The New York Health Act passed the New York State Assembly
In a vote that was 89-47, the New York State Assembly voted for a single-payer health bill today, Wednesday, 27 May, 2015.
The New York Health Act passed the New York State Assembly.
Health Committee Chair Richard Gottfried had introduced this bill annually since 1992 and today there was a vote that passed the bill. The bill would have to be taken up in the Senate as well.
We’re linking to the economic analysis of the New York Health act by University of Massachusetts/Amherst Economics Department Chair Gerald Friedman here.
“New Yorkers deserve better, We should be able to go to the doctor when we need to, without worrying whether we can afford it. We should choose our doctors and hospitals without worrying about network restrictions. We deserve health coverage for all of us, paid for based on our ability to pay, not what the market will bear. I’m proud the Assembly has passed the New York Health Act, and I look forward to working with a great community of advocates including medical professionals, medical students, organized labor, and Senate sponsor Bill Perkins, to enact it into law.” – Assemblyman Richard Gottfried
The New York Health Act would remove the insurance carriers from the process and it would be funded by payroll taxes similar to payroll taxes deducted for Medicare. It is said that employers would pay 80% and employees would pay 20%.
What follows are excerpts from today’s press release:
Assembly Passes Universal Health Care Bill
“Assembly passage of New York Health will elevate the issue on the public agenda and change the conversation from ‘it’s a great idea that will never happen’ to a truly achievable goal,” said Assembly Health Committee Chair Richard N. Gottfried, lead Assembly sponsor of the bill.
New York Health would provide universal, comprehensive health care to all New Yorkers without premiums, co-pays, deductibles, or limited provider networks.
The last time a universal health care bill was on the Assembly floor it passed with a solid majority. “But then, the focus of reform shifted to Washington. While the federal Affordable Care Act has done a lot of good, it’s clear that a lot of problems remain – and if we want to fix them, we have to do it ourselves,” Mr. Gottfried said.
“Funding and administering health insurance is the primary uncontrolled burden on local budgets,” said Albany City Treasurer Darius Shahinfar. “The question for me is how these hidden costs of health care – insurance company profit, administrative waste and inefficiency, mandatory local Medicaid spending – affect our local taxes. The facts are undeniable: New York Health, based on my conservative estimates, would reduce City and School District tax rates by at least 20% and could eliminate many County property taxes entirely. Getting full health care coverage while cutting property taxes seems like a no-brainer to me.”
In December and January, the Assembly Health Committee held hearings on the bill in Syracuse, Rochester, Buffalo, New York City, Mineola, and Albany. The Committee heard testimony from almost 200 witnesses including New Yorkers with insurance who are bankrupted by their deductibles; patients who lose trusted providers due to restricted networks; doctors who spend hours on the phone negotiating with insurance bureaucrats; and medical students who “signed up for medical school, not business school.”
The New York Health Act removes financial barriers to health care – the co-pays and deductibles – that keep some of my patients from seeing me when they need to,” said Oliver Fein, MD, Chair of Physicians for a National Health Program-NY Metro. The New York Health Act is a universal, single payer system that would guarantee equal access to care that is funded fairly – something every New Yorker and resident of this country deserves.”
New York Health would be a boon to business. Employer spending on health care eats up a median 12.8% of payroll costs on health insurance, up more than 50% in a decade, with small businesses spending even higher percentages. According to the Friedman study, New York Health could be funded through an income assessment averaging just 8.1% of payroll.”
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The bill summary and progress report is here.
