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Crain’s: At hearing, City Council gives warm reception to single-payer

By Jonathan Lamantia, 12/7/18

The City Council seems likely to pass a resolution endorsing a state single-payer health care bill after a hearing Thursday in which health committee chair Mark Levine fervently supported such a system and criticized its detractors.

Levine derided the status quo in health care, which costs more per capita in the U.S. than in other developed countries without better outcomes. He said that while he supports a national approach, it is unlikely to be taken up by the Trump administration.

“New York need not and must not stand still in the face of inaction at the federal level,” he said.

The bill would create a statewide public fund to cover all New Yorkers with no out-of-pocket costs. It received broad support at the hearing from nurses, physicians, social workers, immigrant advocates, disability rights activists and community groups.

The New York Health Act has passed the Assembly four consecutive years, and with the Democrats taking control of the Senate in January, there is an increased chance of the bill’s passage next year. Gov. Andrew Cuomo has said he believes the federal government is best positioned to take up the issue.

Assemblyman Richard Gottfried and state Sen. Gustavo Rivera plan to reintroduce the bill in January to address fiscal concerns. One new wrinkle, which Gottfried previewed Thursday, is that it will incorporate long-term care, such as nursing home and home care.

“No New York family will have to wipe out their savings, and no family member will have to give up a career to provide long-term care for a loved one,” he said at the hearing.

A coalition called Realities of Single Payer, which includes the state Health Plan Association, state Conference of Blue Cross and Blue Shield Plans, and the Business Council, said in a statement that the hearing was “nothing more than political theater” and a single-payer system would result in higher taxes and decreased access to care.

An analysis in August by Rand Corp. estimated that the state would need to raise $139 billion more in taxes by 2022 to fund the program, an 156% increase above expected levels. The research organization proposed one possible tax structure, as the current bill lacks one. Under its proposal, households earning up to $290,000 would pay a smaller percentage of their income toward health payments, including the new taxes.

The analysis assumed the state would receive a waiver from the federal government to deliver Medicare and Medicaid benefits through its own program while still receiving federal funds. Centers for Medicare and Medicaid Services Administrator Seema Verma has said she wouldn’t approve such a waiver.

David Rich, executive vice president of the Greater New York Hospital Association, spoke in opposition to the bill at the hearing. He noted the coverage gains New York has made to lower its uninsured rate to 5% from 10% in 2013 and said there were other ways to insure the remaining 5%. He said he worried a single-payer system would provide lower reimbursement to hospitals than the current system.

“Yes, we must cover the remaining 5% of New Yorkers who are uninsured. Yes, we should make health care affordable,” he said. “We can do this without the disruption we think would be caused by a single-payer system.” 

New York Times: 2 New Yorkers Erased $1.5 Million in Medical Debt for Hundreds of Strangers

By Sharon Otterman, December 5, 2018

Carolyn Kenyon, left, and Judith Jones, both of Ithaca, N.Y., raised $12,500 and sent it to a debt-forgiveness charity, which then purchased a portfolio of $1.5 million of medical debts on their behalf. Credit Heather Ainsworth for The New York Times

If a slim, yellow envelope with a Rye, N.Y., return address lands in your mailbox this holiday season, don’t throw it out. It’s not junk.

Some 1,300 such envelopes have been sent to New Yorkers around the state, containing the good news that R.I.P. Medical Debt, a New York-based nonprofit organization, has purchased their medical debt — and forgiven it.

Last spring, Judith Jones and Carolyn Kenyon, both of Ithaca, N.Y., heard about R.I.P. Medical Debt, which purchases bundles of past-due medical bills and forgives them to help those in need. So the women decided to start a fund-raising campaign of their own to assist people with medical debt in New York.

Over the summer months, the women raised $12,500 and sent it to the debt-forgiveness charity, which then purchased a portfolio of $1.5 million of medical debts on their behalf, for about half a penny on the dollar.

Ms. Jones, 80, a retired chemist, and Ms. Kenyon, 70, a psychoanalyst, are members of the Finger Lakes chapter of the Campaign for New York Health, which supports universal health coverage through passage of the New York Health Act.

“The way sort of opened,” Ms. Jones said. They cast a wide net for donations, she said, explaining to people that the campaign was only a short-term fix for the larger problem of out-of-control medical costs.

Many people take on extra jobs or hours to afford health care, and 11 percent of Americans have turned to charity for relief from medical debts, according to a 2016 poll conducted by The Times and the Kaiser Family Foundation.

The 1,284 New Yorkers who had their debts forgiven live in 40 of the state’s 62 counties, from Westchester to Chautauqua. The sources of the debt were some 130 hospitals and branches that had provided medical services, R.I.P. Medical Debt said.

“I like doing this much more than I liked doing collecting,” Mr. Antico said.

R.I.P. Medical Debt had its first star turn in 2016, when John Oliver did a segment on his HBO show “Last Week Tonight,” in which he paid $60,000 to forgive $14.9 million in medical debts through the charity. About 9,000 people received the yellow forgiveness envelopes as a result.

Since then, other high-profile efforts to forgive debts through the charity include fund-raisers sponsored by NBC and Telemundo affiliates.

