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A04738 Summary:

BILL NOA04738A
 
SAME ASSAME AS S04840-A
 
SPONSORGottfried (MS)
 
COSPNSRAbinanti, Barron, Benedetto, Bichotte, Blake, Bronson, Carroll, Colton, Cook, Crespo, Cymbrowitz, Dilan, Dinowitz, Englebright, Gantt, Hikind, Hunter, Hyndman, Jaffee, Jenne, Joyner, Kim, Lavine, Lifton, Lupardo, Mayer, Miller MG, Mosley, Paulin, Peoples-Stokes, Perry, Pichardo, Ramos, Richardson, Rivera, Rodriguez, Rosenthal L, Seawright, Sepulveda, Simotas, Steck, Stirpe, Thiele, Titone, Titus, Walker, Weinstein, Weprin, De La Rosa, D'Urso, Jean-Pierre, Wright, Williams, Vanel, Solages, Wallace, Barrett, Pheffer Amato, Niou, Ortiz, Dickens, Taylor, Pellegrino, Epstein, Simon, Fernandez, Espinal
 
MLTSPNSRAbbate, Arroyo, Aubry, Cahill, Davila, DenDekker, Fahy, Galef, Glick, Gunther, Hooper, Lentol, Magee, Magnarelli, O'Donnell, Pretlow, Quart, Rozic, Skartados
 
Ren Art 50 §§5000 - 5003 to be Art 80 §§8000 - 8003, add Art 51 §§5100 - 5111, Art 49 Title 3 §§4920 - 4927, amd §270, Pub Health L; add §89-i, St Fin L
 
Establishes the New York Health program, a comprehensive system of access to health insurance for New York state residents; provides for administrative structure of the plan; provides for powers and duties of the board of trustees, the scope of benefits, payment methodologies and care coordination; establishes the New York Health Trust Fund which would hold monies from a variety of sources to be used solely to finance the plan; enacts provisions relating to financing of New York Health, including a payroll assessment, similar to the Medicare tax; establishes a temporary commission on implementation of the plan; provides for collective negotiations by health care providers with New York Health.
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A04738 Floor Votes:

DATE:05/16/2017Assembly Vote  YEA/NAY: 94/46
Yes
Abbate
No
Crouch
No
Goodell
Yes
Lifton
Yes
O'Donnell
No
Simanowitz
Yes
Abinanti
No
Curran
Yes
Gottfried
No
Lopez
Yes
Ortiz
Yes
Simon
Yes
Arroyo
No
Cusick
No
Graf
Yes
Lupardo
Yes
Otis
Yes
Simotas
Yes
Aubry
ER
Cymbrowitz
Yes
Gunther
No
Lupinacci
No
Palmesano
Yes
Skartados
No
Barclay
Yes
Davila
Yes
Harris
Yes
Magee
No
Palumbo
Yes
Skoufis
Yes
Barnwell
Yes
De La Rosa
No
Hawley
Yes
Magnarelli
Yes
Paulin
Yes
Solages
Yes
Barrett
Yes
DenDekker
Yes
Hevesi
No
Malliotakis
Yes
Peoples-Stokes
No
Stec
Yes
Barron
Yes
Dickens
Yes
Hikind
Yes
Mayer
Yes
Perry
Yes
Steck
Yes
Benedetto
Yes
Dilan
Yes
Hooper
Yes
McDonald
Yes
Pheffer Amato
Yes
Stirpe
ER
Bichotte
Yes
Dinowitz
Yes
Hunter
No
McDonough
Yes
Pichardo
Yes
Thiele
ER
Blake
No
DiPietro
Yes
Hyndman
No
McKevitt
Yes
Pretlow
Yes
Titone
No
Blankenbush
Yes
D'Urso
Yes
Jaffee
No
McLaughlin
Yes
Quart
Yes
Titus
No
Brabenec
Yes
Englebright
Yes
Jean-Pierre
No
Miller B
No
Ra
Yes
Vanel
Yes
Braunstein
No
Errigo
Yes
Jenne
Yes
Miller MG
No
Raia
Yes
Walker
Yes
Brindisi
Yes
Fahy
No
Johns
ER
Miller ML
ER
Ramos
Yes
Wallace
Yes
Bronson
Yes
Farrell
Yes
Jones
No
Montesano
Yes
Richardson
No
Walsh
Yes
Buchwald
No
Finch
Yes
Joyner
No
Morelle
ER
Rivera
No
Walter
No
Butler
No
Fitzpatrick
Yes
Kavanagh
No
Morinello
Yes
Rodriguez
Yes
Weinstein
No
Byrne
No
Friend
ER
Kearns
Yes
Mosley
Yes
Rosenthal
Yes
Weprin
Yes
Cahill
Yes
Galef
Yes
Kim
Yes
Moya
Yes
Rozic
Yes
Williams
Yes
Carroll
ER
Gantt
No
Kolb
No
Murray
Yes
Ryan
No
Woerner
No
Castorina
No
Garbarino
ER
Lalor
Yes
Niou
No
Santabarbara
Yes
Wright
Yes
Colton
No
Giglio
Yes
Lavine
Yes
Nolan
No
Schimminger
Yes
Zebrowski
Yes
Cook
Yes
Gjonaj
No
Lawrence
No
Norris
Yes
Seawright
Yes
Mr. Speaker
Yes
Crespo
Yes
Glick
Yes
Lentol
No
Oaks
Yes
Sepulveda

