Tag single-payer

PRESS RELEASE: Patients, Providers, Labor, and Others to Testify at Legislative Hearing in Rochester on Universal Single-Payer Health Care

CONTACT:
Mischa Sogut, 518-455-4941 or 202-365-5475
SogutM@nyassembly.gov

October 2, 2019

The NY Senate and Assembly Health Committees will hold a public hearing and press conference in Rochester on October 10 on the New York Health Act.

Millions of New Yorkers with insurance go without needed health care or face serious financial obstacles, debt and bankruptcy to get it.

The New York Health Act, A.5248/S.3577, would establish universal, comprehensive single-payer health coverage, including long-term care, for all New Yorkers. The program would be publicly funded, including existing federal support for Medicaid and Medicare. New Yorkers would no longer have to pay premiums, deductibles, co-pays, out-of-network charges, or have limited provider networks.

The Rochester hearing is the second in a series of statewide hearings, with other hearings to be scheduled in New York City and the Hudson Valley. The hearings will provide an opportunity for comments and suggestions from stakeholders around the state on the New York Health Act. Video and a transcript of the first hearing, held in Albany on May 28, can be found here.

More information, including a form if you wish to be invited to testify, can be found here.

What:
Public hearing and press conference on the New York Health Act, A.5248/S.3577

Who:
New York State Assembly and Senate Health Committees; witnesses including patient advocates; health care provider organizations; labor representatives; small business; and other health care experts and advocates

Where:
Press Conference: Bausch and Lomb Parlor
Hearing: Memorial Art Gallery Ballroom

University of Rochester
500 University Avenue
Rochester, NY 14607

(The Parlor and Ballroom are across the hall from each other)

When:
Press Conference: Thursday, October 10, 9:30 AM
Hearing:Thursday, October 10, 10:00 AM

The hearing will also be webcast live at: https://nyassembly.gov/av/

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Times-Union: At packed hearing, NY lawmakers weigh single-payer health care

At a lengthy, packed hearing on the bill held Tuesday in Albany, lawmakers heard from hospitals, health care leaders, municipal officials, patients, advocates, union leaders and others who all agreed that its goal of providing comprehensive, universal coverage to New Yorkers is laudable. But whether single-payer is the system to achieve that was the topic of spirited debate.

WAMC Radio: NY Legislature Holds Single-Payer Health Care Hearing

The New York State legislature held a daylong hearing Tuesday on a proposal to enact single-payer health care in New York. Supporters and opponents debated whether it’s the answer to the state’s health care
gaps.

Chair Richard Gottfried, a Democrat and prime sponsor of the legislation, known as the New York Health Act, laid out the problem. Millions of New orkers have some form of health coverage, he said. But many still face financial obstacles from private insurance companies in getting the care they need, because of unaffordable co-pays or coverage denials.

Gottfried and Rivera make the case for single-payer health care

If the New York Health Act were to become law, it would revolutionize health care in the United States. No state has ever successfully implemented a single-payer system at such a scale, but the chairs of the Assembly and state Senate health committees say it can be done. City & State caught up with Assemblyman Richard Gottfried and state Sen. Gustavo Rivera to discuss the bills they are sponsoring in their respective chambers and how they think the proposal can make its way through the Legislature.

The Nation: “Richard Gottfried’s Health Care Crusade Is Paying Off”

Two posters hang on the door of New York State Assembly member Richard Gottfried’s Albany office. One has a picture of Dr. Martin Luther King Jr., underneath a quote: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” The other says “Healthcare is a Human Right!” and urges the reader to “Pass the New York Health Act.”

Single-payer healthcare campaign kicks off in Albany

A broad coalition of seniors, people with disabilities, caregivers, home care providers and advocates joined the bills’ sponsors, Assemblyman Richard Gottfried and Sen. Gustavo Rivera, as they kicked off a 2019 New York Health Act push at the state Capitol on Monday.

WXXI: Single-payer sponsors release new, revised plan

Sponsors of a measure to create a single-payer health care system in New York have offered a revised bill, but its future is uncertain. Gov. Andrew Cuomo said the state might not be able to afford it.

