ARTICLE: Senate won't vote on single-payer before hearings, LaMantia, Crains Health Pulse

By Jonathan LaMantia, April 25, 2019

More than four months after Democrats assumed a majority in the state Senate, movement on a single-payer health system has been slow to materialize.

State Sen. Gustavo Rivera, chair of the Senate health committee, said Wednesday the committee would wait until hearings on the bill are held around the state before voting to advance it. Rivera hopes to schedule a joint hearing of the state Legislature on the topic before the end of the session in mid-June and said a schedule for the hearings would be announced "imminently."

"The Senate has never really looked at it deeply," Rivera said. "Some of my colleagues that are new have some serious concerns and questions to ask about it. I want to make sure we get through all of it. What we're trying to do here is to fundamentally restructure how health care is delivered in the state of New York. When we do it, we've got to do it right."

His comments came after speaking at a City & State event at Baruch College, which served as the latest venue for debate on the bill. Rivera and Assemblyman Richard Gottfried spoke in support of the New York Health Act. Eric Linzer, president and CEO of the state Health Plan Association, argued in opposition.

"While it's true that 95% of New Yorkers have some form of health coverage, millions of New Yorkers with health coverage either go without needed health care or suffer financial hardship in order to get it," Gottfried said during the event.

The bill would cover medical expenses and long-term care for all New Yorkers, including undocumented immigrants, with no requirement that residents pay premiums or co-pays. The current version, introduced in February, lacks a tax structure to fund the bill. Its sponsors have said taxes on earned income and non-payroll income, such as capital gains, would be progressive. Earned income below $25,000 would be exempt.

A Rand Corp. analysis conducted last year on an earlier version of the bill estimated its cost would be about $159 billion in 2022.

Linzer said the state should focus on other policies, such as improving outreach to people eligible for government insurance programs and expanding subsidies to buy insurance.

"The focus ought to be, how do we get to that 5%" who are still uninsured, Linzer said. He also warned of "significant cuts that would have to come in provider reimbursement rates."

Gottfried countered that the bill requires the state to pay providers fees tied to the cost of offering health care and maintaining an adequate supply of services.

In a national poll released Wednesday by the Kaiser Family Foundation, 31% of respondents said implementing a national Medicare-for-all plan should be Congress's top priority, with an additional 26% saying it is "important but not a top priority." The most commonly selected top priorities were lowering prescription drug costs and continuing the ACA's protections for people with pre-existing conditions, at 68% and 64%, respectively.

Even if the Legislature approved the bill today, Rivera noted, it would take years to implement. That raises the question of how New York will proceed as some Democratic presidential candidates promote a federal Medicare-for-all program that could be implemented should one of the contenders take the White House in 2020.

"If we manage to get a national Medicare-for-all program, God bless America. We don't have to do this. The best choice is to do it nationally," Rivera said. "Because a national solution is not forthcoming, people in my communities in the Bronx and communities all over the state are getting sick. They're still going broke. They're still uninsured or underinsured, and we need to fix that. So that's why we're pushing forward on this."

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