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Single-payer health care an issue in New York governor's race

Single-payer health care for New York has become an issue in the race for governor. Democratic primary challenger Cynthia Nixon say if she’s elected, she’d enact single-payer for New York. Not all of her opponents think that’s a good idea.

Nixon wants New York to adopt a health care system that would bypass insurance companies and expand existing government-funded health care for seniors to all New Yorkers. She spoke to supporters recently in Albany.

“We can have a New York with a single-payer Medicare-for-all system,” Nixon said as the crowd applauded.

In a video released by her campaign, she said her mother’s ordeal with breast cancer when Nixon was a teenager helped shape her view.

“When I was 13, my mom found a lump in her breast that she rightly suspected was cancerous,” Nixon says in the video.

She said her mother, who was unemployed and without health insurance, got a job with health benefits, then waited a month to go to the doctor so that she could not be disqualified for care because she had a pre-existing condition.

“After four weeks, she went to the doctor, and she had to act surprised when he pointed out the lump,” Nixon said.

Her mother received treatment and recovered.

The single-payer measure, known as the New York Health Act, has been approved several times in the state Assembly but it has stalled in the Senate. Nixon blames her opponent in the Democratic primary for governor, incumbent Andrew Cuomo, for the bill’s failure. Cuomo, until this past spring, backed a group of breakaway Democrats in the Senate who helped Republicans keep control of the chamber.

The RAND Corporation released a cost analysis study of the plan, and found that it would lower costs for patients and providers, and would save the health care system in the state $15 billion over the next 12 years. But it would require nearly $140 billion in new tax revenue by 2022 to make up for the loss of health insurance premiums and co-pays to the health care system. That’s one-and-a-half times more than the state currently collects in revenue.

It would also require the Trump administration to grant a waiver to New York to set up the plan.

Cuomo has expressed support in the past for the idea of a single-payer system, saying on WNYC in September 2017 that it is an “exciting possibility.”

After the RAND study was released, Cuomo expressed concerns about the potential cost of the program, but said he’ll discuss it with the Legislature.

Lately, Cuomo’s been taking steps to preserve protections established under the federal Affordable Care Act into New York law. He spoke before a gathering of health care workers, where he announced that his administration rejected rate increases requested by health insurance companies that provide insurance through the state’s exchange.

“We are going to do it by codifying the Affordable Care Act in New York state law and New York state regulations. We have already started; we banned insurance companies from discriminating against people with pre-existing illnesses, so that is done,” Cuomo said on July 30. “We required all insurance companies to cover the 10 essential benefits laid out in the Affordable Care Act. We mandated insurance companies to end all co-pays for breast cancer screenings and to increase access. And we mandated a woman's right to contraceptive care, that's in the law.”

The ACA, also known as Obamacare, has been largely successful in New York. The state’s health care exchange provides insurance for one-fifth of New Yorkers. Since it began, the rate of uninsured New Yorkers has been cut in half, from 10 percent to 5 percent, according to the state Health Department.

Whichever candidate wins the Democratic primary will face Republican Marc Molinaro in the November elections. Molinaro, concerned about the costs of enacting single-payer health care, said if the Legislature passed a plan, he would veto it.

“New Yorkers cannot afford an additional $92 billion tax and have a government-run health care where choice is eliminated, where private insurers are no longer allowed,” Molinaro said. “The state of New York and the governor can’t run the subway system in the city. I don’t think it’s safe or fair to anyone to put the state of New York in charge of health care.”

Molinaro said he’ll release his own health care plan later in the campaign. He said he backs access to quality health insurance and health care, but he said that system has to include choice and competition.

Karen DeWitt is Capitol Bureau chief for the New York Public News Network, composed of a dozen newsrooms across the state. She has covered state government and politics for the network since 1990.