Assembly sponsor Richard Gottfried, who has championed the issue of single-payer
for several years, said the bill, known as the New York Health Act, has now been amended to include coverage for long-term health care, including home health aides and nursing homes.

Times-Union: NY lawmakers voice vaping, single-payer concerns

ALBANY — New York’s top health officials told lawmakers Tuesday they are unsure how an unexpected $2.3 billion state budget shortfall next year might impact their budgets.

VICE News: This Brewing Healthcare Battle Is a Preview of the Medicare for All War

By Harry Cheadle, 12/13/18

Last month, Democrats achieved an historic win in New York, flipping control of the state senate and thus taking control of the entire government, upending a weird status quo during which a group of breakaway Democrats allowed the Republicans to control the legislature’s upper chamber. Now that they actually have the power to pass laws in one of the most Democratic states in the country, the possibilities seem intoxicating for the left: Abortion access could be codified into law, the subways could finally be fixed, the state’s byzantine election laws could be updated, and New York could commit to fighting climate change.

But right near the top of any progressive wish list is the New York Health Act, the state’s version of Medicare for all—which is to say universal, government-provided—health insurance. Single-payer healthcare, as such systems are also called, has been a left-wing lodestar for generations. If the NYHA passed, it would make New York the first state in the union to guarantee free access to healthcare (and freedom from fear of health-related bankruptcy) to all of its residents, including undocumented people. 

If passed and smoothly implemented, NYHA could be not just a way to improve the lives of New Yorkers but a model for the rest of the country as it debates the merits of Medicare for all, a policy backed by Bernie Sanders and many other potential 2020 presidential contenders. But now that Democrats can actually pass the NYHA, single-payer supporters are facing a fight that could pit them against not just the insurance industry but a host of Democratic constituencies and leaders—a preview of the contentious debate over healthcare that might follow victories in 2020.

The foremost obstacle is the powerful medical industry lobby, which will likely deploy the usual counterattacks—think the “death panels” of the Affordable Care Act debate, or the fear-mongering “Harry and Louise” ads that helped scuttle reform in the 90s. Then you have Democratic lawmakers who may hesitate to back a transformative proposal that would raise taxes on a lot of people, a governor who doesn’t seem particularly warm to the idea, a hostile federal government, and potential lawsuits from employers. While the coming NYHA battle represents a possible turning point in the history of healthcare politics, it won’t be a pretty sight.

Yet if single-payer advocates could get past all that, they’d have a roadmap to victory in other states—and a model that could be replicated in DC.

Richard Gottfried, the chair of the New York State Assembly’s Health Committee and the chief architect of the NYHA, recently explained what it would look like. “It would create universal complete health coverage for every New York resident without premiums, deductibles, copays, or restricted provider networks,” he said over the phone. The bill would pay for this by pooling the money the state gets from the federal government for programs like Medicaid and Medicare, and also by raising taxes. “There would be one tax on payroll income, predominantly paid by employers, and a parallel on unearned income like dividends, capital gains,” Gottfried explained.

This would transform the way New Yorkers pay for healthcare—instead of giving premiums to insurers, they’d be getting taxed—and according to a recent studyby the RAND Corporation, overall health spending would drop by $80 billion, or 2 percent, by 2031, even as the roughly 1.2 million currently uninsured New Yorkers gained access to care. Gottfried said he didn’t necessarily agree with RAND’s report (for one thing, his bill as currently written does not specify tax rates, so RAND analysts made assumptions about what those rates would be) but NYHA backers have trumpeted the finding that the bill could drive costs down.

The arguments against the NYHA are echoes of the normal arguments marshaled against single-payer healthcare. Realities of Single Payer, an anti-NYHA organization made up mostly of business and health insurance interests, warns of high taxes, long wait times for care under a government-run system, and job loss in the insurance industry. (Through a spokesperson, Realities of Single Payer said in a statement that “rather than throwing out a functioning system for a very uncertain future, there should be a greater focus on covering the remaining uninsured New Yorkers.”) Katie Robbins, the director of Campaign for New York Health, a coalition of unions, doctors, and left-leaning groups, called these warnings “talking points that are used to create fear” and noted that this year’s election proved single-payer was popular statewide.

