Category Albany & legislative action

Testimony on the New York Health Act before the New York City Council

Testifying before the NYC Council in support of its resolution endorsing the New York Health Act, December 6, 2018

Testimony of Assembly Member Richard N. Gottfried

in Support of the New York Health Act

Public Hearing: City Council Committee on Health

New York City Hall

December 6, 2018

I am Assembly Member Richard N. Gottfried.  I chair the Assembly Health Committee and I am the introducer, along with Senator Gustavo Rivera, of the New York Health Act, to create single-payer health coverage for every New Yorker.  I appreciate the Council Health Committee holding this hearing on Speaker Corey Johnson’s resolution endorsing the bill.  I support the resolution.

In both houses of the State Legislature, we now have solid majorities who have co-sponsored, voted for, or campaigned supporting the NY Health Act.  And Governor Cuomo supports single-payer health coverage, although he says he has questions about whether it can be done at the state level.

Every New Yorker should have access to the health care they need, without financial obstacles or hardship.  No one says they disagree with that.  And the New York Health Act is the only proposal that can achieve that goal.

In NY State, we spend $300 billion – federal, state, and non-governmental – on health coverage.  Nationally, we spend far more than any industrial democracy as a percentage of GDP.  But 18 cents of the insurance premium dollar goes for insurance company bureaucracy and profit.  Our doctors and hospitals spend twice what Canadian doctors and hospitals do on administrative costs, because they have to fight with insurance companies.  We pay exorbitant prescription drug prices because no one has the bargaining leverage to negotiate effectively with drug companies.

Just about every New Yorker – patients, employees, employers, and taxpayers – is burdened by a combination of rising premiums, skyrocketing deductibles, co-pays, restrictive provider networks, out-of-network charges, coverage gaps, and unjustified denials of coverage.  I know I am, and I bet everyone in this room is.

And those financial burdens are not based on ability to pay.  The premium, the deductibles – the insurance company doesn’t care if you’re a multi-millionaire CEO or a receptionist.

In a given year, a third of households with insurance has someone go without needed health care because they can’t afford it – and usually for a serious condition.

The number one cause of personal bankruptcy is health care — even for those who have commercial health coverage.

We’ve put control of our health care in the hands of unaccountable insurance company bureaucrats. Nobody wants insurance company bureaucrats deciding what doctor you or your family can see and when.

The health insurance system means massive cost increases for most everyone and better health care for hardly anyone. It’s a disaster.

But it doesn’t have to be that way.

The NY Health Act will save billions of dollars for patients, employees, employers, health care providers and taxpayers – while providing complete health coverage to every New Yorker.

Everyone would be able to receive any service or product covered by any of the following:  NY Medicaid, Medicare, state insurance law mandates, and the current state public employee benefit, plus anything the plan decides to add.

And there will be no premiums, no deductibles, no co-pays, no restricted provider network, and no out-of-network charges.

We’ll actually save billions of dollars because we get rid of insurance company bureaucracy and profit, doctors and hospitals will be able to slash their administrative costs, and New York Health will be able to negotiate much lower drug prices by bargaining for 20 million patients.

And this lower cost will be shared fairly, based on ability to pay.  NY Health will be funded by broad-based progressively graduate taxes.

There will be one tax on payroll.  At least 80% of it must be paid by the employer.

There will be a similar tax on currently taxable “unearned” income – like capital gains and dividends.

Because of the savings and the progressively graduated tax mechanism, 90% or more of New Yorkers will spend less and have more in their pocket.

Pumping this money back into our economy will create 200,000 new jobs in New York.

And there will be money to completely cover everyone, and make sure doctors, hospitals and other providers are paid fairly – and today, most of the time, they are not.

The vast majority of our hospitals get most of their revenue from Medicaid, Medicare, and uncompensated care pools – none of which fully cover the cost of care.  The NY Health Act requires full funding for all hospital care, and hospitals will save billions in reduced administrative costs.