In all, the organization says its donations have forgiven $434 million in medical debt so far, assisting some 250,000 people. That remains only a fraction, though, of the more than $750 billion in past-due medical debt that it says Americans owe.

“It is a drop in the bucket,” Mr. Antico said.

R.I.P. Medical Debt specifically seeks to buy the debts of people who earn less than two times the federal poverty level, those in financial hardship and people facing insolvency.

It purchases the portfolios at a steep discount, a penny or less on the dollar. These bills have typically passed through several collection agencies and months or years of collections. The people, who do not know they have been selected, receive the debt relief as a tax-free gift, and it comes off their credit reports.

Mr. Antico said he thought of his charity as a “resolutionary, not a revolutionary” effort, one that offers people relief, but that cannot solve underlying issues like high medical costs. Through personal data associated with the debt accounts, they are able to target specific classes of people, such as veterans, to relieve their debts.

“I do like the idea that people do not have to ask for help,” he said. “The random act of kindness is kind of a cool thing.”

The envelopes from Ms. Jones and Ms. Kenyon’s gift went out in November, but new letters are going out all the time. And don’t worry. Even if you throw your yellow letter out, your debt is still forgiven. You just might not know about it until the next time you run your credit.

Patch.com – Hearing To Discuss Legalizing Marijuana Held In Lindenhurst

By Priscila Korb, 12/3/18

LINDENHURST, NY – Local officials held a public hearing in Lindenhurst on Monday morning to discuss the recreational use of marijuana in New York.

The hearing, held at Babylon Town Hall at 10:30 a.m., was the fourth of four statewide hearings related to the topic following a well-attended Assembly hearing held earlier this year.

“Forty-one years ago, New York decriminalized non-public possession of small amounts of marijuana, making such possession a non-criminal violation punishable only by a fine,” a letter announcing the meeting read. “Despite decriminalization in New York, a disproportionately high number of Black, Hispanic and Latino people continue to be arrested for marijuana-related offenses – particularly possession in public view – which often results in a criminal record that can prevent gainful employment and full participation in society.”

Several states in the U.S., as well as Canada, have recently legalized or are in the process of legalizing adult marijuana use.

“Creating an adult-use system in New York raises important issues about the economic structure and regulation of production, distribution and sale,” the letter read. “Criminal justice and public health concerns, social and economic equity demands, ensuring opportunities for smaller scale and minority-and-women-owned businesses, and other relevant regulatory matters all need to be considered.”

The local officials who attended the hearing included: assembly member Joseph R. Lentol, Chair of the Committee on Codes; assembly member Richard N. Gottfried, Chair of the Committee on Health; assembly member Crystal D. Peoples-Stokes, Chair of the Committee on Governmental Operations and assembly member Linda B. Rosenthal, Chair of the Committee on Alcoholism and Drug Abuse

Thebody.com – New York State May Soon Finally Eliminate Explicit Consent From HIV Testing in Care Settings

By Tim Murphy, November 29

Laws about HIV testing have created decades-long controversy in New York State, pitting health officials who want virtually universal HIV testing against advocates — especially those who remember a darker, more discriminatory time — concerned about the privacy and protection of patients. It was that concern, after all, that in 1988 led to a stringent law requiring that health providers obtain from patients signed consent for HIV testing separate from consent for all other routine tests. And it was that same concern that, in the mid-2000s, led to mighty pushback from advocates when then-NYC health commissioner Tom Frieden tried to downgrade the law from written consent to mere oral consent, with the provider noting as much in their chart. That change did not occur until 2014.

But now, more than a decade later, there is solid evidence not only that early HIV detection and treatment means better long-term health outcomes, but that steady treatment makes people unable to spread the virus. It appears that most of the HIV advocacy community in New York City and the state at large now agree that the current law still obstructs testing for health providers — largely because they find it awkward asking patients if they can test for HIV.

These advocates agree that levels of testing high enough to truly end the state’s HIV epidemic cannot be achieved unless everyone who walks into an emergency room or primary care setting is routinely tested, with no notice to patients except for a sign on the waiting-room wall telling them they can opt out if they speak up and say so. And they are ready to lobby for that change with the state legislature in Albany next year.

On October 31, at the Brooklyn offices of Housing Works, representatives from that agency, Montefiore Medical Center, the large LGBTQ health provider Callen-Lorde, Bronx and Brooklyn Legal Services, the Latino Commission on AIDS, the National Black Leadership Commission on AIDS, Harlem United, the LGBT Center, Boom!Health, and other organizations met. According to Housing Works cofounder Charles King, “I think we came to a working consensus that we want to move HIV testing forward in a routine way.”

King said that the next step would be another meeting in which constituents write a rough draft of proposed bill language that would mandate that health facilities do routine HIV testing and that they post that information clearly in waiting or other public areas, letting patients know they must explicitly refuse HIV testing in order to not be tested.

More than a decade ago, Housing Works was among the leading voices against such a move, engaging in a sustained public protest against Frieden’s efforts that created acrimony between the city health department and much of the city’s HIV/AIDS services community. Thirteen years later, says King, “Less than 10% of all HIV-positive people in New York State don’t know their status,” and many of them are those whose only point of contact with health care is a visit to the emergency room — hence the need to test everyone in those settings.

