The Independent View: New York Health Act

The New York Health Act would provide comprehensive, Universal Health Coverage for every New Yorker and would replace Private Insurance company coverage. You and your Health Care Providers work to keep you healthy. New York Health Pays the Bill.

There would be no Network Restrictions. Only Patients and their Doctors, not Insurance Companies, make Health Care decisions.

All New Yorkers would be covered for all Medically necessary services, including:

- Primary Care
- Preventive Care
- Specialists
- Hospital
- Mental Health Care
- Reproductive Health Care
- Dental
- Vision
- Prescription Drug
- Supply Costs

Today, Insurance Companies set the same High Premiums, Deductibles, and co-Pays, whether it’s for a CEO or a Receptionist, and a big successful company actually pays less than a small new business.

Under New York Health, Individuals and Employers would not pay Premiums, Deductibles, and Co-Pays.

Instead, Coverage would be Funded through a Graduated Assessment on Payroll and Non-Payroll Taxable Income, based on ability to Pay. For 98% of New Yorkers, it will be a substantial reduction in what they now spend. Prof. Gerald Friedman, PhD, Chair of UMass Amherst Economics Department, estimates that there would be Savings for New Yorkers with incomes up to $400,000, with the biggest share of Savings going to Middle-Class families.

The Total Cost would be $45 billion less than what we now spend, because we wouldn’t be paying for huge Insurance company Administrative Costs and Profits or for the costly Time and Paperwork Health Care Providers spend for dealing with Insurance companies. Health Coverage would be Accountable to the People of New York, not to Insurance Company stockholders.

Health Care Costs are a significant and unpredictable problem for business. These Costs as a share of Payroll have increased 50% in a decade, with small Group rates increasing almost 7% on average in 2014, and New York businesses spend over $2 billion annually just to Administer Health Benefits. The New York Health Act simplifies and reduces Costs for Employers, large and small, by taking them out of the business of buying Health Coverage. That would make New York dramatically more Job Friendly, especially for Small Businesses, Start-Ups, Low-Margin businesses, Local Governments, Non-Profits, and Taxpayers.

Any Plan that keeps Insurance Companies in the picture means wasting close to $50 billion a year. The cost of Eliminating Financial barriers to Health Care and providing Universal Coverage would be more than offset by savings on Administration and through Negotiated Pricing for Pharmaceuticals and other Services.

The New York Health Act, A.4738 (Richard N. Gottfried D-75th Assembly District) and S.4840 (Gustavo Rivera D, WF- 33rd Senate District), and has many endorsements.

This bill would create a universal single-payer health plan – New York Health – to provide comprehensive health coverage guaranteed to all New Yorkers.

Eligibility, Benefits

Every New York resident would be eligible to enroll, regardless of immigration status, age, income, wealth, employment, or other status.

There would be no financial barriers to receiving care (premium, deductibles, or co-‑pays).

The benefits will include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, contraception, abortion, laboratory tests, rehabilitative, dental, vision, hearing, mental health 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.

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 two years of passage.

Payment to Health Care Providers

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 phased in.)

Funding

Health care would no longer be paid for by insurance companies charging a regressive “tax” – premiums, deductibles and co‑pays – imposed regardless of ability to pay.

Instead, New York Health would be paid for by premiums based on ability to pay, through a progressively-graduated state payroll tax (paid 80% by employers and 20% by employees, and 100% by self-employed) and a surcharge on other income for the wealthy.

Federal funds now received for Medicare, Medicaid, Family Health Plus and Child Health Plus would be combined with the state revenue in a New York Health Trust Fund. The “local share” of
Medicaid funding – a major burden on local property taxes – would be ended.

Private Insurance

Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents.

Federal Funding and Waivers

For the system to work most effectively, New York would seek federal waivers that will allow New York Health to completely fold in Medicare, Medicaid, Family Health Plus, Child Health Plus, ACA benefits, and any other federally funded program.

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