“There’s been a longtime narrative, a false narrative in my opinion, that this is an issue that only New York City liberals care about,” Robbins said. “But what we saw reflected in the results is that Senate candidates outside of New York City—Long Island, Hudson Valley, upstate in Syracuse—who ran on the New York Health Act, not just standing on it, but making it a priority of their campaign… handily won their elections.”

Those election results create pressure on Democrats, according to Hank Sheinkopf, a longtime Democratic consultant in the state who has worked for everyone from Andrew Cuomo to Michael Bloomberg to Bill Clinton: “They have to do something.”

The NYHA—which Gottfried has introduced into the Assembly every year since 1992—has passed the lower legislative chamber in each of the past four years. But even with increased support in the Senate, its path to becoming law is tricky to say the least. The top Democrat in the State Senate, Andrea Stewart-Cousins, seemingly embraced the NYHA last year, but after the election said Democrats wouldn’t raise taxes. And while Governor Andrew Cuomo said the NYHA was a good idea “in theory” during a debate against his left-wing primary challenger Cynthia Nixon, he was also skeptical of the cost and said he’d like to see single-payer healthcare be implemented on a federal, rather than state, level. (Neither Stewart Cousins nor Cuomo responded to requests for comment left with their offices.)

Meanwhile, unions remain a powerful force in state politics—especially in New York City—and some might oppose the NYHA because members generally have good insurance they won through negotiations and may not want to replace that with government-provided plans. Other barriers include the Trump administration potentially refusing to grant waivers to New York that some say would be necessary for the plan to be implemented (Gottfried disputed that such waivers would be needed) and potential lawsuits from employers under a federal statute called ERISA that protects employers who choose to pay insurance claims themselves.

It’s also not even clear the NYHA will pass the Assembly when the legislature goes back into session in January. “It’s like starting from scratch because the political dynamics changed so much,” Robbins said. In other words, now that everyone knows the NYHA may actually become law, some Democrats may have second thoughts about voting for it.

Gottfried, for one, seemed confident of the bill’s chances. “I fully expect the Assembly to pass the bill again,” he said. He added that he and NYHA Senate sponsor Gustavo Rivera were talking to stakeholders to flesh out the details of the bill and add “additional provisions” to speed its passage through the Senate. They were also “working to convince” Cuomo that the NYHA was the way to go, Gottfried said.

If Gottfried and his allies can pass the legislation quickly in early 2019, it will put Cuomo on the spot, former Assembly member Richard Brodsky—a frequent Cuomo critic—argued in a recent Albany Times-Union column: “Anything short of immediate support puts him under the same kind of statewide and national pressure, intensified by any presidential ambitions he may have.” It’s safe to say that reticence on Cuomo’s part will spark widespread progressive anger. “If Andrew Cuomo’s first appearance in 2019 is to put a bullet through the head of single-payer, it will have political consequences,” Brodsky said in an interview.

If the dynamics of passing the NYHA seem complicated, welcome to a preview of what national politics may look like in 2021. If Democrats can retake control of the federal government in the 2020 elections, they will have likely done so while promising single-payer healthcare, just as New York Democrats did. But passing a bill through Congress will require selling it to voters in the face of intense opposition from insurance companies and the medical industry, and also navigating the push and pull of other priorities like climate change. Medicare for all can seem like a common-sense solution to the country’s patchwork, inhumane, and overpriced healthcare system when advocates talk about it, and it’s popular in many polls. But history suggests the politics turn thorny when government-provided health insurance becomes a real possibility.