“It’s imperative that we identify these folks and get them into care if we’re going to not only save their lives but stop all new infections of HIV in New York State,” says King.

He is part of the state’s Ending the Epidemic initiative, which aims to get new HIV infections in New York to 750 or below by 2020, as well as to make sure that the vast majority of all New Yorkers with HIV are both in regular care and virally suppressed on treatment. These are all necessary factors to effectively end the AIDS epidemic in New York State, historically the nation’s worst.

“In recent years, we’ve learned that the sooner someone with HIV starts on treatment, the better their outcomes,” King says. “We’ve also learned that someone who’s virally suppressed can’t pass on HIV. Those are huge game-changers that have tipped the balance in terms of whether it’s worth intruding on someone’s privacy.”

Donna Futterman, M.D., longtime director of the Adolescent AIDS Program at Montefiore, agrees. She’s long called for getting rid of requiring explicit consent from patients to HIV-test them. “The current stipulations are a proven barrier to more people knowing their status,” she says. “We want it to be part of a routine blood panel. Why do we still need HIV exceptionalism when it comes to testing? No one says, ‘Oh, we’re screening you for cancer,’ but often, routine tests are how you start to find cancer.”

She continues: “With HIV right now, a lot of nurses use unverbalized judgment on who they ask to be tested, based on race, age, or who they think is gay. They shouldn’t have to make that call. Thirty-five years into this epidemic, it’s time for us to let go of some of our old notions, especially now that we have the blueprint to ending this epidemic, and testing is the first piece of that.”

Binghamton.com (video) – NYS Assembly holds hearing about recreational marijuana

November 20, 2018

VIDEO HERE

BINGHAMTON, N.Y. – Elected officials are turning to the public for their thoughts on legalizing recreational marijuana. 

Some Democratic members of the New York State Assembly were in Binghamton today for a public hearing regarding the adult use of marijuana. 

Governor Cuomo has proposed legislation that would legalize the substance for adult recreational use.

It was one of four hearings across the state to gather feedback.

Assembly Health Committee Chair Richard Gottfried says it’s looking likely that legalization will be passed, the main question is how. “Not only about is it a good idea or bad idea. But also about what are the mechanics of it. Creating a new industry is a complicated thing. We haven’t done that in New York since the end of prohibition in 1933. How do we want to organize these businesses? So there are a lot of issues to be dealt with.”

Gottfried says among the concerns brought up include how to test if someone is driving under the influence of pot, how to limit access for children and who would be the major players in the industry.

He supports legalization because he says it would save money spent on law enforcement, lower the number of people incarcerated for non-violent crimes and bring in tax revenue for the state.

NY Post: Medical marijuana could soon be covered by New York health insurance

By Carl Campanile and Nolan Hicks, 11/22/18

Taxpayers could soon be on the hook to help low-income New Yorkers score medical marijuana, thanks to a bill that would force public health-insurance plans to cover it.

Patients in the state currently have to pay out of pocket for their prescription pot.

But state Sen. Diane Savino (D-SI/Brooklyn) and Assemblyman Richard Gottfried (D-Manhattan) and pushing a doobie-ous scheme that would require government health-insurance programs such as Medicaid, Child Health Plus, the Essential Plan, Elderly Pharmaceutical Coverage and workers’ compensation to cover weed as they would any other prescription.

“It’s unfair not to cover marijuana when opioids, OxyContin and Ambien are covered,” Savino told The Post. “We have to push the envelope.”

The lawmakers claim it will help battle the opioid epidemic ravaging the state.

“For thousands of patients, medical marijuana is a safer and more effective medication than other drugs, especially opioids,” Gott­fried argued.

But both lawmakers acknowledge the state would likely have to draw from the public purse to cover their plan.

The federal government likely wouldn’t provide financial support for the program because authorities in Washington still classify weed as an illegal drug.

The bill also wouldn’t require private insurers to offer coverage, although Savino says she would support an amendment to mandate that they do.

“Insurance companies are leery because the federal government still considers marijuana an illegal drug,” she said.

Medical marijuana in New York can come in a variety of forms, including tablets and oils that can be vaped, but it can’t be smoked under the current program, which was launched in 2016.

Public health experts are turning to marijuana to help cancer patients and others manage chronic pain as a nonaddictive alternative to opioids, which have fueled an overdose epidemic across the country.

Nearly 1,500 people died in the five boroughs last year because of overdoses — five times as many people who died in homicides — figures from the city’s Health Department show.

Opioids were linked to more than 80 percent of those overdose deaths.

There are 98,101 New Yorkers registered in the medical-marijuana program, but a study found one-third of the patients visited a dispensary only once for weed treatment.

New York lawmakers are under increasing pressure to act as New Jersey quickly moves toward full-scale legalization, which could be in place by next year.

Lawmakers in Trenton are expected to begin debating the matter on Monday, although Democratic lawmakers and Democratic New Jersey Gov. Phil Murphy are still at loggerheads over who would oversee the budding business — the executive branch or a five-person commission.

