State-based SP bills
+A. 5248 (sponsor Gottfried) New York Health Act (71 co-sponsors; has passed the assembly 4 times)
+S. 3577 (Sponsor Rivera) New York Health Act (31 co-sponsors; 1 shy of a majority)
The New York Health Act establishes a single-payer health insurance system that covers all New Yorkers, regardless of income or immigration status. There will be no premiums, deductibles or other cost-sharing and residents can choose their provider without restrictions. Comprehensive benefits include anything currently covered by Medicare, Medicaid, CHIP, and public employee union health plans, including dental, optical, hearing, pharmacy, and long-term care, at home, in the community, or in an institution. The program will be financed by a payroll tax starting after $25,000 based on the ability to pay and shared 80% by the employer and 20% by the employee, and a progressive tax on unearned income.
+The legislation will be implemented with or without federal waivers.
+All residents must choose a care coordinator to advise on health care but not serving as a gatekeeper.
Related legislation (na)
Obstacles to SP in the current context
A skeptical governor (Cuomo). “Supporting” senators from wealthier, high-tax suburbs in Long Island and Westchester are dragging their feet. They were supported by Cuomo in the most recent election. Despite previously endorsing the bill, and campaigning successfully on it, they are creating some “headwinds” for it, requiring prerequisites for their support: 1) a hearing where alternative ideas are aired, and 2) a detailed financing plan from the sponsors, with input from experts and a discussion of implications for provider payments.
The SP caucus is worrying about the huge implications of banning an entire industry in the state and worrying about getting federal buy-in if the federal waivers aren’t awarded to keep getting the federal money that is currently coming into the state for health care.
Unions: Despite many endorsements from unions, several large and politically powerful public employee unions have come out against the legislation (e.g., AFSCME/DC-37, UFT/NYC Teachers). They are friendly and want to keep talking with the sponsors about possible changes, but they have dug in. Their concerns include:
- Fears of dropping their high-quality plans and handing everything over to the state.
- Although long-term care is a welcome new benefit, their current plans are largely premium-free, have low cost-sharing, and networks that, while narrow, appear to be not unreasonable.
- Fear that if unions give up their role as guardians of health care benefits, then the Janus ruling will make them essentially irrelevant and they will lose members.
- Fear that union welfare fund and supplemental benefits programs will be hollowed out, causing job losses, compromising union HQ office contracts, etc.
- Questions about how the legislation will affect workers who live in NJ, CT, PA, VT but work in NY, and implications for retirees who move out of state.
Advantages for SP in current context
SP bills have passed the Assembly easily for years.
Newly minted significant Democratic majority in State Senate this session. Expect the first-ever hearing in the senate June-July 2019 (but see above).
Addition of long-term care is an additional inducement.
(Note that the bill states that lack of waivers will not stop implementation, but it will be easier if they get them.)
Goals for SP movement in CA 2019-2020
Gain the additional senate co-sponsor and present a two-chamber bill to the Governor.
Convincing non-supportive unions that taking health care off the bargaining table will in fact lead to better wage and pension benefits.
Addressing other frequently asked questions especially about out-of-state workers working in NY and NY retirees who have moved out of state.
Where can people find news about Single Payer in your state and/or join a group?*
Campaign for New York Health www.nyhcampaign.org