“You’re treading into unknown territory here. There’s no map for how to get this down the road.”
–Richard Brodsky

Recent single-payer pushes have come tantalizingly close in other states, only to fail, sometimes in dramatic fashion. In 2014, Vermont Governor Peter Shumlin pulled the plug on a single-payer bill, saying his state couldn’t pay for it. Two years later, a Colorado ballot measure that would have created a single-payer system was rejected by voters after a confusing election-season scrum—abortion-rights groups opposed the measure because the new system wouldn’t have covered such procedures. Last year, a California single-payer bill was effectively axed by Assembly Speaker Anthony Rendon, who said it was “woefully incomplete” and didn’t describe how the system would be paid for. (Single-payer advocates were so incensed they subsequently attempted to remove Rendon from office.)

Gottfried said that unlike the California bill, the NYHA clearly describes where the funding would come from, and unlike Vermont, New York has enough wealth to make paying for a single-system more practical. But other Democratic factions, including some unions and the governor, may not be persuaded by those arguments, setting up a fight between single-payer advocates and the rest of the party, with lawmakers caught in the middle.

As Robbins pointed out, six of the eight former members of the Independent Democratic Caucus—the rogue Democrats who gave control of the Senate to Republicans—lost primaries to grassroots opponents earlier this year, indicating the same base that is demanding single-payer has some teeth. “I would think that the folks who are in elected office now should really figure out how to deliver what they promised in their campaigns,” she said, “because clearly there is a motivated base with high expectations and now the electoral muscle to make them pay at the polls if they don’t deliver.”

That said, Robbins added that “there’s absolutely no guarantee” the bill will pass, and a lot could depend on pressure from activists. Brodsky suggested NYHA sponsors consider a “toned down” bill that is less costly and helps manage the transition so as to address criticisms about job losses in healthcare. He also said Gottfried had the “political shrewdness” to get it done.

“You’re treading into unknown territory here. There’s no map for how to get this down the road. It’s an enormous challenge,” Brodsky said, adding, “the political climate has changed from roughly unfavorable to roughly favorable. That’s not chopped liver.”

The battle over the NYHA will be a state-level political knife fight, but the stakes could be even higher than the future of healthcare in New York. The hope among advocates is that once a single-payer system gets a foothold in one state, it can be exported around the country. The passage of the NYHA would not be the end point of the movement, but the beginning of a new chapter.

“Social progress in this country historically, usually begins at the state level,” Gottfried said. “Our labor laws, a lot of our consumer protection laws, public support for healthcare for poor people, the child health insurance program—all began at the state level.”

City & State: Has single-payer health care’s time finally come?

By Rebecca Lewis, 12/9/18

With their new majority in the state Senate, Democrats are finally preparing to pass long-stalled progressive legislation. Perhaps the most expansive and expensive item on the agenda – and among the most controversial – is the New York Health Act, which would establish a single-payer health care system in the state, and one study estimated it would cost $139 billion in 2022. Many incoming lawmakers campaigned on the promise that they would get it done, but even if it does pass, it likely won’t be implemented right away.

The Democratic-controlled Assembly has passed the legislation every year since 2015, but in that time it never came up for a vote in the state Senate thanks to the Republican majority. Now that the chamber will be in Democratic hands, the legislation seems far more likely to pass.

A single-payer health care system means that a single entity covers the cost of all health care, which is still delivered by private or nonprofit providers. Everyone pays into a single plan run by the government, which in turn is the only provider of coverage paying claims. Assemblyman Richard Gottfried’s single-payer bill has proposed one public option and a ban on the sale of private insurance unless it offers additional coverage not included in the state plan.

One major obstacle the New York Health Act must overcome is a less than enthusiastic governor. Although Gov. Andrew Cuomo has expressed support for single-payer health care as a concept, he has repeatedly said that it would be better implemented at the national level. In a recent interview on WCNY, he expressed doubt that the state would be able to finance the $150 billion program, since that would nearly double the state’s budget. “There will be rhetorical desire to do things,” Cuomo said. “Governmentally there will have to be a reality test to get all things to fit in the budget.”

