NY Pols Debate Senate Single-Payer Plan; No Vote Planned Until 2020

New York won't be passing a state-level single-payer health care system this year, but that hasn't kept the sparks from flying as proponents clash with industry critics who say such a proposal is unworkable.

New York Health Plan Association President Eric Linzer argued at City & State's Healthy NY Summit that a single-payer health care system would lead to wait times of 10, 15 or 20 weeks for patients, even for routine procedures like MRIs, CAT scans or X-rays. "Look no further than the VA system or the Canadian system, where there are significant wait times, and I don't think that's something that consumers want to be having to wait in New York," Linzer said.

Assembly Health Committee Chairman Richard Gottfried pulled no punches with his counterpoint. "A lot of New Yorkers have a wait time that is forever until they die," Gottfried fired back, referring to people who struggle with health care costs even with insurance. "So when you talk about wait times, people who can't afford the care, then the wait time is forever."

The exchange on Wednesday between Gottfried and Linzer distilled one of many issues in a debate over Medicare for All, a matter that has been gripping the country. In New York, it has taken shape with the New York Health Act, a bill that would implement single-payer care at the state level. An entirely Democratic state government has supporters more optimistic than ever that the bill can pass.

But even Gottfried and his state Senate counterpart, Sen. Gustavo Rivera, acknowledged what might still be a long road ahead – the Senate has no plans to vote on the legislation this session, and neither lawmaker would say when the bill might be ready to pass. And proponents can anticipate a prolonged battle with the insurance industry – which would cease to exist in New York under such a system – and other skeptics of a single-payer system.

Despite support among progressive members in the state Legislature, the New York Health Act will not become law this year. Rivera, the bill's Senate sponsor, said that he has scheduled a series of joint public hearings to gain input about the legislation, the dates of which he will announce soon. The state Senate has never before voted on the bill and has had little opportunity to study it. Although the Assembly has not yet decided whether it will bring the bill to a vote this session, as it has many times before, Rivera has no intention to take action on the bill this year in order to allow the hearings to conclude and to give his colleagues a chance to closely examine it.

Yet Gottfried, the Assembly bill sponsor, said he remains confident that the New York Health Act will ultimately have the support of Gov. Andrew Cuomo when it is builds enough support to pass both chambers. Although Cuomo has not endorsed the legislation and has questioned whether a single-payer system could work on a statewide level, he supports the concept of single payer on the national level – which Gottfried said makes him more supportive than nearly every other governor in the country.

But both lawmakers said it it will be important to make sure New Yorkers are demanding it and that is has broad support. "Gov. Cuomo is exceptionally good at getting things done that he believes not to be politically done," Rivera said during the panel discussion. "So we need to make it politically necessary for him to do."

Before that can happen, the legislation still has roadblocks. Linzer, who represents the insurance industry, supports building on current health insurance options, which have helped bring uninsured rates to historic lows, while finding ways to cover the 5% of New Yorkers who don't have health insurance. Linzer pointed out that creating a new, government-run system would destroy an industry, leading to tens of thousands of lost jobs.

He also said that the New York Health Act would take away consumers' choice and lead to long wait times that most New Yorker's may not experience right now. "At the end of the day, what (New Yorkers) want is meaningful solutions that are going to get us to making health care more affordable," Linzer said. "There should be incremental steps taken … Let's start with getting folks who are eligible for coverage … let's get them covered."

One disconnect in the debate is who needs assistance. While Linzer focused on ensuring those without insurance gain access, Gottfried said the New York Health Act would help a broader population. About half of of the roughly 1 million uninsured New Yorkers are already eligible for public health insurance like Medicaid. Gottfried asserted his bill would help the millions who already have insurance, but for whom it is still not enough or still too expensive.

He added that even if the state manages to insure the entire population, those problems would remain. "Having millions of New Yorkers not be able to get the health care that they need or having to suffer financial hardships to get it is not acceptable, and there is no plan other than a single payer system that enables us to get over the financial obstacles and make sure that every New Yorker gets the health care they need," Gottfried said.

Gottfried and Linzer largely dominated the hour-long panel discussion. When Linzer said the legislation would eliminate tens of thousands of jobs, Gottfried said the bill is estimated to produce an estimated 200,000 jobs and would also provide training to help anyone who might lose a job gain a new one. When Gottfried said the state would have greater bargaining power to bring down the costs of medication, Linzer questioned if the state would be actually be able to effectively handle the bureaucracy involved with managing health insurance, especially at such a large scale.

Without a firm timeline for the state Legislature to take action on the bill, for now, its future seems far from certain.