Meanwhile, Massachusetts began selling recreational marijuana earlier this week.

Gov. Cuomo has said New York will likely legalize pot for all adults in 2019.

Times-Union: As deaths rise, NY lawmakers push for addiction medicine in all state prisons, jails

By Bethany Bump, November 14

NEW YORK — A group of New York lawmakers are seeking support for a bill that would require all jails and prisons in the state to offer medication that has been proven to reduce death among individuals with opioid use disorder.

On Wednesday, members of the Assembly held a hearing on the effectiveness of “medication assisted treatment,” or MAT, in the state’s jails or prisons, and concluded the state falls woefully short when it comes to its use of the evidence-based treatment. Currently only six of the state’s 54 state-run correctional facilities offer MAT, which relies on one of three FDA-approved medications to help curb opioid cravings and stabilize brain function.

“It’s a start, but time is fleeting,” Assemblywoman Linda Rosenthal told state officials after they testified that New York has seen great progress implementing MAT in its correctional facilities in recent years.

“This is a recurring problem,” she continued. “People come into our facilities with a substance use disorder; others develop it while incarcerated. And when they leave, many go back into the neighborhoods they came from and overdose. So I think it’s incumbent on the state to take a giant leap and go for it in all our facilities.”

Roughly 78 percent of all inmates in New York have a diagnosed substance use disorder, according to the state Department of Corrections and Community Supervision. While state officials could not provide a figure for the segment that’s addicted to opioids, it’s safe to assume the number is high, as opioids remain a leading cause of overdose death nationwide.

MAT has been a proven treatment for opioid use disorder for at least three decades, with studies showing it prevents relapse and significantly lowers overdose rates. But it remains controversial, in part because the medications used to curb cravings are themselves powerful and because abstinence-only proponents view any reliance on drugs as a negative.

Supporters, however, note that abstinence-only policies don’t work for everyone and stigmatize those who have gone on to lead normal, productive lives thanks to drugs like buprenorphine and methadone. These so-called maintenance drugs, they argue, save lives by preventing overdose.

Those in the drug reform movement characterize disdain for these drugs as yet another example of how those suffering from mental and behavioral conditions are treated differently than those with medical conditions.

“I hope and I believe that in every correctional facility in the state our inmates with diabetes and high blood pressure and multiple sclerosis have treatment available to them,” said Assemblyman Richard Gottfried, a co-sponsor of the bill. “If there were only six prisons in the state that had diabetes treatment available, nobody would find that acceptable.”

The high rate of fatal overdoses among former inmates has made the rollout of MAT in jails and prisons a key issue for recovery advocates.

2007 study, for example, found that former inmates of Washington State prisons were 12.7 times more likely to die in the first two weeks after their release than the average state resident, with drug overdose the leading cause. And that was in the late 1990s and early 2000s, before the emergence of highly potent fentanyl in America’s drug supplies.

Today, public health experts believe the chances are much higher, as synthetic opioids like illicitly manufactured fentanyl are among the fastest-growing category of drugresponsible for overdose deaths.

Forced to detox before they’re incarcerated, inmates enter jail or prison without the physical dependence on a substance but continue to battle the underlying addiction. Illicit drugs smuggled into these facilities can further enable this addiction — or, if an inmate manages to stay clean behind bars but is exposed to drugs upon release, their lower tolerance greatly increases their chances of fatal overdose.

To help treat the underlying addiction, Sean Byrne, executive deputy commissioner of the state Office of Alcoholism and Substance Abuse Services, and Acting DOCCS Commissioner Anthony Annucci testified Wednesday that 53 of the 54 state correctional facilities offer psycho-social counseling services for inmates battling substance use disorder.

“They’re intense,” said Annucci. “They can last between six and 12 months.”

They also noted that while they’d like to expand MAT systemwide, it would be unwise to move too fast, as the programs currently in place downstate are only pilot programs. Obstacles, such as obtaining agreements with outside treatment providers who are licensed to provide the drugs, still have to be ironed out before a systemwide expansion is feasible, they said.

“I’ve been around a long time — 34 years — in this agency and the worst thing you can do is get excited about a pilot, rush it and then unfortunately have something happen where you lose buy-in from participants,” Annucci said.

The Villager: Small Biz Survival Bill Finally Gets its Hearing

By Lincoln Anderson, October 26

Before the hearing, David Eisenbach, of Friends of S.B.J.S.A., led a rally outside City Hall in support of passing the bill. Photos by Tequila Minsky

BY LINCOLN ANDERSON | Updated Oct. 26, 4:45 p.m.: More than 200 people packed a hotly anticipated hearing on the Small Business Jobs Survival Act at City Hall Monday. Scores of people signed up to testify on the issue, and the hearing turned into a marathon, lasting more than eight hours.

Among some of the main takeaways were that it became clear the de Blasio administration does not support the S.B.J.S.A., and that, according to City Council Speaker Corey Johnson and others, the bill should not be O.K.’d as is, and needs some modifications.

The hearing also saw a testy exchange between Johnson and John Banks, president of the powerful Real Estate Board of New York, which has long been accused of working behind the scenes to keep the bill  from ever coming up for a vote.