‡ Indicates voting via videoconference
DATE:06/14/2018Assembly Vote  YEA/NAY: 91/46
Yes
Abbate
Yes
Cook
No
Garbarino
Yes
Lupardo
Yes
Pellegrino
No
Stec
Yes
Abinanti
Yes
Crespo
No
Giglio
Yes
Magee
Yes
Peoples-Stokes
Yes
Steck
ER
Arroyo
No
Crouch
Yes
Glick
Yes
Magnarelli
Yes
Perry
Yes
Stern
No
Ashby
No
Curran
No
Goodell
No
Malliotakis
Yes
Pheffer Amato
Yes
Stirpe
Yes
Aubry
No
Cusick
Yes
Gottfried
Yes
McDonald
Yes
Pichardo
No
Tague
No
Barclay
Yes
Cymbrowitz
Yes
Gunther
No
McDonough
Yes
Pretlow
Yes
Taylor
Yes
Barnwell
Yes
Davila
No
Hawley
No
Mikulin
Yes
Quart
Yes
Thiele
Yes
Barrett
Yes
De La Rosa
Yes
Hevesi
No
Miller B
No
Ra
Yes
Titone
Yes
Barron
Yes
DenDekker
ER
Hikind
Yes
Miller MG
No
Raia
ER
Titus
Yes
Benedetto
Yes
Dickens
ER
Hooper
No
Miller ML
Yes
Ramos
Yes
Vanel
ER
Bichotte
Yes
Dilan
Yes
Hunter
No
Montesano
ER
Richardson
Yes
Walker
ER
Blake
Yes
Dinowitz
Yes
Hyndman
No
Morelle
Yes
Rivera
Yes
Wallace
No
Blankenbush
No
DiPietro
Yes
Jaffee
No
Morinello
Yes
Rodriguez
No
Walsh
Yes
Bohen
Yes
D'Urso
Yes
Jean-Pierre
Yes
Mosley
Yes
Rosenthal D
No
Walter
No
Brabenec
Yes
Englebright
Yes
Jenne
No
Murray
Yes
Rosenthal L
Yes
Weinstein
Yes
Braunstein
Yes
Epstein
No
Johns
Yes
Niou
Yes
Rozic
Yes
Weprin
Yes
Brindisi
No
Errigo
Yes
Jones
Yes
Nolan
Yes
Ryan
ER
Williams
Yes
Bronson
Yes
Espinal
Yes
Joyner
No
Norris
No
Santabarbara
No
Woerner
Yes
Buchwald
Yes
Fahy
Yes
Kim
No
Oaks
No
Schimminger
Yes
Wright
No
Butler
Yes
Fernandez
No
Kolb
Yes
O'Donnell
Yes
Seawright
Yes
Zebrowski
No
Byrne
No
Finch
No
Lalor
Yes
Ortiz
Yes
Simon
Yes
Mr. Speaker
Yes
Cahill
No
Fitzpatrick
Yes
Lavine
Yes
Otis
Yes
Simotas
Yes
Carroll
No
Friend
No
Lawrence
No
Palmesano
Yes
Skoufis
No
Castorina
Yes
Galef
Yes
Lentol
No
Palumbo
No
Smith
Yes
Colton
ER
Gantt
Yes
Lifton
Yes
Paulin
Yes
Solages

