Earlier this week, Governor Kathy Hochul released her Executive Budget proposal totaling $233 billion for State Fiscal Year 2025. The budget proposes several initiatives targeted at improving access to, quality of, and reimbursement for women’s health and reproductive care, which includes initiatives that will bolster prenatal and postpartum reporting, doula coverage, scope of practice, and maternal mental health support. Governor Hochul also proposed several budget items for childcare services that will have a direct impact on caretakers who are predominately women.  

Women’s and Reproductive Health Services

The Governor announced an ambitious proposal in her State of the State Address to reduce infant and maternal mortality in New York State, which included the following proposals:

• Requiring managed care plans to report on prenatal and postpartum care, filling in information gaps that can be used to develop targeted interventions.
• Convening regional stakeholder groups to develop recommendations for reducing infant mortality.
• Providing new Medicaid financial incentives for hospitals to reduce unnecessary C-sections.
• Allowing access to doula services without a physician referral.

As proposed, the Executive Budget includes the following:

• Invests $10 million for Securing Reproductive Health Centers capital grants.
• Permits minors to give consent for any and all medical, dental, health, and hospital services relating to reproductive health care, including consent to terminate a pregnancy for any reason.
• Invests $4 million in the Roswell Park Cancer Institute to finance new mobile breast and prostate cancer screening vans and expanded cancer screening activities.

Maternal Mental Health

The budget proposes an increase in the 988 Crisis Hotline by $100,000 in order to specialize in maternal mental health training programs for providers. This investment is intended to help connect pregnant and postpartum New Yorker residents to counselors trained to navigate maternal mental health challenges.

The budget proposal includes $1.5 million annually to expand Project TEACH (Training and Education for the Advancement of Children’s Health) through specialized support for mental health and substance use treatment for individuals during pregnancy and postpartum.

Maternal Care Coverage

The budget proposes to eliminate cost-sharing for most pregnancy-related benefits in both the Essential Plan and Qualified Health Plans. The Essential Plan will also add coverage for doula services. The Executive Budget authorizes the Commissioner of Health to issue a statewide standing order for the provision of doula services, expanding access to doula services for all birthing parents.
The budget proposes paid breaks for breast milk expression in the workplace. The budget advances legislation to require all break time for up to 20 minutes for breast milk expression be paid.

The budget amends New York Paid Family Leave (PFL) to permit up to 40 hours of leave for eligible employees to attend prenatal appointments, without impacting the 12 weeks of PFL.

Abortion Care and Family Planning

The budget proposes to address abortion providers’ data privacy by directing the Department of Health to modernize technology for electronic reporting of induced abortions, eliminating the need for paper records.

The proposed budget authorizes any New York health care practitioner, acting within their scope of practice, to prescribe or distribute a contraceptive device or medication when, according to the practitioner’s reasonable and good faith professional judgment based on the facts of the patient’s case, they determine the patient can medically tolerate such treatment.

Child Care Services

The proposed FY 2025 budget provides nearly $1.8 billion in resources towards childcare assistance. The funding bolsters the following improvements to childcare:

• Reimburse child care providers for quality improvements by creating an increased differential payment rate for high-quality providers that are accredited by a nationally recognized child care organization, participate in New York’s Quality Rating and Improvement system, or have completed training and are an active participant in the Office of Children and Family Services’ Non-Patient Epinephrine Auto-Injector Initiative.
• Pilot staffed Family Child Care Networks¹ in regions around the State, with a focus on supporting and growing the capacity of family and group family child care providers.
• Increases funding to double the amount of early childhood mental health consultations across the State.

Gender Affirming Care

The budget proposes to take several actions to ensure access to gender-affirming care for adult transgender and nonbinary members in the Medicaid program by removing or reducing barriers to accessing gender affirming surgery.

The New York State Legislature will next hold a public hearing to gather testimony and public comment on the health provisions of the proposed budget on January 23, 2024. The New York State Senate and Assembly will then work to release their prospective “one-house” budget proposals in response to the Governor’s proposed budget, and work to negotiate a final budget agreement to meet the April 1 deadline for an on-time budget.

_{¹ These types of providers operate small programs out of their homes for children and care for a large portion of
children in families participating in the Child Care Assistance Program.}