Banks said the bill would “stifle” economic activity and deprive property owners of their rights. REBNY, among others, is expected to sue if the Council passes the bill and it is not vetoed by de Blasio.

Former Manhattan Borough President Ruth Messinger was on hand to testify in support of the legislation — currently known as Intro. 737A — which she originally introduced when she was an Upper West Side city councilmember.

Advocates for the act in the audience frequently would silently flutter their hands over their heads — a permitted form of displaying support — at statements backing the bill or small merchants. Council security staff quickly greeted any applause or cheering with rebukes not to interrupt the hearing.

Meanwhile, about 50 representatives of business improvement districts a.k.a. BIDs and others against the bill sat in the audience wearing blue baseball caps sporting the slogan “Vote No on Commercial Rent Control” on their fronts. The group also included commercial real estate brokers and representatives of residential co-ops and condos.

The S.B.J.S.A. has languished in the City Council for three decades. The measure would address what advocates say is the biggest hurdle facing mom-and-pop shops — the lease-renewal process. When leases expire, landlords, especially in gentrified Manhattan, typically jack up the rents to levels that current tenants can no longer afford.

Seventy-five business improvement districts, or BIDs, across the city oppose the bill. Their members were among a group of about 50 people wearing blue “No Commercial Rent Control” caps at the hearing.

However, for a merchant with an expiring lease, the S.B.J.S.A. would mandate mediation with the landlord and then, if needed, binding arbitration to reach agreement on a 10-year lease renewal.

Shortly after being elected the Council’s speaker earlier this year, Johnson pledged that he would hold a hearing on the long-snubbed bill. Yet, at the same time, he warned that the S.B.J.S.A. was “not a silver bullet,” in his opinion, and that an array of other strategies would also be needed to help small businesses survive.

Despite suffering from a bad chest cold — that sometimes saw him loudly coughing on the dais — Johnson sat through about four-and-a-half hours of Monday’s hearing, which was chaired by Mark Gjonaj, head of the Council’s Small Business Committee.

Johnson said small merchants provide essential services and products, mentioning “bodegas, laundromats, shoe-repair shops… .”

“When a longtime business is shuttered, we lose a piece of New York,” Johnson said.

Small businesses help make New York more livable in many ways, he noted, from providing essential services, like shoe repairs, to holding packages and mail for residential neighbors.

“I don’t have a doorman,” Johnson said. “I don’t need one. I have a deli right at my corner at 15th St. and Seventh Ave.”

At the same time, he said, “Advocates aren’t going to like this — I don’t think this bill is a perfect bill. … This is a complicated issue.”

He and other councilmembers also warned of potential “unintended consequences” of the S.B.J.S.A.

Former Borough President Ruth Messinger introduced the first version of the S.B.J.S.A. around 30 years ago when she was a city councilmember.

Gregg Bishop, the commissioner of the city’s Department of Small Business Services, made it clear that the de Blasio administration has issues with the S.B.J.S.A. Bishop said that because landlords often have more resources than their tenants, the arbitration process would not be fair. He also wondered if New York would have “enough arbitrators” to handle all the lease-renewal cases.

But Assemblymember Richard Gottfried, in his testimony later on, said the situation already is unfair toward the tenants and could not possibly be worsened by the S.B.J.S.A.

State Senator Brad Hoylman held out his report, “Bleaker on Bleecker,” which detailed the crisis of empty storefronts on the famed Village strip.

Johnson and others took issue with the fact that the bill would cover all commercial tenants in New York City — including not just ground-floor storefronts, but upper floors occupied by financial firms and white-shoe law firms.

As one speaker put it, “shopping malls” would even be covered by the S.B.J.S.A.

At the same time, Johnson repeatedly grilled Bishop on what the city plans to do about the problem of merchants’ rents “doubling, tripling, quadrupling and quintupling.”

Johnson repeatedly brought up the example of Tortilla Flats, the long-running and beloved far West Village bar and restaurant, that sadly is closing on Sat., Oct. 27, due to high rent.

“It just came out in the last two days that they are closing,” Johnson said. “Clayworks pottery was forced out of its spot in the East Village after 44 years,” he said, referring to another store that closed a year ago due to an unaffordable rent.

John Banks, president of the Real Estate Board of New York, said that the S.B.J.S.A. would “stifle” economic activity.

“The Associated Supermarket on 14th St. and Eighth Ave., one of the last affordable supermarkets in the Village — they tripled their rent, and that store is still empty,” Johnson said.

It was also noted that McNally Jackson, the independent bookstore on Prince St. in the Little Italy area, is being forced to leave its space.

The city’s retail landscape is at risk of being homogenized, Johnson said, stressing, “We can’t let that happen. We chose not to live in a city of corporate cookie-cutter businesses.”

Bishop didn’t have any ready answers on dealing with escalating rents. The S.B.S. commissioner did say that the department is open to the idea of a tax on storefronts that are left vacant too long — an idea endorsed by the mayor — and also of creating a “storefront registry,” to quantify how many empty stores there are around the city.

