Single-Payer Healthcare Campaign Kicks Off In Albany
By Rachel Silberstein Albany Times Union February 11, 2019
ALBANY — The state's proposed single-payer healthcare bill has been amended this year to include coverage of long-term care and home support services.
A broad coalition of seniors, people with disabilities, caregivers, home care providers and advocates joined the bills' sponsors, Assemblyman Richard Gottfried and Sen. Gustavo Rivera, as they kicked off a 2019 New York Health Act push at the state Capitol on Monday.
"Long-term care is an intolerable drain on family finances and a burden on thousands of family caregivers – disproportionately women – who provide unpaid care to family members," said Gottfried, who chairs the Assembly Health Committee. "We can cover long-term care, providing dignity and financial security to millions of aging and disabled New Yorkers, under a progressive public financing model."
Gottfried, D-Manhattan, has introduced versions of the single-payer bill every year since 1992, but recently the bill has gained traction, and a majority of Democratic lawmakers in both houses have either signed on to the legislation or expressed support for the measure.
Eighty-one of 150 Assembly members are listed as original co-sponsors on the New York Health Act, and a comparable ratio of senators is expected to support the Senate version when is released later this week.
Democrats reclaimed the state Senate in November's election, enabling them to pass a flurry of liberal initiatives in the first month of session.
The inclusion of home care in the single-payer bill follows a year of lobbying by advocates, who note that women typically bear the brunt of unpaid care giving when a family member is unable to care for themselves.
"As the population of older adults in New York and across the United States rises, so does the imperative need for care giving and an improved system of providing long-term care," said Rachel McCullough, co-director of the New York Caring Majority.
Inclusion of long-term care "places true value on services and supports to enable aging adults and people with disabilities to access the full scope of care," she added.
Cuomo has been skeptical of the single-payer plan, noting that attempts to implement a single-payer system in states like Vermont and California have been unsuccessful.
He did not include the legislation in his executive proposal for 2019-2020, and the bill's sponsors anticipate that the Legislature will take it up after the budget — due Apr. 1 — is passed.
"The single-payer (bill), in theory, makes sense," Cuomo said on Monday. "In practice, I don't see how you do it without doing it on a federal level. ... States have tried to do it on their own, they've all failed. The estimates in New York are basically that you would have to double the state budget to do it."
The original New York Health Act would provide complete health coverage to all New Yorkers without deductibles, co-pays, restricted provider networks, or out-of-network charges. It relies on a steep payroll tax, 80 percent of which will be covered by employers, while the remaining 20 percent would be paid by employees.
Implementation would require a waiver from the federal government, which critics note is unlikely to occur under the Trump administration, but Gottfried says the state could create "wrap-around" coverage, such as supplementary insurance program used by medicare recipients, in the interim.
The expense of implementation and the specifics of the tax structure to finance the plan each year have yet to be decided. The state would need to secure $139 billion a year in tax revenue to finance the plan, according to a RAND Corporation report released earlier this year.
"Setting up of the claims process is something the state would spend a year or two doing before we implement the plan, but (the cost of) setting that up is a tiny slice of the savings that this program is going to generate," Gottfried said.
The Realities of Single Payer, a coalition of insurance companies, healthcare providers, and business interests that oppose the New York Health Act, said the addition of coverage for long-term care makes the bill even less practical at a time when the state is facing a $2.3 billion budget deficit.
The new bill immediately provides long-term care benefits, which increases the cost by an estimated $43 billion, $18-22 billion for government programs plus $21 billion currently covered by the privately insured, according to Unshackle Upstate Executive Director Michael Kracker.
"Supporters of this single payer scheme either have forgotten or choose to ignore the fact that New York state imposes the highest tax burden in the nation," Kracker said. "More than 1 million hardworking men and women have left New York during the last decade; due largely to the state's high taxes and lack of economic opportunities."