Written by Henry Moss
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.” They want to see a more detailed financing plan from the sponsors and are concerned with the financial impact on suburban residents and providers.
They are also concerned about the implications of banning an entire industry in the state and how the federal government may act to impede the legislation through changes to federal programs or legal challenges.
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.
The sponsors have been conducting intense negotiation especially with municipal unions in NYC. They have added a clause that allows public employee retirees who live out of state to continue their coverage as though they were state residents, Importantly, the next iteration of the legislation will likely include coverage for workers or self-employed living out-of-state but working in New York, a major union concern. It will also likely include adding a clause to make the non-payroll income tax more progressive at the lower bound, to protect those who rely on their investment income in retirement.
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.
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
The addition of long-term care last year has proven to be a valuable source of increased support for the legislation
Goals for SP movement in NY in 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.
Creating a “draft” companion financing bill that will help various constituencies understand how the legislation will not increase overall costs and 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
State-based SP organizations
National Affiliations: PNHP
National SP organizations with significant presence
Metro New York Health Care for All email@example.com
Contact: Mark Hannay firstname.lastname@example.org