Jessica Lappin, a former Upper East Side councilmember, now president of the Downtown Alliance, said the retail landscape of her Lower Manhattan BID’s district has benefitted from flexibility, but that the S.B.J.S.A. would potentially lock commercial tenants in place for decades.

City Council Speaker Corey Johnson, right, spoke extensively during the hearing, which was chaired by Councilmember Mark Gjonaj, next to Johnson.

Jessica Walker, president of the Manhattan Chamber of Commerce, noted that online retail is really hurting bricks-and-mortar stores — currently gobbling up about 10 percent of all purchases — and will only grab more of the market in the years to come. She predicted some landlords would respond to the S.B.J.S.A. by simply not renting to small merchants. Similarly, Bishop, of S.B.S., said landlords could just choose not to rent their spaces to anyone if they felt they were being forced to lowball potential rents. Walker said pressing problems that the city should address instead are high commercial rent taxes and property taxes.

David Eisenbach, head of Friends of S.B.J.S.A., told the councilmembers he would be O.K. with cutting white-shoe law firms and such out of the bill’s protections, but that other tenants “on the second floor” — like yoga studios and dentists offices — need the bill’s protections. A Columbia professor, Eisenbach is running for public advocate, with the S.B.J.S.A. being one of his main campaign planks.

But others who have been advocating for the bill longer — in some cases, for decades — boycotted the hearing, slamming it as “a sham.” Eisenbach led a rally at noon before the hearing, touting the bill.

The group Community Control of Land Use New York held its own rally at 10 a.m. organized by Chelsea activist Marni Halasa. CCLUNY, as she explained it, is a group she founded after she ran for City Council “to educate small businesses and the public on the S.B.J.S.A. and organize activists, businesses and tenants to have a greater voice in land use decisions.” Joining that rally was Steve Barrison, of the Small Business Congress, whose members have angrily been predicting that Johnson and the Small Business Committee would “water down” the bill.

The Greenwich Village Society for Historic Preservation supports the S.B.J.S.A., as its executive director, Andrew Berman, made clear at the City Council hearing.

Meanwhile, members of Barrison’s S.B.C. don’t trust Eisenbach and his group. But Eisenbach says he is “playing the inside game” while the others have relegated themselves to being on “the outside” by publicly predicting Johnson will neuter the bill.

At one point, Johnson slammed the boycotters, the annoyance evident in his voice and body language as he huffily scoffed, “Advocates say, ‘No changes to the bill — none.’”

The Council speaker asserted that he is sincere in pushing the legislation.

“Today’s hearing is about moving this bill,” Johnson said. “It wouldn’t happen if we weren’t serious about it.”

Councilmember Ydanis Rodriguez, who is “carrying” the bill as its main sponsor, said, “We are here to get that bill across the finish line,” adding, “This is not about commercial rent control.”

There was a flurry of hand-waving in the audience.

Advocates say the strategy of REBNY and others is to confuse the S.B.J.S.A. with commercial rent control, which would standardize commercial rent increases across the city.

Some advocates had pushed in vain for the Council’s Legal Department to issue an opinion prior to the hearing that the bill is fully legal. But that is not usually done in the Council, and it didn’t happen this time either.

As Jaime McShane, REBNY’s senior vice president for communications, noted as he watched the proceedings, the Council leadership wouldn’t introduce a bill if they didn’t feel it was legal.

During the hearing, Gjonaj, the committee’s chairperson, said, “I don’t intend to deal with the legal issues of the bill [today]. I will leave that to the judges and the attorneys.”

As for what happens next, Johnson explained, the bill will now undergo modifications by the Council’s Legal Department.

The Villager asked for a time line of what will happen next — such as when the Council might vote on a modified bill — but a City Council spokesperson only responded in general terms.

“The Committee on Small Business heard testimony for about eight hours on this complex legislation, with over 120 members of the public signed up to testify,” the statement said. “A wide array of stakeholders gave helpful feedback on many aspects of the legislation, as well as proposing additional approaches to the small business crisis that need to be assessed. Now, the committee will immediately review the testimony and begin its work with advocates and the administration toward legislation that is properly targeted and effective.”

Gotham Gazette: With Full Democratic Control, Sponsors of New York Single-Payer Health Care Hopeful About 2019

Victor Porcelli, November 14

Though Governor Andrew Cuomo has not expressed support for instituting a single-payer health care system in New York, his fellow Democrats campaigned on the issue as they flipped control of the state Senate, landing all of state government into Democratic hands and providing a significant boost of optimism to the lead sponsors of the New York Health Act, which would create a government-administered single-payer health care system.

The bill has passed the Democrat-dominated state Assembly several times and all the members of Senate Democratic conference signed on as co-sponsors at the end of last legislative session in a unified show of support for the program heading into the election season.

Cuomo has said he supports a Medicare for all-type system at the federal level, but cast doubts on the cost and complexity of doing it in New York, and since their resounding wins on Election Day, the incoming leaders of the Democratic Senate majority have indicated that the massive undertaking of single-payer is not at the top of the agenda.

