August 10, 2023 By

Henry Moss, NY Health Campaign

State-based SP organizations

1. Campaign for New York Health www.nyhcampaign.org

2. PNHP-Metro NY Chapter www.pnhpnymetro.org

National Affiliations: PNHP, Healthcare-NOW, Labor Campaign for Single Payer 

State-based SP bills

+A.7897 Sponsor Paulin, re-submission 7/19/2023, New York Health Act (69 co-sponsors). Text

+S. 7590 Sponsor Rivera, re-submission 7/7/2023  New York Health Act (33 co-sponsors) Text

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, starting after $50,000.

+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

The legislation has a significant majority in the larger State Assembly and has passed the full Assembly four times in the past. The situation in the Senate is more problematic. The 2023 bill will likely have a majority for endorsement but the Senate Majority Leader, a past supporter, will not bring the bill to the Senate floor until she is satisfied that it will pass amid concerns expressed by some endorsing senators. The Governor is skeptical.  “Supporting” senators from wealthier, high-tax suburbs in Long Island and Westchester are concerned about additional tax burdens for their residents.   

Unions: Public service unions are the bigger problem, however, with several endorsing Senators concerned that key unions, particularly in New York City, are opposing the legislation. Although the bill has a number of union endorsements, several large and politically powerful municipal unions have come out against the legislation (e.g., AFSCME/DC-37, UFT/NYC Teachers). They are friendly but dug in. Their concerns include:

• Fears of dropping their high-quality plans, losing control, and handing everything over to the state.

• Although long-term care is a welcome new benefit, their current plans are comprehensive, largely premium-free, have low cost-sharing, and networks that, while narrow, appear to be not unreasonable.

• Concern about the lack of a concrete revenue plan in the bill that they can show members. The bill currently defers financing to a second bill.

• Interest in getting a “carve out” that has the employer (the government) pick up 100% of the tax burden, rather than 80%, in recognition of the wages they’ve sacrificed in the past to get decent health plans.

• Fear that union welfare fund and supplemental benefits programs will be hollowed out, causing job losses, compromising union HQ office contracts, etc.

The bill has already been amended to address some union concerns, including an option to allow public employee retirees living out of state to stay with their current health plans, and the sponsors have been conducting intense negotiations to address other concerns.

Advantages for SP in the current context  

SP bills have passed the Assembly easily for years.

Significant Democratic majority in State Senate after years of GOP control.

Outrage that NYC and the municipal labor leadership will be switching retirees to a Medicare Advantage plan starting in September 2023.

Successful public hearings have been held by the Assembly and Senate health committees, jointly, in Albany, the Bronx, Rochester, and Kingston.  The chairs of those committees are also the lead sponsors of the bill and the hearings were packed by SP supporters from the community, labor, small business, the disabilities community, and health care professions. Coverage especially by local media was strong.

SP supporters also participated in a hearing on rural health based on a policy document created by the Campaign to show how the legislation will positively impact access to care in rural areas.

The addition of long-term care in 2021 has proven to be a valuable source of increased support for the legislation  

Goals for SP movement in NY in 2023-24

Gain additional co-sponsors and present a two-chamber bill to the Governor.

Shorter-term initiatives

Organizing among union members and retirees. Expanding a nascent “Labor Activists for New York Health” movement.

Creating a possible companion financing bill that will help various constituencies understand how the legislation will likely save money for 90+% of New Yorkers while improving the health care system.

 Where can people find news about Single Payer in your state and/or join a group?*

Campaign for New York Health  www.nyhcampaign.org

Metro New York Health Care for All metrohealth@igc.org

Contact: Mark Hannay metrohealth@igc.org