A07854 Summary:

BILL NO    A07854 

SAME AS    Same as Uni. S 4884

SPONSOR    Gottfried

COSPNSR    Millman, Lancman, Kellner, Dinowitz, Cook, Colton, Benedetto, Abbate,
           Jacobs, Gunther, Titone, Reilly, Paulin, Magnarelli, Lifton, Perry,
           Camara, Titus, Aubry, Mayersohn, Schroeder, John, Boyland, Jaffee,
           Cymbrowitz, Espaillat, Rosenthal, Cahill, Hooper

MLTSPNSR   Bing, Brennan, Christensen, Farrell, Glick, Heastie, Koon, Lavine,
           Lentol, Lupardo, Maisel, Markey, McEneny, Meng, Pheffer, Scarborough,
           Schimel, Sweeney, Thiele, Towns, Weinstein,

Ren Art 50 SS5000 - 5003 to be Art 80 SS8000 - 8003, add Art 51 SS5100 - 5110,
Art 49 Title III SS4920 - 4928, amd SS2510, 2511 & 270, Pub Health L; amd
SS364-j & 369-ee, Soc Serv L

Establishes New York Health Plus to provide comprehensive health coverage to
all New Yorkers; provides for a phase-in period for such program and requires
the governor to submit a financing plan to include assessments on employers.

A07854 Actions:

BILL NO    A07854 

04/27/2009 referred to health
06/02/2009 reported referred to codes
06/15/2009 reported referred to ways and means
01/06/2010 referred to health

A07854 Votes:

A07854 Memo:

BILL NUMBER:A7854                Revised 5/27/09

TITLE OF BILL:  An act to amend the public health law and the social
services law, in relation to establishing New York health plus

PURPOSE OR GENERAL IDEA OF BILL: Offer comprehensive
publicly-sponsored health coverage to all New Yorkers

SUMMARY OF SPECIFIC PROVISIONS:  The new plan - called New York Health
Plus - builds on the Family Health Plus and Child Health Plus programs
to provide a full benefit package that is more comprehensive than most
commercial health insurance programs. All New Yorkers would be
eligible, regardless wealth. Individuals would choose from among
participating health plans, as is now done under Family Health Plus
and Child Health Plus.  The state would also run a fee-for-service
option. No one would have to give up the doctors or other providers
they use. Instead of individuals and employers paying premiums, the
state would set and pay the premium under New York Health Plus.
Deductibles would also be eliminated and co-payments would be
non-existent or nominal, as they are under Family Health Plus.

New York State would pay for the coverage (plus Federal matching funds
where eligible), using revenue based on ability to pay, from an
assessment modeled on the Medicare payroll assessment, plus a
surcharge on upper-bracket non-wage-and-salary taxable income.

Premiums and deductibles are a regressive "tax" we wouldn't have to
pay anymore. New York State would pay for the coverage (plus Federal
matching funds where eligible), using revenue based on ability to pay.

JUSTIFICATION:  New York employers and individuals now spend over $100
billion a year for premiums, deductibles and co-payments, plus more
for care for the uninsured. New York Health Plus would save us $20-30
billion. New York Health Plus would more effectively control costs
while also assuring better quality care and more preventive care.

Health plans today are accountable mainly to cost-conscious employers,
so they are under extraordinary pressure to refuse to pay for care and
to pay as little as possible. The pressure from employers is almost
entirely "downward." Under New York Health Plus, there would certainly
be pressure from taxpayers and elected officials to control costs. And
the state as purchaser would be able to do that.

There would also be "upward" pressure on our elected government from
millions of vocal voting customers to make sure that the state uses
its power - as sponsor and purchaser of the coverage -to make sure
that participating health plans deliver quality care and deal fairly
with patients and providers.

All patients who choose to join the plan - rich and poor - and health
care providers would be in the same boat. That is the best guarantee
that the Governor and the Legislature (not insurance companies) would
make sure that the balancing of downward and upward pressure makes it
the best possible coverage. This is what has made traditional Medicare
such a successful and popular program.


Family Health Plus and Child Health Plus now provide comprehensive
coverage at lower cost than anything employers or individuals can buy.
New York sets the premium it pays. And unlike privately-sponsored
coverage, New York has kept its premiums virtually flat for the last
several years.

New York Health Plus would have standards and incentives to improve
the quality of care. But under privately-sponsored coverage, health
plans have little incentive to promote quality or preventive care,
because an individual patient is likely to have moved on to another
employer or another health plan by the time any savings are seen.

New York Health Plus does not require complex new programs or
bureaucracies, because it is based on Family Health Plus and Child
Health Plus.

Today, we pay premiums and deductibles set by insurance companies.
It's a regressive "tax" - without regard to whether the person being
covered is a receptionist, assistant manager, or company president, or
whether an employer is a huge prosperous company or a small business
struggling to get by.

New York Health Plus would replace that regressive tax and also save
$20-30 billion a year. The state would pay for the coverage, using
revenue based on ability to pay (plus Federal matching funds where
eligible), without deductibles or co-pays. The revenue would come from
an assessment modeled on the Medicare payroll assessment, plus a
surcharge on upper-bracket nonwage-and-salary taxable income.
Individuals or employers who choose to opt out and buy private
coverage would receive a credit against most of the assessment.

Compare health care with education. Educating children is a parent's
responsibility. But we don't ask parents to pay a premium or
deductible to send their children to school. We insist that New York
provide free quality education for every child.

Universal health coverage is a major issue not just because a minority
of the population lacks coverage. It's also because the overwhelming
majority is fed up with our current system and wants it changed. Any
serious plan for universal coverage will be attacked by powerful
special interests. To overcome those attacks and win public support, a
plan should offer real change that people want: universal access,
ability to control costs, ability to promote preventive care and
quality care, fairness and equity. That's what New York Health Plus
will do.

PRIOR LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS:  The program would be funded by its own revenue
stream. Public employers, like other employers, would see savings from
the improved efficiency of New York Health Plus versus traditional
employment-based coverage.

EFFECTIVE DATE:  Immediately, with phased-in implementation.