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would have health coverage. Last year the Governor authorized the expansion of Child Health Plus. A program that increased eligibility of the federal poverty level from 250 percent to 400 percent. In addition Governor Spitzer funds the expansion of New York's Child Health Plus program with state-only funding.

The bulk of the budget restructuring is targeted at providing insurance to children in the city. Uninsured children are much more likely to NOT receive a well-child checkup once a year. Nearly fifty percent of uninsured children did not see a doctor at all in 2003. That is twice the rate for children with insurance. Even a minor medical emergency-like a child needing stitches to close a cut can cost $800. The Health Care Security Act was introduced by the city council-to try and expand health care coverage to more than 400,000 working New Yorkers and their families.

New York's $47 billion dollar Medicaid program needs restructuring and re-balancing. New York has the nation's highest per patient spending Medicaid program. The administration is hopeful that future efforts will allow them provide access to health care for all New Yorkers. Some of the biggest obstacles include millions of dollars being exhausted on preventable inpatient care. If unnecessary hospitalizations can be decreased by utilizing less expensive preventive and primary care-there would be more funds available of existing programs.

One goal the state has set for itself is to increase performance. If the states Medicaid system was ranking closer to other states it could resulted in 43,000 children being up-to-date on their immunizations and 300,000 diabetic adults receiving exams and tests that prevent or delay further complications.

Commissioner Richard F. Daines, M.D. told committee members,
"The steps to reform began with a health care system no one is happy with not patients, not providers, not health plans, not employers, and not government. We looked at what can be fixed easily, what needs to be rebuilt from scratch, and what should be changed over time. The overarching goal of the health care reforms in this Budget is to transform a low-performing health care system that is increasingly unaffordable and inaccessible into a high-performing system that is accessible, affordable, and focused on improving health outcomes. Last year, we started the reform process with changes that make it easier for low-income New Yorkers to enroll and maintain coverage in Medicaid, Child Health Plus and

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