Still, with Democratic control of the Senate and the Assembly by wide margins, single-payer healthcare could be passed as early as the 2019 session, according to Assemblymember Richard Gottfried, chair of the Assembly Health Committee and lead sponsor of the New York Health Act.

“It was clear in the country and New York that healthcare was the number one issue on voters’ minds,” Gottfried said, before pointing to his legislation. “A solid majority of the new state Senate has either been a cosigner, voted for it in the Assembly, or campaigned on it. So I think we’re on track to get it passed in the Assembly and state Senate.”

The New York Health Act would replace health insurance companies with New York state government as the payer of healthcare costs for all New Yorkers. It has been passed in the Assembly four years running but has yet to be voted on in the Senate, where Republicans have held control. All of the other 30 Democratic senators joined lead sponsor Senator Gustavo Rivera of the Bronx to co-sponsor the legislation, though the Senate Democratic conference is seeing significant turnover due to primary wins by insurgent challengers. But, those challengers have in general been even more vocally supportive of single-payer health care than their more moderate predecessors. These facts give Gottfried confidence that the New York Health Act will pass during the 2019 session, which begins in January.

But the bill still faces an uphill battle, in part because of the massive changes it would institute, and the fact that though it might reduce overall individual and business healthcare costs after implementation, for the state to run the system it would require raising taxes significantly, something many Democrats have promised not to do and Cuomo is vehemently opposed to. It would also drastically impact the state’s private and public hospitals, the health insurance industry, and more. Some of the changes would of course be beneficial to New Yorkers, but the undertaking is complex and the New York Health Act as currently written leaves a lot of detail undetermined, including funding.

The governor has repeatedly opposed single-payer healthcare at the state level, suggesting that it would be more rational and financially feasible if administered by the federal government. Cuomo questioned in the past how a single-payer system could be put in place without doubling the tax burden, and cited California’s and Vermont’s debates over single-payer — which both ended when supporters were not able to answer one question: where would the funding come from? — as paragons of the impracticality of state-level single-payer.

Gottfried, a Manhattan Democrat, is confident that with his fellow lead sponsor Senator Rivera, who is likely to be the Senate health committee chair come January, and other legislators, he will be able to sway Cuomo to support the legislation.

“He’s obviously not on board yet, but he and his staff are very open to working with the Legislature on the issue,” Gottfried said. “I’m convinced we can satisfy their concerns.”

And after a recent study by RAND Corporation concluded that the New York Health Act would result in a reduction of administrative costs, provide all New Yorkers with healthcare, and reduce healthcare costs for most, Gottfried says the financing of the bill will not be a problem.

“New Yorkers are all going to have to think about what they will do with the hundreds of thousands of dollars that will end up in their pockets, and that’s a nice problem to have,” Gottfried said.

The study has a caveat, however, stating in its conclusion that “the estimated effects depend heavily on the assumptions about provider payments, administrative costs and drug prices.” Politico highlighted these assumptions as well as the likely tax increases that have largely been brushed aside by Democrats supporting the legislation. Wealthy people leaving the state, companies restructuring, the cost of hospital expenses rising at a faster rate or the Trump administration not issuing a federal waiver to redirect all healthcare-related funds to the new state entity are all possible events that could result in RAND’s conclusion falling apart.

For it to work, while health care costs drop, taxes would undoubtedly increase significantly for many New Yorkers. As cited by Politico, “a household reporting $150,000 in income would see its state tax rate increase from 6.45 percent in 2017 to 18.3 percent,” under one model scenario. Additionally, those who receive Medicaid or fall under the state’s Essential Plan, which subsidizes health insurance for low-income New Yorkers, have less to gain from the expansion. According to RAND, though, 1.2 million New Yorkers would gain health coverage.

It is likely that funds for New York single-payer health care would partially come from a new payroll tax, which RAND projects to fall largely on employers. However, RAND suggests the health act payroll tax would cost less for businesses already contributing toward employee health insurance and the Medicare payroll tax, estimating decreases in employer costs fairly quickly.

Concerns about businesses and high-income individuals leaving the state persist, with a tax atmosphere in New York that many, including Cuomo, acknowledge is already burdensome and became more so for many taxpayers, especially top earners, under the new federal tax code.

Senator Rivera, aware that cost is the primary argument against single-payer health care, repeatedly emphasized the need to work towards a version of the bill that would reduce the financial strain.

“I will continue working diligently with Assembly Member Gottfried, Senate Majority Leader Stewart-Cousins and the Senate Democratic Conference to make the New York Health Act a bill that is not only fiscally responsible, but that provides comprehensive coverage to all New Yorkers,” Rivera wrote in an email to Gotham Gazette.

The bill and its potential ramifications have been studied closely by Bill Hammond, director of health policy at The Empire Center, a think tank. “Regardless of which party controls the state Senate, the New York Health Act remains a wildly unrealistic idea,” Hammond said by email. “It means putting New York’s entire health-care system — representing one-fifth of the economy — in the hands of the same state government that struggles to run the subways. It requires massive, draconian tax hikes, enough to roughly triple total state revenues.”

“Plus, a true single-payer plan would need federal waivers that the Trump administration has vowed to block,” Hammond continued, also noting a political angle — that if Democrats spend great sums of money and political capital on a health care overhaul of this magnitude, what will they ignore, like fighting climate change or improving mass transit.

