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.
He said the addition, among other things, would benefit women, who often lose income under the current system.
“It often means that a family member — in our culture, usually a woman — gives up a career, income, a large part of her life, to care for a family member,” Gottfried said. “That is not morally or socially acceptable.”
Although the measure has been approved several times in the Assembly, it stalled in the Senate, where until this year, Republicans controlled the chamber.
Democrats now hold the majority, and Senate sponsor Gustavo Rivera said hearings on the measure will be held this spring. But Rivera said he does not expect the bill, which has fiscal implications, to be part of the state budget package that’s due April 1. He said that’s not necessarily a sign that the measure lacks enough support.
“I’ve always thought that complicated issues like this should not be dealt with in the budget,” Rivera said. “And not have to do it under a timeline of just April 1.”
A Rand Corporation study in August 2018 found that total health care spending would be slightly lower under the plan, but it would require $139 billion in additional state revenue to make the transition. It also said that employers would ultimately pay less money under a payroll tax in the measure than they currently pay to health insurance companies for premiums.
Business groups disagree, and say the costs are closer to $250 billion. A coalition formed to oppose the measure, called Realities of Single Payer, calls it a “quarter of a trillion dollar boondoggle” and “malpractice” by lawmakers.
Michael Kracker is with Unshackle Upstate, which is part of the coalition.
“This is what amounts to the largest tax increase in history,” Kracker said. “The costs are really unprecedented.”
Kracker also said about 150,000 New Yorkers employed in the health insurance industry would lose their jobs.
He said business leaders are not completely happy with the current system, but he said it’s better to work with the existing structure, which includes health exchanges under the federal Affordable Care Act, than to make big changes. He said he backs a plan by Cuomo to create a commission to provide coverage to the 5 percent of New Yorkers who currently lack insurance.
“That’s a common-sense approach,” Kracker said.
Gottfried said the business groups’ predictions of increased expenses are exaggerated.
“No thoughtful observer who has studied this topic agrees with those wacky numbers,” Gottfried said.
He said similar concerns were expressed in the 1960s, when the federal government initiated Medicare for older Americans. He said it is now a universally valued program.
Cuomo, when asked about the measure in an unrelated news conference, said he doesn’t think the state can afford to enact single-payer by itself.
“Single-payer in theory makes sense; in practice, I don’t see how you do it without doing it on a federal level,” Cuomo said. “States have tried to do it on their own. They’ve all failed.”
Cuomo said the Rand report indicates that the state budget would have to be “doubled” in size to implement single-payer. He said that’s even more of an obstacle now that the state has a $2.3 billion budget deficit.