Here are 3 basic numbers:  The savings from insurance company bureaucracy and profit, provider administrative costs, and drug prices will total $55 billion.  The increased spending for covering everyone; eliminating deductibles, co-pays and out-of-network charges; and paying providers more fairly will cost $26 billion.  So the net savings to New Yorkers is $29 billion.

The way our society deals with long-term care – meaning home health care and nursing home care – for the elderly and people with disabilities is a moral outrage.  NY’s Medicaid does a much better job than other states.  But today, New Yorkers spend $11 billion a year out-of-pocket for long-term care.  And family members – usually women – provide unpaid home care worth $19 billion.

In January, Senator Rivera and I will be announcing that the NY Health Act will cover long-term care.

Now, that will use up $19 billion of the net savings.  But it means no NY family will have to wipe out lifetime savings, and no family member will have to give up a career, to provide long-term care for a loved one.  That’s profoundly important.

How much tax revenue will we need?  With the net savings, we’ll need $129 billion from the NY Health taxes.  When we add home care and nursing home care, we’ll need $159 billion.

How do we know the NY Health program will treat us – and our doctors and hospitals – fairly?  Two ways.

First, the legislation explicitly requires that provider payments be reasonable, related to the cost of providing the care, and assure an adequate supply of the care.  No coverage today has that guarantee.

Second, we’ll all be in the same boat; rich and poor.  Every New Yorker – every voter – will benefit from the program.  And every voter will have a stake in making sure our elected officials keep it as good as possible.

Remember where we started:  Every New Yorker should have access to needed health care, without financial obstacles or hardship.  We’re not there today.  The NY Health Act will get us there.  If anyone doesn’t like the NY Health Act, they should either put on the table another plan that will get us there, or admit that they’re OK with depriving millions of New Yorkers of health care or family financial stability.

Concerns have been raised by many of NY City’s municipal labor unions.  They are justifiably proud of the good deal they have won for their members over the years.  Good scope of coverage.  The City pays the full premium.  And the contract says that if there are savings in the health benefit, the savings go into a stabilization fund to pay for salaries and benefits.  As they remind us: at the bargaining table they have given up wages and benefits to protect this deal.

Under NY Health, by law, every municipal employee, like every New Yorker, would have an even broader scope of benefits, and without deductibles, co-pays and restricted provider networks and out-of-network charges.

Under the bill now, collective bargaining could continue to have the City pick up the whole tab for the payroll tax and pass on the savings to the stabilization fund.  But Sen. Rivera and I have offered to add bill language that by law would require the City to do that, without the need to bargain for it.

Our parents didn’t raise us to screw workers.  Period.  Sen. Rivera and I are determined to make sure that labor’s concerns are protected under the NY Health Act.  We are continuing the dialogue with them.

Thank you for letting me testify.

New York Daily News: New York State Bill to Boost Prisoner Health Care to be Introduced Following Reports of Treatment That Led to 50 Deaths

By Reuven Blau, November 12

Assembly Member Richard Gottfried plans to create legislation to give the state Department of Health more power over prisoner medical treatment. (Anthony DelMundo/New York Daily News)

Prisoner health care must be significantly improved and staffing levels should be regularly monitored, a state lawmaker said Monday following reports of horrific medical abuses that led to 50 deaths over the past five years.

State Assemblyman Richard Gottfried (D-Manhattan) will introduce legislation to give the state Department of Health more oversight power over prisoner medical treatment. Currently, medical treatment is largely handled internally by the Department of Corrections and Community Supervision.

“People in prison and jail, sort of by definition, are not looked at kindly by most New Yorkers,” Gottfried said. “We also have to realize they are human beings. They are in our custody, and we have a constitutional obligation to protect their health, whether they have done wrong or not.”

The Daily News on Monday reported that a state medical review board concluded 50 prisoner deaths may have been prevented had they gotten better health care.