“It was easy to cast a symbolic yes vote for a single-payer bill that had no chance of passing,” Hammond said. “Now that that it might actually happen, supporters are going to be forced to confront the practical realities. Then, hopefully, they’ll focus on helping the 6% of New Yorkers who still lack insurance, rather than disrupting coverage for those who already have it.”

Rivera acknowledged that moving to single-payer would not satisfy everyone, especially those who benefit from the current system, and that there are negotiations to come that will likely adjust the bill to make it more palatable to holdouts.

“The biggest challenge will be to reach a consensus among stakeholders that the NY Health Act is feasible [and] fiscally responsible,” Rivera wrote.

Citing “healthcare practitioners, prescription drug companies, healthcare providers, employers, unions and New Yorkers,” as the various groups involved, Rivera also mentioned courting Cuomo as an important step to take in the coming legislative session.

“Our main priority for the next legislative session is to continue shaping the bill so that it is feasible, affordable, that the Governor is willing to sign, and that primarily, provides quality healthcare for everybody,” Rivera wrote. “During the next legislative session, we will focus on making the necessary amendments to the bill so that it truly reflects the different healthcare needs affecting all New Yorkers.”

For now, it is very difficult to imagine Cuomo coming on board, especially given the pains he’s taken to keep state spending increases at around 2 percent per year and to lower taxes. Asked about single-payer health care during a Thursday appearance on The Capitol Pressroom with host Susan Arbetter, Cuomo painted it as unrealistic given budget constraints. He said Democrats are generally in agreement on the concept, but legislators will have to deal with reality in working with him on a state budget next year, while he also said he thinks it’s much more workable on the federal level. “Single-payer health plan, for example,” Cuomo said, “conceptually I think it’s the right way to go in. I believe it’s more feasible financially on the national level. No state has been able to finance the transition costs.”

A variety of factors, including the challenge of getting Cuomo’s support and not wanting to come into power quickly pursuing something as revolutionary as single-payer health care, may be why the likely next Senate majority leader, Andrea Stewart-Cousins, and her likely deputy, Senator Michael Gianaris, have not highlighted it as top priorities for the coming session.

Assemblymember Gottfried noted that state Senators’ public approval of the bill gives him no reason not to “take them at their word,” and said he expects the legislation to move through the Legislature. He knows that private health insurers are certain to vehemently oppose the continued push.

“The insurance industry will be fiercely lobbying against the bill and they have a lot of money, going up against their lobbying will take a lot of work,” Gottfried said. “but I’m convinced with so many senators on the record in support of the bill, we will prevail.”

Bushwick Daily: City Food Carts Will Start Having Letter Grades This December

By Jarrett Lyons, November 13

How often do you let the giant letter displayed in New York City restaurant windows dictate whether you’ll eat there? Soon, you’ll be able to take letter grades into account when you want a quick bite from a food cart or truck on the street.

“New Yorkers are known around the world for always being on the go – and New York is known around the world for the amazing diversity of its street food, ranging from halal hot dogs to curry in a hurry,” said Assembly Member Richard N. Gottfried, Chair of the Assembly Committee on Health in a recent press release.

The Assembly Member also outlined that though they should be celebrated, food carts should also meet uniform health standards, just like brick and mortar restaurants have to. 

The Health Department published their rules in the city record for the implementation of a letter grading program for mobile food vendors. Like the regulations used in restaurants since 2010, vendors will receive points for health code violations which will dictate whether there’s an “A,” “B” or “C” hanging on their cart or truck.

“Letter grades on food carts and trucks will help New Yorkers see how these businesses fared on their latest inspection, right when they want to place an order,” said Acting Health Commissioner Dr. Oxiris Barbot. “Just as diners appreciate letter grading in restaurants, we expect this program to be popular among customers.” 

All of New York City’s whopping 5,500 authorized food carts and trucks will be required to post their grade. The Health Department plans to attach location-sharing devices on each unit in order to keep track of when a vendor is due for inspection.

The project is estimated to take about two years to roll out, similar to the 2010 restaurant grade roll out. The department says this information will be protected and only accessible to their staff or a court order.

“I cannot imagine someone not looking for a restaurant’s letter grade from our city’s Health Department before deciding whether or not to patronize a restaurant. The letter grade has become absolutely essential as it relates to restaurants.” said Council Member Karen Koslowitz,a prime sponsor of the new law.

To prep for the roll-out, the Health Department will be hosting food safety education workshops for mobile food vendors. The classes will acclimate vendors to the grading program, a refresher of food handling and common food safety violations that are easily avoided. According to the department’s website, the schedule of Spring classes will be posted in early 2019.

“Yet, every day, countless numbers of people in New York purchase food from a street vendor without knowing to a general degree the cart’s compliance with the NYC Health Code,” said Council Member Koslowitz. “I believe that the customers who buy food from a street vendor deserve to have the same ability to make an informed decision as do patrons of restaurants.”

Bushwick Daily will continue to report on how this will potentially affect Bushwick’s many food vendors.