By Andrew F. Biernat, Vice President/Strategic Business Advisor at Gilroy Kernan & Gilroy
Past President, Current Board Member & Membership/Media Chairman for the New York State Association of Health Underwriters

The New York Health Act – Simply A Bad Public & Health Policy for New York State

Last month, the New York State Assembly’s Health Committee released the New York Health Act A.6058 (Gottfried) (S.5474) Rivera in Senate, which would abolish the current health care system in New York State and create a government run, “single payer” system.  While forcing every New Yorker onto a one size-fits-all health plan and leaving them with no other options for their health insurance, the legislation would require a massive tax increase estimated between $139 – $250 billion and eliminate over 150,000 jobs across the state.

With more than 95% of New Yorkers currently insured through a combination of private, employer-sponsored, union provided and government supported plans, the New York Health Act is unnecessary and will do more harm than good.  Recent polling shows that more than 90% of New Yorkers like their health plans and want to keep their coverage, and instead of starting over legislators should build on the current system to ensure that every resident is covered.

• The New York Health Act would cover all New York State residents without any eligibility requirements, including undocumented immigrants, and would provide each resident with long-term care coverage.  The bill would also eliminate private health insurance carriers (initial job loss estimated between 150,000 – 175,000).  Currently New York State has the lowest uninsured rate in its history at under 5% with many counties reporting 2% or less.

• Initial cost estimates of between $139 – $250 billion in new taxes to fund New York Health Act (current entire 2021 New York State budget $212 billion)

• Insurance premiums replaced with tax payments residents would pay – 20% of taxes paid by employees and 80% paid by employers.

• Employers would pay 80% tax for ALL employees (no waivers like current employer marketplace), including out-of-state employees. Result – significant increase in employer costs.

• Provider/Hospital reimbursement will be determined by elected officials or some other governing body (providers will leave New York State and hospitals would suffer estimated 17% – 19% revenue loss with lower reimbursements similar to Medicaid)

• Benefit design includes everything covered under Medicare, Medicaid, CHIP, ACA, NYSHIP and have no copays, deductibles or out of pocket costs which would be richer than today’s Platinum plans under the ACA. This would increase medical utilization, result in rationing of care and further drive up costs for New Yorkers.

As alternatives to the New York Health Act, the following ideas have been developed by healthcare professionals as “realistic” cost-containment methods that would reduce health plan rates and health insurance premiums while improving quality:

• Value-Based Payments – to reward good healthcare outcomes and reduce the amounts spent on unnecessary healthcare.

• Expansion of Managed Care – to continue to “bend down the curve” in underlying costs of providing necessary healthcare, as lower costs cannot be achieved with unlimited access to healthcare.

• Management of Chronic Conditions – such as obesity and diabetes, via greater emphasis on public health spending and effective wellness programs to promote better patient outcomes, which present the most significant areas for potential reduction in the medical costs of chronic and acute care.

• Elimination of Fee-for-Service Healthcare – by establishing Capitation and Global Budgeting to restrain unnecessary spending

• Continuation of Affordable Care Act (ACA) Provisions – that eliminate preexisting conditions exclusions, continue advance premium tax credit (APTC) subsidies, and expand Medicaid coverage, all of which have greatly contributed to the reduction in the number of uninsured New Yorkers

• Reduce Redundant Medical Facilities – by reinstituting Regional Health Planning Councils and better use of the Certificate of Need (CON) Program

• Control of Prescription Drug Pricing – by reducing excessive pharmaceutical profits

• Other alternatives could also include instituting Transparency in Healthcare Pricing, to provide data-drive tools by requiring transparent pricing practices that encourage consumers to reduce their healthcare expenses by cost comparison and selection in an open healthcare marketplace.

Over the last decade, through a public-private partnership, New York has done more than almost any other state to expand health care coverage, bolster services for its most vulnerable residents and improve the quality of care.  These efforts underscore the strength of our current system and argue against those who advocate for a government-run, single payer health care system. Moreover, according to  recent polls, the vast majority of New Yorkers — 91% — are satisfied with their current health insurance and support building on what’s working in health care to expand access to coverage and care, not starting over.

Every New Yorker deserves high-quality, affordable health care. Together we should build on and improve what’s working to make health care better, simpler and more affordable. Whether it’s called single payer, Medicare for All, or the New York Health Act, a government-run, one-size-fits-all approach to health care will never allow us to achieve those goals.

Below is the link for “Operation Shout” – for any citizen in New York State  to use to notify their state senator, legislators or assembly member of their opposition to the legislation.

National Association of Health Underwriters | Tell the New York State Legislature to Oppose S.5474/ A.6058! (quorum.us)