BILL NO A05062
SAME AS SAME AS S03525
SPONSOR Gottfried (MS)
COSPNSR Abinanti, Barron, Benedetto, Bichotte, Blake, Bronson, Brook-Krasny,
Clark, Colton, Cook, Crespo, Cymbrowitz, Dinowitz, Englebright,
Gantt, Hikind, Jaffee, Jean-Pierre, Joyner, Kavanagh, Kim, Lavine,
Lifton, Linares, Lupardo, Mosley, Peoples-Stokes, Perry, Pichardo,
Ramos, Roberts, Rodriguez, Rosenthal, Russell, Schimel, Seawright,
Sepulveda, Steck, Stirpe, Titone, Titus, Walker, Weinstein, Weprin,
Dilan, Gjonaj, Richardson, Moya
MLTSPNSR Abbate, Arroyo, Aubry, Brennan, Cahill, Davila, Fahy, Farrell, Glick,
Gunther, Hooper, Lentol, Magee, Magnarelli, Markey, Mayer, McDonald,
O’Donnell, Ortiz, Paulin, Persaud, Pretlow, Quart, Rivera, Robinson,
Rozic, Simon, Skartados, Solages, Thiele, Wright
Ren Art 50 SS 5000 – 5003 to be Art 80 SS8000 – 8003, add Art 51 SS5100 – 5110,
Art 49 Title 3 SS4920 – 4927, amd S270, Pub Health L; add S89-i, St Fin L
Establishes the New York Health program, a comprehensive system of access to
health insurance for New York state residents: provides for administrative
structure of the plan; provides for powers and duties of the board of trustees,
the scope of benefits, payment methodologies and care coordination; establishes
the New York Health Trust Fund which would hold monies from a variety of
sources to be used solely to finance the plan; enacts provisions relating to
financing of New York Health, including a payroll assessment, similar to the
Medicare tax; establishes a temporary commission on implementation of the plan;
provides for collective negotiations by health care providers with New York
BILL NO A05062
02/11/2015 referred to health
02/26/2015 reported referred to codes
05/19/2015 reported referred to ways and means
05/21/2015 advanced to third reading cal.415
05/27/2015 passed assembly
05/27/2015 delivered to senate
05/27/2015 REFERRED TO HEALTH
TITLE OF BILL: An act to amend the public health law and the state
finance law, in relation to enacting the “New York health act” and to
establishing New York Health
PURPOSE OR GENERAL IDEA OF BILL:
This bill would create a universal single payer health plan -New York
Health – to provide comprehensive health coverage for all New Yorkers.
SUMMARY OF SPECIFIC PROVISIONS:
Every New York resident would be eligible to enroll, regardless of
age, income, wealth, employment, or other status.
There would be no premium, deductibles, or co-pays. Coverage would be
publicly funded. The benefits will include comprehensive outpatient
and inpatient medical care, primary and preventive care, prescription
drugs, laboratory tests, rehabilitative, dental, vision, hearing, etc.
– all benefits required by current state insurance law or provided by
the state public employee package, Family Health Plus, Child Health
Plus, Medicare, or Medicaid, and others added by the plan.
Everyone would choose a primary care practitioner or other provider to
provide care coordination – helping to get the care and follow-up the
patient needs, referrals, and navigating the system. But there would
be no “gatekeeper” obstacles to care.
As with most health coverage, New York Health covers health care
services when a member is out of state, either because health care is
needed while the member is traveling or because there is a clinical
reason for going to a particular out-of-state provider.
A broadly representative Board of Trustees will advise the
Commissioner of Health. Long-term care coverage is not included at the
start, but the bill requires that the Board develop a plan for it
within five years of passage.
Health care providers, including those providing care coordination,
would be paid in full by New York Health, with no co-pays or other
charges to patients. The plan would develop alternative payment
methods to replace old-style fee-for-service (which rewards volume but
not quality), and would negotiate rates with health care provider
organizations. (Fee-for-service would continue until new methods are
The bill would authorize health care providers to form organizations
to collectively negotiate with New York Health.
Health care would no longer be paid for by insurance companies
charging a regressive “tax” – premiums, deductibles and co-pays –
imposed regard- less of ability to pay. Instead, New York Health would
be paid for by assessments based on ability to pay, through a
progressively-graduated payroll tax (paid 80% by employers and 20% by
employees, and 100% by self-employed) and a surcharge on other taxable
income. A specific revenue plan, following guidelines in the bill,
would be submitted to the Legislature by the Governor.
Federal funds now received for Medicare, Medicaid, Family Health and
Child Health Plus would be combined with the state revenue in a New
York Health Trust Fund. New York would seek federal waivers that will
allow New York to completely fold those programs into New York Health.
The “local share” of Medicaid funding – a major burden on local
property taxes – would be ended.
Private insurance that duplicates benefits offered under New York
Health could not be offered to New York residents. (Existing retiree
coverage would be phased out and replaced with New York Health.
