fisheries Commission has best practices ensuring crab survival after blood extraction. Synthetic alternatives lack widespread FDA approval and require costly case-by-case approval. The biomedical exemption should be preserved, particularly given horseshoe crabs' role in COVID-19 vaccine development.

Horseshoe crab blood is critical for endotoxin testing in vaccines and medicines, with synthetic alternatives lacking widespread FDA approval. The bill should carve out biomedical uses, as the Atlantic States Marine Fisheries Commission has best practices ensuring crabs survive the blood-harvesting process.

Noted the bill applies only to fully insured policies covering 50 percent of the market, questioned whether the protections already exist under the Affordable Care Act and prior 2019 state guidance, and raised concerns about creating unequal mandate environments where some maintenance drugs have co-pays and others do not.

Expressed concerns about the onerous nature of the tiered reduction thresholds and increased strain on hospital operators and the Department of Health, noting potential conflicts with existing August 2023 DOH guidance and questioning whether temporary bed reductions would trigger the full process.

Questioned whether the bill is necessary given existing state law prohibitions on gag clauses and federal protections under Medicare and private insurance requirements. Argued that enforcement of existing law would be more effective than clarification, and suggested the real issue is PBM non-compliance rather than unclear legal language.

Argued that federal law already prohibits plans from penalizing pharmacies for informing patients about cost differences, and that state protections already exist. Questioned why PBMs would follow this new law if they are already violating existing state and federal law, and noted the bill lacks enforcement mechanisms for bad actors.

Expressed concerns about the onerous nature of public notification requirements and increased strain on hospital operators and the Department of Health. Questioned whether the bill's timing requirements conflicted with existing August 2023 DOH guidance and whether the tiered thresholds were too complex for implementation.

Questioned the necessity of the bill, noting that New York law already prohibits gag clauses and federal law already protects pharmacist speech about price differences between insured and uninsured costs. He argued that if PBMs are violating existing law, enforcement should be strengthened rather than clarifying legislation passed.

Argued that federal law already prohibits plans from penalizing pharmacies for informing patients about cost differences between insured and uninsured options. Questioned why additional state law is needed if PBMs are already violating existing state and federal law, and noted the bill lacks enforcement mechanisms for bad actors.

Expressed support for the concept but cited lack of clarity on program specifics, including how many times a used vehicle can be resold and remain eligible, and whether direct-to-consumer manufacturers can participate. Concerned about implementation timeline.

Criticized the MCO tax as a 'Federal money laundering scheme' without contingency plans, noted prior failed waiver precedent with health care worker bonus, questioned why EMS essential service designation was withdrawn by Governor, noted 3% Medicaid rate increase for EMS was removed, and questioned whether $500 million savings from CDPAP restructuring justifies significant program changes affecting vulnerable populations.

Criticized the MCO tax as a 'Federal money laundering scheme' with no contingency if waiver is denied, noting prior failure of health care worker bonus waiver. Questioned why EMS essential service designation was removed despite Governor's proposal, why EMS was excluded from 3 percent Medicaid rate increase, and whether CDPAP restructuring would achieve meaningful savings relative to program size.

Criticized reliance on unproven federal MCO tax waiver (comparing to failed health care worker bonus waiver), lack of EMS essential service designation despite Governor's proposal, exclusion of 3% Medicaid rate increase for EMS, and questioned whether CDPAP restructuring savings of $500 million justify significant administrative changes affecting vulnerable populations.

Criticized MCO tax as 'Federal money laundering scheme' with no contingency plan; noted prior failed health care worker bonus waiver precedent; questioned why EMS essential service designation was withdrawn by Governor after being proposed in Executive Budget; expressed concern that CDPAP restructuring creates significant disruption for minimal $200-500 million savings; questioned whether capital cuts discourage health care facility investment.

Criticized the MCO tax as a 'Federal money laundering scheme' with no contingency if waiver is denied, citing precedent of failed health care worker bonus waiver. Questioned why EMS essential service designation was withdrawn by the Governor, noted reduced Early Intervention funding (5-4% vs. requested 7.5%), and expressed concern that CDPAP restructuring ($200-500M savings) is insufficient given $7.9B program size and minimal impact on costs driven by minimum wage increases.

Existing State Health regulations already require 90-day notice to residents and families; elected officials lack statutory authority over closures; financial constraints drive most closures and community input cannot remedy them; the bill is unnecessary as communities can act without it.

Raised concerns about drafting ambiguity in the bill language and questioned whether it requires listing all ingredients or only major allergens. Also expressed concern about implementation burden on small businesses lacking labeling equipment and suggested an alternative approach using posted allergen lists at food counters.

Jensen questioned whether the Department of Health already has sufficient authority and information to make closure decisions, whether the bill's enforcement mechanisms would actually prevent closures opposed by communities, and whether the extended timeline could cause hospitals to lose staff and vendor contracts. He expressed faith in the Department of Health's existing statutory obligations.

Expressed concern that the 270-day notice period would cause staff to seek alternative employment and hospitals to lose ability to renew supply contracts, potentially worsening care during the notice period. Questioned whether $2,000 penalties are meaningful deterrents for financially distressed hospitals.

Expressed concern that posting individual star ratings without context could mislead consumers and negatively impact nursing homes. Noted that inspection data may be outdated, staffing numbers fluctuate due to external factors, and quality measures are assessed at specific time periods. Argued that ratings need accompanying explanatory data to be meaningful.

Questioned risks of Medicaid Investment Fund approval given upcoming Presidential election and potential change in Federal administration, and asked whether the $4 billion from the fund is the sole source of proposed Medicaid rate increases.

Shared personal experience that his twins would only sleep in a Boppy and later a Rock 'n Play, and that parents should have options to meet their children's evolving needs. Advocated for awareness campaigns rather than bans.

Raised concerns about distinguishing policy-based exclusions from legitimate medical limitations (lack of NICU, financial constraints). Questioned whether financial decisions not to offer certain services would qualify as reportable exclusions. Suggested Certificate of Need process would be more efficient mechanism than annual DOH reporting. Asked about frequency of updates if individual physicians have exclusions.

Argued the bill would impose tremendous financial and spatial burdens on nursing homes to build storage capacity they may not afford, and that addressing deceased persons' treatment should be a collaborative effort involving local communities and infrastructure, not nursing homes alone.