‡ Indicates voting via videoconference
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A04738 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A4738A
 
SPONSOR: Gottfried (MS)
  TITLE OF BILL: An act to amend the public health law and the state finance law, in relation to enacting the "New York health act" and to establishing New York Health   PURPOSE OR GENERAL IDEA OF BILL: This bill would create a universal single payer health plan -New York Health - to provide comprehensive health coverage for all New Yorkers.   SUMMARY OF SPECIFIC PROVISIONS: Every New York resident would be eligible to enroll, regardless of age, income, wealth, employment, or other status. There would be no network restrictions, deductibles, or co-pays. Cover- age would be publicly funded. The benefits will include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, laboratory tests, rehabilitative, dental, vision, hearing, etc. - all benefits required by current state insurance law or provided by the state public employee package, Family Health Plus, Child Health Plus, Medicare, or Medicaid, and others added by the plan. Everyone would choose a primary care practitioner or other provider to provide care coordination - helping to get the care and follow-up the patient needs, referrals, and navigating the system. But there would be no "gatekeeper" obstacles to care. As with most health coverage, New York Health covers health care services when a member is out of state, either because health care is needed while the member is traveling or because there is a clinical reason for going to a particular out-of-state provider. A broadly representative Board of Trustees will advise the Commissioner of Health. Long-term care coverage is not included at the start, but the bill requires that the Board develop a plan for it within two years of passage. The Board shall also develop proposals relating to retiree health benefits and coverage of health care services covered under the workers' compensation law. In addition to the Board, there will be six regional advisory councils to represent the diverse needs and concerns of the region. The councils shall include but not be limited to representatives of health care consumers, providers, municipal and county government, and organized labor. The councils shall advise the Board, Commissioner, Governor, and Legislature on matters relating to the NY Health program and shall adopt community health improvement plans to promote health care access and quality in their regions. Health care providers, including those providing care coordination, would be paid in full by New York Health, with no co-pays or other charges to patients. The plan would develop alternative payment methods to replace old-style fee-for-service (which rewards volume but not qual- ity), and would negotiate rates with health care provider organizations. (Fee-for-service would continue until new methods are phased in.) The bill would authorize health care providers to form organizations to collectively negotiate with New York Health. Health care would no longer be paid for by insurance companies charging a regressive "tax" insurance premiums, deductibles and co-pays imposed regardless of ability to pay. Instead, New York Health would be paid for based on ability to pay, through a progressively-graduated payroll-based tax (paid at least 80% by employers and not more than 20% by employees, and 100% by self-em- ployed) and a progressively-graduated tax based on other taxable income, such as capital gains, interest and dividends. A specific revenue plan, following guidelines in the bill, would be submitted to the Legislature by the Governor. Federal funds now received for Medicare, Medicaid, Family Health and Child Health Plus would be combined with the state revenue in a New York Health Trust Fund. New York would seek federal waivers that will allow New York to completely fold those programs into New York Health. The "local share" of Medicaid funding - a major burden on local property taxes - would be ended. Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents. (Existing retiree coverage could be phased out and replaced with New York Health.)   