The state constitution states: “The protection and promotion of the
health of the inhabitants of the state are matters of public concern
and provision therefor shall be made by the state and by such of its
subdivisions and in such manner, and by such means as the legislature
shall from time to time determine.” (Article XVII, S 3.) All residents
of the state have the right to health care.
New Yorkers – as individuals, employers, and taxpayers – have
experienced a rapid rise in the cost of health care and coverage in
recent years. This increase has resulted in a large number of people
without health coverage. Businesses have also experienced
extraordinary increases in the costs of health care benefits for their
employees. An unacceptable number of New Yorkers have no health
coverage, and many more are severely underinsured.
Health care providers are also affected by inadequate health coverage
in New York State. A large portion of voluntary and public hospitals,
health centers and other providers now experience substantial losses
due to the provision of care that is uncompensated. Individuals often
find that they are deprived of affordable care and choice because of
decisions by health plans guided by the plan’s economic needs rather
than their health care needs.
To address the fiscal crisis facing the health care system and the
state and to assure New Yorkers can exercise their right to health
care, this legislation would establish a comprehensive universal
single-payer health care coverage program, funded by broad-based
revenue based on ability to pay, and a health care cost control system
for the benefit of all residents of the state of New York.
The state will work to obtain waivers relating to Medicaid, Family
Health Plus, Child Health Plus, Medicare, the Patient Protection and
Affordable Care Act, and any other appropriate federal programs, under
which federal funds and other subsidies that would otherwise be paid
to New York State will be paid by the federal government to New York
State and deposited in the New York Health trust fund. Under such a
waiver, health coverage under those programs will be replaced and
merged into New York Health, which will operate as a true single-payer
program. If such a waiver is not obtained, the state shall use state
plan amendments and seek waivers to maximize, and make as seamless as
possible, the use of federally-matched health programs and federal
health programs in New York Health, The goal of this legislation is
that coverage be delivered by New York Health and, as much as
possible, the multiple sources of funding will be pooled with other
New York Health funds and not be apparent to New York Health members
or participating providers.
This program will promote movement away from fee-for-service payment,
which tends to reward quantity and
requires excessive administrative expense, and towards alternate
payment methodologies, such as global or capitated payments to
providers or health care organizations, that promote quality,
efficiency, investment in primary and preventive care, and innovation
and integration in the organizing of health care.
This act does not create any employment benefit, nor does it require,
prohibit, or limit the providing of any employment benefit.
In order to promote improved quality of, and access to, health care
services and promote improved clinical outcomes, it is the policy of
the state to encourage cooperative, collaborative and integrative
arrangements among health care providers who might otherwise be
competitors, under the active supervision of the commissioner. It is
the intent of the state to supplant competition with such arrangements
and regulation only to the extent necessary to accomplish the purposes
of this act, and to provide state action immunity under the state and
federal antitrust laws to health care providers, particularly with
respect to their relations with the single-payer New York Health plan
created by this act.
PRIOR LEGISLATIVE HISTORY:
1992: A.8912-A passed Assembly
1993: A.5900 reported to Ways and Means
1994: A.5900 referred to Health Committee
1995-96: A.6801 reported to Ways and Means
1997-98: A.6172 reported to Ways and Means
1999-00: A.3571 reported to Ways and Means
2001-02: A.6779 reported to Ways and Means
2003-04: A.6952 reported to Ways and Means
2005: A.6576 reported to Ways and Means
2006: A.6576 referred to Health Committee
2007-08: A.7354 – reported to Ways and Means
2009-10: A.2356- referred to Health Committee
2011-12: A.7860-A – referred to Ways and Means
2013: A5389 referred to Health Committee
2014: A5389 – reported to Ways and Means
Full funding for New York Health would come from the revenue measures
to be proposed by the Governor under guidelines in the bill, plus
available federal funds. The revenue package would also replace:
local share of Medicaid, the state share of Medicaid, state and local
payments for public employee health coverage, and various other health
care spending. Numerous analyses document that a single-payer system
would be most effective for reducing and controlling costs, for
taxpayers, employers and individuals.
Immediately. The program will actually begin functioning when the
Commissioner of Health declares the beginning of the implementation