New York is on the Cusp of a Health Care Overhaul, but Sticking Points Remain

A top sticking point for the New York Health Act, which would create a universal, single-payer health care system in New York, is opposition from public sector labor leaders over how it would change coverage for their members, a key lawmaker said Monday.

Assembly Health Chair Richard Gottfried, who’s carried the legislation for decades, said they’re still working with public sector labor leaders on ways to accommodate their concerns. 

“I think the public sector unions in particular are the main group that we need to work out issues with,” said Gottfried, D-Manhattan.

“I believe that if we and they can sit down at a table, roll up our sleeves, there are ways we can modify the language in the bill that can guarantee them that their concerns will be more than satisfied. But that has taken a lot of effort so far, it’s going to take more effort.”

The New York Health Act is no stranger to leaders in labor. The legislation has already garnered support from some of the state’s most influential unions, including 1199SEIU, the New York State Nurses Association, and more.

But that hasn’t been enough to ward off concerns over the bill, and prevent it from coming to the floor in the state Legislature for a vote. 

A majority of Democrats in both the Senate and the Assembly have signed on to support the bill this year for the first time since it was introduced by Gottfried more than two decades ago. It’s gone through several amendments in the meantime, garnering support along the way.

The bill would transform New York’s health insurance system from a series of private and public insurance plans to one mandated and managed by the state. It would eliminate all out-of-pocket costs for individuals, and end network restrictions.

Instead of premiums paid to insurance companies, a progressive payroll tax would be paid by individuals who earn more than $25,000 each year to finance the new system. 

Gottfried said some of the resistance to the New York Health Act comes from a place of comfort. People know the system as it is now, even if they don’t always get the best deal.

“Americans are used to what is pretty rotten health coverage and the industry has convinced us that it’s a good deal,” Gottfried said.

Cynthia Nixon, an actor who unsuccessfully ran as a Democrat to oust Cuomo from the left in 2018, said the current system needs reform, regardless of how you look at it. She was in Albany Monday to support the New York Health Act.

“New Yorkers are literally dying for lack of health care, for lack of health insurance, they’re going bankrupt,” Nixon said.

Business groups have warned that the cost of health insurance under the new system could be higher for some, and that the bill could have ripple effects that would cost the state jobs. Supporters disagree, saying the cost of health care would be lower for most.

Republicans in the state Legislature are opposed to the measure, citing the concerns of business groups. 

“I think it would bankrupt the state of New York,” said Senate Republican Leader Rob Ortt, R-Niagara. “There’s just simply no way the state of New York could afford it. You’d put a ton of people out of work.”

Analysts have been split on the impact of the New York Health Act. 

RAND Corporation, a nonprofit policy think tank, wrote in an analysis of the legislation three years ago that low-income residents would pay less for health care under the legislation while wealthy earners would pay more. 

Other analysts, like Bill Hammond from the Empire Center, have warned that such a system could be vulnerable to uncertainty if wealthy earners choose to move out of New York due to higher costs.

It’s unlikely at this point of the legislative session that lawmakers will strike a deal on the bill before they’re scheduled to leave for the year Thursday. 

But time works differently in Albany. For some, four days is more than enough time to reach an agreement on even the most controversial measures. Lawmakers aren’t scheduled to return to Albany after Thursday until January.