Although this sounds like it could put a serious damper on the future of the legislation, Gottfried called the governor’s stance “a perfectly reasonable position for a governor,” noting that Cuomo is already far more progressive than other governors by simply supporting the concept of single-payer health care. Gottfried said he has been in talks with the administration and expects those conversations to accelerate now that passage is more realistic.

Gottfried said that stakeholders who have remained quiet in the past are coming forward to voice their concerns. Most recently, Gottfried and state Sen. Gustavo Rivera, the bill’s Senate sponsor, have been negotiating with New York City public unions over concerns that union members would pay more or have fewer benefits. “What we’re talking about is modifications just to accommodate concerns that people are raising now that it looks like it can easily pass both chambers this session,” Gottfried told City & State. “People who we haven’t heard from are starting to come forward and say, ‘Gee, could you add this nuts and bolts?’ or ‘Tighten it up here.’’”

Gottfried said making tweaks to the bill will continue at least a couple weeks into the session, which begins in early January. However, Gottfried said that he and Rivera will not make any major structural changes to the bill and said the Assembly is “well positioned” to pass the bill this upcoming session.

People who we haven’t heard from are starting to come forward and say, ‘Gee, could you add this nuts and bolts?’ or ‘Tighten it up here.’ – Assemblyman Richard Gottfried

Rivera expressed more caution, telling City & State that he feels confident that the chamber will engage in meaningful conversations about the bill, which it has never done before, but did not want to make any promises about a timeline for passage. “This is not a simple thing that we’re trying to do,” Rivera said. “We want to make sure that we don’t put anything up for a vote, to be signed by the governor, unless it’s ready to go.”

Bill Hammond, a health policy expert at the right-leaning Empire Center for Public Policy, argued that no amount of change to the New York Health Act would actually make the legislation viable. “I think (Gottfried and Rivera’s) posture right now is not to acknowledge the sacrifice, it’s to make it even more attractive to whatever interest group thinks they’re going to lose,” Hammond told City & State. He added that any changes would likely add to the already astronomical cost of the bill.

But Gottfried maintained that a single-payer system will lead to lower overall health care spending despite the introduction of a new payroll tax because the average New Yorker would no longer pay insurance premiums and copays. He cited the Rand Corp. study, commissioned by the New York State Health Foundation, which found total health care spending could be lower under the New York Health Act than under the status quo. “To me, the issue is not about where your check goes,” Gottfried said. “What people really care about is how much are they going to have to spend, and how much they will be able to keep under the New York Health Act.”

However, Hammond pointed out that since there is no precedent for the system in the country, the details of the new tax plan have not been worked out yet and it is hard to accurately predict the cost of the program, so the Rand study could be wrong. He added that it also hinges on the federal government providing waivers to in order to divert Affordable Care Act, Medicare and Medicaid funding into the single-payer system, an unlikely prospect with the current administration. “There’s all kind of doubt and uncertainty about who’s going to pay more and who’s going to pay less,” Hammond said.

Rivera dismissed the idea that the New York Health Act depends on receiving those federal waivers, saying they would be helpful, but not necessary. “We believe, both my colleague and myself, believe that there are ways within the system that we could actually extend the New York Health Act as a wraparound service that would ultimately not require waivers,” Rivera said. He added that since the single-payer system would take years to put into place, he remained hopeful that a different, more sympathetic administration would be in the White House by then.

Another sticking point in evaluating and passing the New York Health Act is the fact that the previous legislation contained no specific language on tax rates for the proposed payroll tax, forcing Rand to use a hypothetical tax schedule. Gottfried said no language about tax brackets will be added to the legislation that he and Rivera will introduce and that it will be worked out after the bill’s passage since the program will take years to implement. He added the absence of this information will not pose an impediment to passage and that it could be easily added in if it becomes necessary.

Despite the many obstacles the legislation appears to face, Gottfried said that he and Rivera have learned from their previous mistakes, such as not including a revenue stream, and they remain confident New York will lead the country in single-payer health care. “Anything has to start with somebody,” Gottfried said. “And New York is ideally suited to be the state that begins single-payer coverage.”