Commission of Correction review panels repeatedly criticized prison medical staff for failing to complete basic checkups and mental health screenings. In multiple cases, doctors and nurses totally discounted prisoner complaints until they were too serious, according to the death probes.

Gottfried’s proposed legislation will also require state officials to study health care staffing in prisons and issue a report on the issue twice each year.

The number of health care practitioners employed by the department shrank by 3%, according to DOCCS. Some doctors are in charge of 500 or more prisoners.

“I think today it is all too easy to ignore inadequate staffing in prisons and jails particularly relating to health care,” Gottfried said. “If DOCCS and the Health Department are required to study and report on it that gets us a lot closer to dealing responsibility with it.”

The legislation was introduced last year but failed to pass the Assembly after it got stuck in the Codes Committee. The bill would also have likely gotten voted down in the GOP-controlled State Senate.

Gottfried believes the Democratic takeover of the Senate will lead to its passing.

In 2009, Gottfried and former State Sen. Thomas Duane passed a similar measure requiring the Department of Health to “conduct annual reviews of HIV and Hepatitis C care” in correctional facilities. That bill, which was signed by former Gov. David Paterson, has been hailed as a success by prison advocates.

Gothamist: Can NY Make The Leap To Universal, Government-Run Healthcare?

By Caroline Lewis, August 22

Since it was first introduced in 1992, a bill that would provide New Yorkers with universal health care has passed the state Assembly five times, including the last four years in a row, but it has always died in the Republican-controlled State Senate. Now, the New York Health Act—which aims to replace all existing forms of health insurance with one state-run, tax-funded health plan for everyone—is just one sponsor short of a majority in the Senate. With elections coming up for state lawmakers, the Senate could be poised to flip, giving the bill a chance of making it as far as Governor Andrew Cuomo’s desk.

Some 59 percent of Americans now support a Medicare for all model under which everyone would qualify for a government health plan, according to a recent Kaiser Family Foundation poll. Cuomo’s Democratic challenger Cynthia Nixon, candidates vying for state Senate seats, and some members of the New York City Council—including Speaker Corey Johnson—are framing support for single-payer as both a moral imperative and a progressive badge of honor.

The New York Health Act has reached the level of political viability for people on both sides of the ideological divide to start taking it seriously enough to get into the details of what it would entail.

Politico NY: Gottfried closing in on half-century in Albany

By Bill Mahoney, July 3

ALBANY — There are certain things New Yorkers can count on. They know that rush-hour subway service will be maddeningly slow. They realize that the Mets will lose key players to the disabled list. And they assume that Assemblyman Dick Gottfried will run for reelection every two years.

But while the subways and the Mets are capable of upsetting expectations, in theory anyway, Gottfried has no intention of doing so. He has stood for election in his Hell’s Kitchen- and Chelsea-area district 24 times beginning in 1970. And he’s doing it again this year.

Assuming he wins — that outcome isn’t really in doubt — and finishes his term, he’ll enter the record books as one of only two legislators in New York history to serve for half a century. (The late John Marchi, who represented Staten Island in the state Senate from Jan. 1, 1957, to Dec. 31, 2006, is the other.)

Technically, Gottfried will become the longest-serving New York legislator ever, assuming he wins in November. He’ll have been in office for 18,262 days compared to Marchi’s 18,261, thanks to the way leap years have fallen during his tenure.

All those decades of service have made Gottfried something of an institution in Albany at the age of 71. And with seniority comes power — as chairman of the Assembly Health Committee for years, he has been present at the creation of significant health care initiatives through several gubernatorial administrations.

Press wrap-up: RAND study confirms NY Health expands coverage, net savings

A new report by the RAND Corporation finds that the New York Health Act single-payer bill would cover all New Yorkers while generating a net savings.  More information can be found here; the full report here; and a summary here.

