IF PASSED, THE NEW YORK HEALTH ACT (NYHA) would provide comprehensive health care for all New Yorkers.
Photo courtesy of the New York Progressive Action Network

For the last 31 years, Richard (Dick) Gottfried has been the primary sponsor and most effective proponent of the New York Health Act (NYHA). On Jan. 4, 2023, for the first time in 52 years, the New York State Assembly convened without him among its members.

If passed, the NYHA would provide comprehensive health care for all New Yorkers. As stated in the bill, healthcare “would no longer be paid for by insurance companies charging a regressive ‘tax’ [of] 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.”

The bill passed in the State Assembly in 1992 and then again in 2015, 2016, 2017, and 2018. In 2021 and 2022, it had a veto-proof majority of co-sponsors who promised to vote for passage in both the Senate and the Assembly. So, the bill’s supporters had high hopes that the NYHA would be signed into law before Gottfried’s retirement, but it never made it to the floor of either chamber.

What is going to happen to the New York Health Act now that its most effective advocate has retired from the State Assembly and from his position as chair of the Health Committee in the State Assembly?

According to State Senator Gustavo Rivera, chair of the Senate Health Committee, Gottfried will continue to be influential in the future of NYHA. At a community ZOOM meeting on Dec. 14, Rivera said that “Dick is in conversation with the speaker and the speaker’s staff. What he says will carry great weight.”

However, Rivera was dubious on the prospect of the NYHA getting to the floor for a vote in both legislative houses this year, saying “before redistricting,” he explained, “an internal working group was working on the bill.” The new districting upended that group because its members had to focus on getting re-elected in their newly formed districts. Rivera promises to restart the working group this year and get most members of the conference fully supportive.

“I am still committed to this,” says Rivera. “It is something we have an obligation to do. We need to shine the light on it and turn up the heat.” He added, “We need champions, not just sponsors.”

Members of the Campaign for New York Health would agree with Rivera’s conclusion. The Campaign is a coalition of organizations that has been the primary coordinator of non-legislative strategies to raise public support for the NYHA and give elected officials the push they need to pass the bill. Jeff Mikkelson, a regional Coordinator of the Campaign recently said that, with Gottfried gone, “There are nothing but question marks about where the NYHA is going.” No one knows who the sponsor will be in the Assembly and who will chair the Health Committee. Even the Campaign for New York Health is in a state flux and is searching for a new director. “This will be a building year to build the base, build public awareness around the bill, and build support in the legislature,” Mikkelson said.

The crux of the problem appears to be that too many of the legislators who signed on as co-sponsors did so only because it plays well with voters. They were not committed supporters. When the number of co-sponsors constituted a supermajority and it appeared that the NYHA could actually have been enacted, numerous sponsors failed to act on their promise. They did nothing to pressure the leadership to get the bill to a floor vote in either house. These are not the ‘champions’ of the bill that Senator Rivera says are needed.

“It seems that the closer we get to passing this thing,” says Mikkelson, “the farther away we are.”

In addition, Mikkelson suggests that serious supporters of the NYHA are needed who will run primary challenges against these soft supporters now in office. He pointed to the recent success of Sarahana Shrestha in ousting thirteen-term incumbent Democrat, Kevin Cahill, chair of the powerful Insurance Committee and nominally a co-sponsor of NYHA. “Shrestha, a political newcomer, ran to the left of Cahill in a conservative district as a vocal supporter of the NY Health Act. She won because the NYHA is widely popular and urgently needed.” This outcome, says Mikkelson, “should act as a cautionary tale for any NY State Democrat who has been sitting on their hands or quietly blocking progress on the NY Health Act.”

Rivera and Mikkelson both talked about another obstacle blocking passage: Some powerful municipal unions oppose passage of the Act.

Unions would seem to be natural supporters of NYHA, and, indeed, many unions do support it. They understand that if they did not have to bargain for health care coverage because everyone was getting that cost covered by the state, then the unions could focus on their core goals of higher wages and better working conditions. Unfortunately, some unions, like UFT, DC37, and CSEA, are actively opposing the bill. Part of the explanation for this phenomenon is that a primary success of the unions that draws and keeps members is the provision of health benefits.

“The NYHA removes a competitive advantage that unions can offer their members,” Mikkelson explains. “Persuading more unions to support the bill will require convincing enough rank-and-file members and their leaders that the enhanced benefits they will enjoy under NYHA—taking health care off the table in negotiations, eliminating copays, expanding networks, guaranteeing long-term care, etc—outweigh the vested interest unions have in administering health benefits under the private insurance system.”

Finally, there is the question of who pays what. George Albro, co-director of the statewide New York Progressive Action Network, points out that UFT members, for example, have no deductions taken out of their paychecks to pay for health insurance. NYHA will provide better coverage, but everyone with income will have to pay something in the form of a tax. The non-supporting unions demand to know exactly what the costs will be. Although the bill has yet to specifically provide a formula for cost allocation, Albro believes that Senator Rivera will be modifying the NYHA to resolve this problem.