[ad_1]
Deputy Richard Gottfried | AP Photo
ALBANY – Democrats have enacted one of the most progressive agendas the state has seen in decades in law this year, but perhaps the most ambitious and elusive measure is being considered for 2020: a system of single-payer health care in New York.
Assembly Health Committee Chairman Richard Gottfried, a Manhattan Democrat who first pitched the idea nearly three decades ago, and Senate co-sponsor Gustavo Rivera appeared optimistic about the chances of New York’s so-called health law eventually relocating to Albany.
But legislative leaders and Governor Andrew Cuomo have yet to adopt the measure vocally, and there’s a reason for that.
The proposed single-payer system would revolutionize the way health insurance is established in New York City. By some estimates, it would cost as much as $ 200 billion and force New Yorkers to abandon their existing private health insurance for a state-administered plan. This system would eliminate, among other things, deductibles, co-payments, off-grid charges and out-of-pocket expenses for long-term care.
Sponsors of the bill have brought the price closer to $ 158 billion, arguing that it will replace the $ 131.5 billion currently spent on premiums – including employer and employee actions, individual coverage and benefits. Medicare Part B premiums – as well as the $ 29 billion spent outside of out-of-pocket expenses and the local cost of Medicaid’s $ 9 billion.
According to supporters, this would represent more than $ 11 billion in savings compared to the current model.
But opponents have warned that these costs will be unsustainable and mostly borne by taxpayers and business owners. Health plan administrators, providers and others have also argued that a single-payer system will endanger tens of thousands of insurance and administrative jobs and increase health care costs. They urged lawmakers to focus on universal coverage instead and put in place the current health care infrastructure without disrupting insurance options.
And, according to critics from the healthcare community, before New York State attempts to revolutionize health insurance, it should probably grapple with its estimates. Medicaid budget gap of $ 4 billion.
“I think having only one payer – the New York Health Act in particular – [discussion] in this context would be irresponsible, ”said Bea Grause, president of the Healthcare Association of New York State, referring to the deficit.
As the Cuomo administration prepares to announce $ 1.8 billion cuts to Medicaid to close the deficit in the coming weeks, it has argued that the budget deficit – not single-payer – will be the biggest one. problem for many healthcare organizations including HANYS in 2020.
Leanne Politi, spokesperson for Realities of Single Payer – a coalition of insurers, business groups, professional associations and others opposed to the New York Health Act – agreed that “New Yorkers shouldn’t to feel comfortable [with single-payer] given the current Medicaid deficit.
But Rivera, a Democrat from the Bronx who chairs the Senate health committee, argues that the Medicaid deficit is just the latest example of why the state should pass New York’s health law.
“One of the things, and I’ve always argued, to control the costs of growing or spending Medicaid is to move to a single-payer system,” he said in an interview. “The kind of savings this system creates allows you to have long-term sustainability. … We have the best way to manage long-term costs and meet growing Medicaid budget deficits. “
Budget Division spokesman Freeman Klopott said New York’s health care bill would “cost up to $ 200 billion,” more than the entire FY2020 budget, which is $ 175 billion.
A RAND analysis published in 2018 found that New York’s health law is financially feasible and could reduce future spending, should hypotheses ranging from the questionable to the unlikely occur.
He estimated that total health care spending under the legislation could be slightly lower than the status quo – 3% less by 2031 with cumulative 10-year net savings of around 2% – because l The increased use of health services would be offset by a reduction in administrative costs. The report noted that the decrease over time reflects the assumption that claimant payment rates increase more slowly under the legislation.
RAND further estimated that New York would need an additional $ 139 billion in tax revenue by 2022 – an increase of more than 150% – to fund the program after the shift in federal and state health spending.
Grause, who was president and CEO of the Vermont Association of Hospitals and Health Systems when that state unsuccessfully attempted to switch to a single-payer model, has rejected efforts to present the single payer as a solution to the budget problems of New York.
“There is no simple, easy or quick answer, so the New York Health Act is not the answer. Passing this bill would take the state in a different direction. … It would take [at least] five years to make that transition and it would cost hundreds of billions of dollars, and we have a deficit of $ 6 billion today, ”she said. “So explain to me how is the answer?” I do not understand.
Grause questioned whether New York lawmakers had factored in the unexpected costs and politically difficult decisions they would be forced to make to establish a single-payer health care system – things that she says have helped condemn Vermont politics.
“We will all have the same problems,” she argued.
Ken Thorpe, chair of Emory University’s health policy and management department, who has worked with Vermont officials on their efforts to implement a single-payer system, told POLITICO in a recent interview that ‘he didn’t see how the policy was “nowhere realistic”. if he failed in such a small progressive state.
But Rivera argued that it was unfair to compare New York and Vermont, which have different policies, populations, and tax bases. The sponsors, he added, believe New York has “the ingenuity to do it and do it and get it right.”
Gottfried noted that he and Rivera were working on a series of amendments to gain more support for the bill and to address concerns raised in long and sometimes controversial four, statewide public hearings.
Lawmakers heard contrasting testimony from dozens of individuals, hospital groups, insurers and providers who would be affected by the proposed move to a single-payer health care system during the hearings – which Republicans say were used “to distort public opinion by of the adoption of this legislation. “
While most of the legislative changes to the law, which are expected to be unveiled in January, are largely technical, Gottfried said, they should help clarify lingering issues, such as how employees outside of the state would be treated under the New York Health Act.
“We don’t know how this will change the atmosphere in the Senate,” he said. “Neither we nor the Senate [Majority Leader Andrea] Stewart-Cousins really knows how this is going to play out, but I think we have done a good job of answering the questions that senators have asked us. Hope they like the changes we’re making, so I think we’re making some significant progress.
Stewart-Cousins, whose room was widely blamed for delaying the bill in 2019, told WCNY’s “The Capitol Pressroom” in November that his caucus “isn’t trying to blow things up” when it comes to New York’s health care system.
“I think the governor, the president, my colleagues in both houses, everyone understands the importance of doing certain things right and health care is one of those things,” she said, noting that Democrats are not ideologically opposed to the idea, but disagree on how to achieve it.
It is not known whether the Assembly will pass the New York Health Act in 2020. The chamber did not propose the bill in 2019, despite passing single-payer health bills in each of the four. previous legislative sessions. The difference in 2019 from previous years was that the Senate was controlled by Democrats, meaning that such legislation actually had a chance of being passed.
Spokesmen for Senate Democrats and Assembly Speaker Carl Heastie did not respond to requests for comment on whether New York’s health bill will be a priority for the chamber when lawmakers return next month.
Gov. Andrew Cuomo, whose office referred questions about the bill to the budget office, said he believes a single-payer health care system should be in place at the federal level, not the federal level. state, but he would sign the bill if he reached his office.
Still, he added an important caveat during an interview with The Atlantic in March.
“No sane person will pass it,” he said.
[ad_2]
