Republicans in Congress and President Trump will soon repeal the Affordable Care Act, eliminating healthcare coverage for millions of Americans, and weakening the insurance coverage for millions more. President Obama’s signature achievement can be defunded and effectively repealed within months. More than 20 million Americans would have a year or two before they lose their health coverage. As many as 2.7 million in New York stand to lose their coverage without the ACA. Given that Trump, Pence, or another Republican of Paul Ryan’s choosing will be in the White House for the next four years, there is no chance that Democrats will be able to make any improvements to the healthcare system in that time. So what can we New Yorkers do about it?

The Campaign for New York Health, led by a coalition of nurses, physicians, teachers, organized labor, and others, is working to create a single-payer, universal healthcare system for New York State. The New York Health Act will provide universal, comprehensive healthcare coverage and billions of dollars in savings for New York families, businesses, and local governments.  

Despite attempts to address the outsized corporate influence in our healthcare system, healthcare spending as a percentage of GDP has grown from around five percent in 1960 to just under 18 percent in 2014. Despite this rise in spending, the uninsured rate in 2014 was the same as in 1973, right around the time Medicaid was expanded to include people with disabilities. 

Though the ACA has slowed the increase of healthcare as a share of GDP, insurance costs in real dollars are still on the rise. 

By shifting to a single-payer program, we will reduce the overall cost of healthcare in New York by tens of billions of dollars. According to an analysis by University of Massachusetts economist Gerald Friedman, single-payer will save over $70 billion, including $26 billion in savings on insurance administration and profit, $16 billion in reduced drug and medical device prices, and $5 billion in reduced fraud related to overbilling.  

If that sounds like a lot of money, it is. The billions of dollars we waste each year through the inefficient allocation of healthcare resources is why healthcare costs have risen every year for decades. The New York Health Act will radically reduce this waste, making it possible to provide every New Yorker comprehensive health coverage. 

Making Medicine Affordable Again

Americans have been price gouged for years on pharmaceuticals and medical devices. Private equity sociopath Martin Shkreli notoriously acquired the 62-year-old drug Daraprim and raised its price from $13.50 per tablet to $750 per tablet. Last week a Senate amendment proposed by Bernie Sanders, which would have allowed the re-importation of drugs from Canada at much lower prices, had bipartisan support but was defeated by senators—including 13 Democrats—in the pocket of Big Pharma. Pharmaceutical companies get away with charging Americans much higher prices than they charge Canadians, because Americans lack the collective negotiating power of a single healthcare payer.

Passing the New York Health Act will means drug companies will have to negotiate with the government for access the 20 million person New York health care market, which will dramatically reduce drug prices.

Nuts and Bolts

The New York Health Act will establish a trust fund that pools federal funding from Medicare, Medicaid, children’s health plans, and other federal entitlements. A progressive payroll tax on income and a capital gains tax on unearned income will also be paid into the fund.  These sources of funding will replace health care premiums, deductibles, and copays. This is vitally important: The New York Health Act creates new taxes, but those taxes replace all other healthcare spending. 

The progressive payroll tax will provide a fair source of funding for healthcare. For all workers, the first $25,000 of income is tax-free, and the tax increases progressively the more money a person makes. Payment of the tax will be shared by employers and employees, with employers paying the bulk of the cost. However, because of the savings under single-payer, coverage will be much more affordable than from the private insurance companies.

As an added benefit, businesses will no longer have to manage health insurance plans. Right now, we ask businesses to provide health insurance for their employees. Supermarkets and department stores are among those who have no choice but to participate in the healthcare business. They have to research multiple payer options and choose one to offer employees. 

Single-payer gets businesses of all sizes out of the healthcare business to focus on the reason their doors are open in the first place.   

Benefit to Erie County

New York is one of the only states that forces counties to contribute to Medicaid.  The New York Health Act will shift those costs from the county back to the appropriate level of government—the state.  This will reduce counties’ costs significantly. In 2012, Erie County paid $242 million into Medicaid, which is equal to 82 percent of what the county collected in property taxes. Eliminating the local share of Medicaid will give Erie County the ability to lower property taxes, create an emergency surplus for economic downturns, rebuild infrastructure like failing roads and bridges, and fund other important programs.  

Comprehensive Coverage

All New Yorkers would be “covered for all medically necessary services, including: primary, preventive, specialists, hospital, mental health, reproductive health care, dental, vision, prescription drug, and medical supply costs.” The care provided under the New York Health Act would be more comprehensive than plans offered by health insurance companies today. 

A Workable Way Forward

New York State can be the first in the country to pass universal, single-payer health insurance into law. When the Affordable Care Act is repealed, the millions who would otherwise lose insurance in New York would be protected. If the federal government will not ensure basic healthcare for its citizens, state governments must act. The New York Health Act will cover every New Yorker, reduce the costs of administering local government, and help people avoid bankruptcy. 

This bill has already passed the New York State Assembly twice. Now it’s time for the State Senate to lead. Please call your state senator this Friday, January 27, on the statewide call-in day of action. Your senator needs to hear from you to know why single-payer is important and why you are willing to fight for New Yorkers’ healthcare.

If you live in Tim Kennedy’s district, tell everyone you know about the New York Health Act and get them to sign up and call in. The sooner Senator Kennedy comes on board, the sooner we can focus our efforts on Senate Republicans. 

Go to nyhcampaign.org to learn more about the legislation and about how you can support the campaign or contact Liberty Union Progressives on Facebook to get plugged in.