The report has generated widespread press coverage including:

PRESS RELEASE: RAND study confirms NY Health expands coverage, net savings

RAND CORPORATION STUDY CONFIRMS: NEW YORK HEALTH ACT “COULD EXPAND COVERAGE WHILE REDUCING TOTAL HEALTH SPENDING”

Think tank concludes: New York Health would cover all New Yorkers with net health care savings

Bill sponsors Senator Rivera and Assembly Member Gottfried will continue to push for the passage during the next legislative session

            State Senator Gustavo Rivera and Assembly Health Committee Chair Richard Gottfried, sponsors of the New York Health Act in the New York State Legislature, welcomed the findings of a study of the bill by the highly-regarded, independent, non-profit RAND Corporation. The study confirms that New York Health would reduce total health care costs, while increasing spending on actual care rather than administration and insurance company profit; provide full health coverage to every New Yorker; save substantial money for almost all New Yorkers; and generate a net increase in employment due to increases in disposable income.

NY Times: It Wasn’t a Crime to Carry Marijuana. Until the Police Found a Loophole.

By Benjamin Mueller,  August 2

It was the 1970s, and marijuana raids and mass arrests had been sweeping college campuses and suburban concert venues in New York. The crackdown outraged parents. There was talk of ruined reputations and “Gestapo” police tactics.

State legislators in 1977 devised what they took to be a simple fix: a bill that made carrying small supplies of marijuana a ticket-worthy violation, not a crime. To win enough votes from Republicans, the authors carved out an exception that said it was still a crime to carry marijuana “open to public view.”

The bill’s backers thought the addition was harmless enough, given that people did not usually take out their stash in front of the police anyway. The era of mass arrests for carrying around marijuana seemed to be over.

City & State: Gottfried’s Janus Workaround Reopens Labor Debate

By Max Parrott, July 10

When information leaked to the Empire Center, a fiscally conservative think tank, that Assemblyman Richard Gottfried, a Democrat from Manhattan, was planning to sponsor legislation that would reverse the effects of the Supreme Court’s recent Janus decision limiting the power of public sector unions, it swiftly attacked the bill as unconstitutional.

The Janus ruling on June 27 held that public sector unions cannot force employees covered by collective bargaining agreements to pay membership dues. Five days later, Gottfried circulated a memo to members of the Assembly summarizing his proposal, which would allow unions to collect reimbursement for the costs of collective bargaining from the state rather than from employees who opt out through agency fees.

Absent an intervention like Gottfried’s, the Janus decision will start draining funds from unions. Last week, it was reported that the National Education Association, the nation’s largest teachers union, announced it will cut its budget by $28 million.

The Supreme Court’s 5-4 decision, which was split along the usual conservative-liberal dividing line, ruled that the government cannot compel employees to support collective bargaining because to do so infringes on the free speech rights of anti-union workers.

NY Post: Dem lawmaker has “workaround” to SCOTUS unions decision

By Nolan Hicks, July 4

New York’s most senior Democratic lawmaker is proposing an end-run around a US Supreme Court ruling that could cost the state’s powerful public-employee unions more than $100 million a year.

Assemblyman Richard Gottfried (D-Manhattan), a longtime labor ally, plans to introduce legislation that would allow unions to include collective-bargaining costs in their contracts with government agencies to replace the mandatory fees banned under last month’s Janus v. ­AFSCME ruling.

“I would call it a workaround,” said Gottfried, who has served for 50 years in Albany. “I don’t think there’s a lot of logic to the Janus decision to start with, but New York state — in our Constitution and law — has long recognized that public employees have the right to collectively bargain.”

WCBS Newsradio (audio) – NY Assemblyman Gottfried has plan to circumvent SCOTUS union dues ruling

(Audio in link) – July 5, 2018

NEW YORK (WCBS 880/CBS News/AP) — A U.S. Supreme Court ruling issued last week will make it more difficult for unions to collect dues from people who do not want to pay.

Now, a New York state lawmaker has a plan to circumvent the decision.

“I think this is about fundamental fairness,” said Assemblyman Richard Gottfried (D-Manhattan).