Feb. 7th – Mini-Lobby Day – Albany, NY
January 31, 2012
Single Payer New York is holding a mini-lobby day next Tuesday, Feb. 7th in Albany to meet with key legislative leaders to build support for a state single payer bill. Contact email@example.com if you would like to participate. A main focus is to line up more Senate sponsors.
Our major statewide lobby day will take place in Albany on May 1. We would like to get 50 plus people to participate.
Assemblymember Gottfried has drafted an update to his single payer bill. A summary is below and attached.
Empire State Health
Draft Legislation to be introduced by Assembly Health Committee Chair Richard Gottfried
This is a single payer bill that will create a state-run public plan, Empire State Health, in the Department of Health to provide universal comprehensive coverage for all New Yorkers. (Long-term coverage is not included, but a plan for it is to be developed within five years of passage.)
A broadly representative Board of Trustees will advise the Commissioner of Health.
Federal Funding and Waivers
Under the bill, New York would seek federal waivers that will allow ESH to encompass Medicare, Medicaid, CHIP, PPACA, and any other federally-funded program.
Private insurance that duplicates benefits offered under ESH cannot be offered to NYS residents.
Eligibility, Benefits and Cost-Sharing
Every New York resident is eligible to enroll, with no premium or other charge.
The benefits will be those provided by Family Health Plus, Child Health Plus, Medicare, and, for those eligible for Medicaid, by Medicaid (except long-term care).
There is no cost-sharing (deductible, co-pay, co-insurance) under the program. Members are required to enroll with, and use the services of, a care manager, but services are not denied if they have not yet had the opportunity to choose one.
Payment to Providers
Initially, payment to providers will be on a fee-for-service basis, except for care management, but other payment methodologies can be set up by the Commissioner. Fees would be negotiated with providers’ representatives.
The bill does not include funding, but provides that the Governor will propose a funding plan composed of a graduated payroll tax, paid 80% by employers and 20% by employees, and a non-payroll assessment on unearned income (dividends, interest, capital gains). These funds, and Federal funds received under various waivers, will be placed in an Empire State Health Trust Fund.
*Summary prepared by Dr. Len Rodberg, Research Director, PNHP-NY Metro