On an oddly mild winter day in Ann Arbor, Michigan, Judith Arnold (MPP ‘83) stood beside the podium at the front of Paula Lantz’s Ford School course on social disparities in health. There, the school presented Arnold with the Neil Staebler Award for Distinguished Alumni Service. Then students settled in to learn about Arnold’s work as director of the Division of Eligibility and Marketplace Integration for the New York State Health Department.
While Arnold’s job title sounds abstruse, her work is as real and important as it gets. New York runs one of the nation’s largest and most successful healthcare marketplaces--New York State of Health--and Arnold played a pivotal role in designing and implementing it.
Unlike many other state exchanges, New York State of Health is fully integrated, allowing residents to use a single form to access a range of coverage programs including Medicaid, the Children’s Health Insurance Program (CHIP), the Essential Plan (which provides coverage for as little as $20 a month), and Qualified Health Plans, with or without tax credits.
The form itself is cumbersome, admits Arnold. For a family with complex circumstances, it can take 30 to 45 minutes to complete (the state provides phone and in-person assistance for anyone with questions). But with the old paper system, says Arnold, forms took 30 to 45 days to process; with the new online system, when applicants submit data that agrees (within 10 percent) with federal and state records, they can get an eligibility determination and enrollment at the end of the session.
Most notably, the system is fully integrated--something few other state exchanges have managed to accomplish. With a single application, New York households can apply for Medicaid for an expecting mom, CHIP for her children, and tax credits for her partner. And when it comes time to renew coverage the following year, many New Yorkers find that their renewal is automatic, dramatically improving continuity of care.
When Arnold joined the Health Department, 17 percent of New Yorkers were uninsured. By 2013, before implementation of the Affordable Care Act, the state was down to 10 percent. Today, thanks to New York State of Health and other initiatives--many of which Arnold played a pivotal role in developing and implementing--only 4.7 percent of New Yorkers are uninsured, and only 2 percent of the state’s children.
Today, the New York State Health Department is a national leader in healthcare coverage. For over a decade, says Arnold, the state’s leaders have viewed Medicaid as an insurance program, rather than a government handout, recognizing that coverage is good for families and the economy alike.
“All I ever wanted when I was sitting where you are was a career in public service and an opportunity to do my part to make the world a better place,” Arnold told the Ford School students gathered in Lantz’s class.
For Arnold, service meant shaping health policy, particularly for the most vulnerable members of society, a goal she was committed to from the very start of her graduate studies. While Arnold says she had hoped that by now, the United States would “join every other industrialized nation in guaranteeing access to healthcare for all,” she says she’s proud of the role she has been able to play “to move the country incrementally toward universal coverage.”