NYS Assembly Passes Single Payer Health Care Bill

Chris Gaetano
Published Date:
May 17, 2017

By a  94 to 46 majority, the New York State Assembly has passed a measure that's intended to transition the Empire State into a single payer health care system. The bill, titled the New York Health Act, would establish a public health insurance system called New York Health, which would be open to all state residents. The benefits would include comprehensive inpatient and outpatient care, primary and preventative care, prescription drugs, behavioral health services, laboratory testing, and rehabilitative care, as well as dental, vision, and hearing care, according to a press release on the matter. There would be no network restrictions, deductibles or co-pays. 

As for how to fund this thing? The bill says that there will be a progressively graduated premium on all payroll and self-employed income paid by employers in a similar way to the Medicare tax. Higher income brackets would be assessed at a higher marginal rate than lower brackets. The employer would be responsible for 80 percent of this premium and the employee responsible for 20 percent (though the employer may agree to pay all or part of the employee share). Self-employed individuals pay the full premium. 

In addition, there will be a progressively graduated premium on taxable income not already subject to the payroll premium, such as interest, dividends and capital gains. These premiums would be set at levels anticipated to produce sufficient revenue to finance the program, and would be scaled up as enrollment grows. 

This state funding would then be combined with federal funds currently received for Medicare, Medicaid, and Child Health Plus. The state would seek federal waivers to allow it to completely fold these programs into New York Health, which would also end the local share of Medicaid funding. 

State residents employed out-of-state by an employer subject to New York state law, both the employer and employee will be required to pay the payroll premium as if that employee were, in fact, in the state. If the employer is not subject to state law, then either the employee and employer will voluntarily comply with the premium, or the employee will pay the premium as if they were self-employed. The premium will also apply to out-of-state residents who work in New York. In this case, the individual's employer will be able to take a credit against the payroll premiums they would otherwise pay; individuals would get a credit for amounts they spend on health benefits that would otherwise be covered by the program as if they were a member of it. 

Additionally, state funding would be combined with federal funds that are currently received for Medicare, Medicaid and Child Health Plus to create the New York Health Trust Fund. The state would also seek federal waivers that will allow New York to completely fold those programs into New York Health. The local share of Medicaid funding would be ended, offering major property tax relief for New Yorkers. 

This is not the first time the Assembly has passed such a bill, having done so in 2015 and 2016, but both times further efforts were quashed in the Senate, according to Mic. This time, however, a Senate caucus called the Independent Democratic Caucus, which does not caucus with the rest of the Democrats, has signed off on the bill, meaning that the measure needs only one more Senate vote to pass. 

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