New York Health Act

A. 4738, S. 4840
Carter Burden Network: Roosevelt Island
January 10, 2019
 New York State Constitution

“…the protection and promotion of the health of the

inhabitants of the state are matters of public concern
and provision therefore shall be made by the state and
such of its subdivisions and in such manner, and by
such means as the legislature shall from time to time
determine.”
 NYHA Principles
• Universal coverage.

• No premiums or co-insurance, and no deductibles or co-pays. Medicare

premiums would be assumed by the state.

• Publicly funded through broad-based, progressively-graduated taxes on

payroll income and taxable non-payroll income. Counties would no
longer contribute based upon local property taxes.

• Everyone would choose a primary care physician or other appropriate

provider to provide care coordination but there would be no
“gatekeeper” obstacles to accessing care.
 Principles (cont.)
• No provider network restrictions

• No one could sell coverage that duplicates any NY Health

benefit. Rich and poor will use the same system.

• Comprehensive benefits, including dental, optical, hearing,

preventive care, mental health, and full prescription drug
coverage, and, in the 2019 bill, long-term care.
 Financing NY Health
• Pools all ongoing federal subsidies and reimbursements,
including Medicare, Medicaid, CHIP, ACA refundable
premium tax credits into a NY Health Trust Fund.

• Remaining costs would be covered by state tax

assessments based on the ability to pay.
• A payroll tax based on income and paid 80% by employers, 20% by
employees, 100% by the self-employed.
• Further graduated tax assessments on upper-bracket non-payroll
income such as capital gains, rents, interest, and dividends.
• Bottom line: The employee tax on $50,000 in wages = 1% of income.
How the New York Health Act will Benefit Older Adults
Despite Medicare, older adults in New York still spend an average of 15-
20% of their income on health care expenses, including:

• Premiums for Medicare Parts B, C (Medicare Advantage), and D.

• Medicare deductibles and co-pays; or additional premiums for

Medigap coverage.

• Out-of-pocket spending for uncovered hearing, optical, drug,

mental health and dental services.

The New York Health program eliminates all these out-of-pocket

costs, allowing older adults to retain their savings and social security
income
 What about Long-term Care?
• The sponsors of the New York Health Act are in the process of
including long-term care as a universal benefit when they resubmit
the bill in 2019.
• Disabled younger and older adults will no longer have to self-
impoverish to qualify for a personal care assistant or a nursing home.
• Family members will no longer have to reduce work hours or quit jobs
to care for a disabled relative.
• Disabled younger adults will no longer have to forgo higher education
and careers in order to be poor enough to qualify for Medicaid
 Information sources

• PNHP NY Metro Chapter www.pnhpnymetro.org/single_payer_resources

• Campaign for New York Health www.nyhcampaign.org/resources

• Henry Moss: hmoss011@gmail.com