JUSTIFICATION: The state constitution states: "The protection and promotion of the health of the inhabitants of the state are matters of public concern and provision therefor shall be made by the state and by such of its subdi- visions and in such manner, and by such means as the legislature shall from time to time determine." (Article XVII, § 3.) All residents of the state have the right to health care. New Yorkers - as individuals, employers, and taxpayers - have experi- enced a rapid rise in the cost of health care and coverage in recent years. This increase has resulted in a large number of people without health coverage. Businesses have also experienced extraordinary increases in the costs of health care benefits for their employees. An unacceptable number of New Yorkers have no health coverage, and many more are severely underinsured. Health care providers are also affected by inadequate health coverage in New York State. A large portion of voluntary and public hospitals, health centers and other providers now experience substantial losses due to the provision of care that is uncompensated. Individuals often find that they are deprived of affordable care and choice because of deci- sions by health plans guided by the plan's economic needs rather than their health care needs. To address the fiscal crisis facing the health care system and the state and to assure New Yorkers can exercise their right to health care, this legislation would establish a comprehensive universal single-payer health care coverage program, funded by broad-based revenue based on ability to pay, for the benefit of all residents of the state of New York. The state will work to obtain waivers relating to Medicaid, Family Health Plus, Child Health Plus, Medicare, the Patient Protection and Affordable Care Act, and any other appropriate federal programs, under which federal funds and other subsidies that would otherwise be paid to New York State will be paid by the federal government to New York State and deposited in the New York Health trust fund. Under such a waiver, health coverage under those programs will be replaced and merged into New York Health, which will operate as a true single-payer program. If such a waiver is not obtained, the state shall use state plan amendments and seek waivers to maximize, and make as seamless as possible, the use of federally-matched health programs and federal health programs in New York Health, The goal of this legislation is that coverage be delivered by New York Health and, as much as possible, the multiple sources of funding will be pooled with other New York Health funds and not be apparent to New York Health members or participating providers. This program will promote movement away from fee-for-service payment, which tends to reward quantity and requires excessive administrative expense, and towards alternate payment methodologies, such a s global or capitat- ed payments to providers or health care organizations, that promote quality, efficiency, investment in primary and preventive care, and innovation and integration in the organizing of health care. This act does not create any employment benefit, nor does it require, prohibit, or limit the providing of any employment benefit. In order to promote improved quality of, and access to, health care services and promote improved clinical outcomes, it is the policy of the state to encourage cooperative, collaborative and integrative arrangements among health care providers who might otherwise be competitors, under the active supervision of the commissioner. It is the intent of the state to supplant competition with such arrangements and regulation only to the extent necessary to accomplish the purposes of this act, and to provide state action immunity under the state and federal antitrust laws to health care providers, particularly with respect to their relations with the single-payer New York Health plan created by this act.   PRIOR LEGISLATIVE HISTORY: 1992: A.8912-A passed Assembly 1993: A.5900 reported to Ways and Means 1994: A.5900 referred to Health Committee 1995-96: A.6801 reported to Ways and Means 1997-98: A.6172 reported to Ways and Means 1999-00: A.3571 reported to Ways and Means 2001-02: A.6779 reported to Ways and Means 2003-04: A.6952 reported to Ways and Means 2005: A.6576 reported to Ways and Means 2006: A.6576 referred to Health Committee 2007-08: A.7354 - reported to Ways and Means 2009-10: A.2356- referred to Health Committee 2011-12: A.7860-A - referred to Ways and Means 2013: A5389 referred to Health Committee 2014: A5389 - reported to Ways and Means 2015: A5062 - Passed Assembly 2016: A5062 - passed Assembly 2017: A4738 - passed Assembly   FISCAL IMPLICATIONS: Full funding for New York Health would come from the revenue measures to be proposed by the Governor under guidelines in the bill, plus available federal funds. The revenue package would also replace: local share of Medicaid, the state share of Medicaid, state and local payments for public employee health coverage, and various other health care spending. Numerous analyses document that a single-payer system would be most effective for reducing and controlling costs, for taxpayers, employers and individuals.   EFFECTIVE DATE: Immediately. The program will actually begin functioning when the Commissioner of Health declares the beginning of the implementation period.
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