Pictured Above: Protesters gathered outside Stony Brook Southampton College in January of 2017 vowing to fight for health care. This year, many of the same people helped to organize an information session on a dramatic change to health insurance in New York.
New York State is closer than it ever has been before this week to radically changing the way health care is paid for here.
Manhattan State Assemblyman Richard Gottfried introduced this year’s iteration of the New York Health Act, which would create a single-payer health care system to cover all New Yorkers, on Feb. 8.
The New York Health Act would do away with private insurance companies in the state, providing a Medicare-style program for all New Yorkers that would likely be paid for through a progressive payroll tax, which would charge a higher percentage of income for higher-income New Yorkers. Proponents argue that this method of paying for health insurance would be cheaper than what most people pay now for premiums, deductibles and copays through private insurance plans.
Prior versions of the bill have always stalled in the formerly Republican-controlled State Senate, but with the Democratic takeover of the senate this last election cycle, 35 of the 63 current State Senators are on the record as supporters of the concept, often called “Medicare-for-All.”
So what does this mean for everyday New Yorkers?
A coalition of progressive and religious groups, lead by Progressive East End Reformers, held a seminar at Stony Brook Southampton College Feb. 9 to get at some common questions about the bill, including how it would be paid for, how coverage would change, and whether Governor Andrew Cuomo will support it.
South Fork State Assemblyman Fred Thiele, who sat on the Feb. 9 panel, has voted for prior versions of the bill, while North Fork State Assemblyman Anthony Palumbo has voted against it. The New York State Senate did not vote on the most recent iteration of the bill.
How Much Will It Cost?
One of the core questions asked by people unfamiliar with state-run, single payer health care is how costs to individuals will change once it is implemented.
Citing a recent study on the New York Health Plan by the independent Rand Corporation, Mr. Thiele told the crowd gathered for the panel that, “in a nutshell, we can provide better coverage, more affordable coverage, and can save money for about 90 percent of the people in New York because of the progressive cost structure.”
People who make less than $25,000 per year would be exempt from paying the tax.
The Rand Corporation’s study calculated that “among New Yorkers with household compensation below the ninetieth percentile under the status quo in 2022 (average household compensation $105,300), average health insurance payments would decrease by about $2,800 per person.”
The Rand Corporation’s figures show residents in the 90th to 95th percentile, making a household average of $337,800, costs would increase by about $1,700 annually per person, while the top fifth of New Yorkers, with an average household income of $1,255,700 would see a $50,200 increase in taxes to fund health care.
Dr. Martha Livingston, a public health professor at SUNY Old Westbury who has been a fierce advocate for the New York Health Act, was also on the panel.
Dr. Livingston said that by the Campaign for Health Care in New York’s calculations, “98 percent of us would pay less than we currently pay.”
She added that, according to CHCNY’s calculations, taxpayers who make more than $150,000 per year for an individual or $400,000 per year for a family would pay more.
“If I think about my paycheck, I pay for Medicare and and federal taxes for all kinds of medical services I’m not eligible for. In New York State, part of my taxes go to Medicaid, and I haven’t seen any care yet,” she said of the current health insurance cost structure. “When you add premiums, deductibles and copays and you start to add it up, it’s very clear that I wind up paying much more now than in the New York Health Act.”
“What we actually spend on health care in the United States is $3.3 trillion last year, about $10,000 for every man, woman and child residing in this country,” she said. “It’s over one-sixth of our gross domestic product… If we took the money currently in the system and used it to actually provide care, we could cover everybody for everything. There is no scarcity in the system. That’s what the guys who are on the other side of this argument want to scare you about.”
Dr. Livingston added that New York counties are currently required to pay one quarter of the costs of Medicaid in their counties. For example, CHCNY has calculated that Suffolk County is now paying $239.5 million per year for Medicaid — which makes up 37.5 percent of the county’s revenue from property taxes. That would change under the New York Health Act.
“That’s what converted the Albany city treasurer” to back the New York Health Act, she said. “He looked at the numbers and said ‘I’d have money to do all these other things.’”
What About Andrew?
Governor Andrew Cuomo hasn’t yet said he supports the New York Health Act. He proposed a “commission on universal access to health care” in his January State of the State address.
Mr. Thiele said that when he asked Assemblyman Gottfried about the commission “he used a Yiddish word to describe it that was not a positive word.”
Panelists in Southampton said they believed this was the governor’s attempt to kick the can down the road and not make a decision on the bill.
PEER leader Kathryn Szoka urged attendees to call the governor’s office to voice opposition to the commission.
“Now, hallelujah, we have a Senate in which it might pass,” said Dr. Livingston. “And you may say, ‘oh, but Andrew.’ Here’s what we know about Andrew Cuomo: If the parade is long enough, he will be at the front, and he will say he started it.”
“The governor’s silence on this has been deafening,” added Mr. Thiele.
What Does This Mean for the Health Care Industry?
Amy Reich, a nurse who has worked in palliative care, oncology and pediatrics on the South Fork and on the policy side in Washington D.C. and David Mayer, a Hampton Bays resident who makes prosthetic devices, talked about the struggles patients face under the existing health insurance system.
Ms. Reich shared stories of oncology patients who struggle, sometimes for months, with getting insurance companies to agree to pay for their treatment, all the while getting more sick.
“We find out often that we have to postpone treatment because insurance denied it, and then the physician has to take time away from the patient, submit journal articles to show evidence, and sometimes patients have to go for further testing and biopsies, MRIs and PET scans,” she said.
Mr. Mayer agreed, saying that patients who have already had insurance cover amputations then need to prove to the insurance company all over again why they may need prosthetics, even though their insurer had already covered the amputation that caused the need.
He added that he was always happy when he worked with Medicare rather than a private insurer.
“Medicare is the gold standard. They can pay within three days,” he said, adding that he’s waited as long as six months to be paid by a private insurance company.
“Imagine if you didn’t pay your health insurance premium for six months,” he said. “You wouldn’t be covered.”
Insurance Company Reaction
Dr. Livingston said the term used within the insurance industry to describe money they pay for health care is “medical loss ratio.”
“They’re not in the business to provide health care. They’re a for profit industry, and they’re in the business to make money,” she said. “Why should we expect them to behave differently? We shouldn’t.
“The insurance industry is massing at the border of the city of Albany as we speak,” said Mr. Thiele, prompting an audience member to blurt out ‘Can we build a wall?’”
“We can’t build a wall and we can’t get them to pay for it,” said Mr. Thiele. “In the past they came to visit us, but this is real. They will be there in force.”
“The lobbying is going to be intense. What’s going to happen to the poor insurance industry, I think, is the question,” said Mr. Thiele. “There’s enough risk and liability out there to keep the insurance industry busy for a long time. But they are going to need another risk to insure, at least in the State of New York.”