State legislator offers public health care option | News, Sports, Jobs

Assemblyman Kenneth Zebrowski, D-Rockland, speaks at the opening of a new corporate headquarters of Jawonio Inc., which provides services to people with intellectual/developmental disabilities, behavioral health issues and chronic medical needs. Photo submitted

Assembly Democrats are proposing a new way to provide health coverage in New York State.

Assemblyman Kenneth Zebrowski, D-Rockland, introduced A.10664 to establish a public health insurance option and related fund for program revenue. Zebrowski’s approach is a stark difference from the New York Health Act, which has been pushed by many Democrats for more than three decades.

Many state legislative Democrats pushed for the New York Health Act, which would create a single-payer health care system in New York State. First introduced by Assemblyman Richard Gottfried, D-New York City, in 1991, the New York Health Act has been much discussed and debated — it even won Assembly approval from the State five times from 1993 to 2018 – but never became law. Gottfried is expected to retire from the Assembly at the end of 2022.

The sticking points for the New York Health Act have largely been costs. The legislation would nearly eliminate private insurers from the state unless they provide coverage not provided by the state plan. The system, deemed feasible if certain conditions regarding federal funding were met, would increase state health spending by $34.1 billion to $172.5 billion, according to an analysis by Rand Corporation.

Zebrowski’s approach is different from Gottfried’s. A public health care option is always operated by the state or federal government, but may be administered by a private entity or private insurance company and then offered as an option alongside existing private health insurance companies. .

Much remains to be fleshed out in Zebrowski’s proposal, such as fee structures, as it would be up to the state health commissioner to present an implementation plan to the state legislature after the legislature establishes the program. The Rockland Democrat is proposing a board to run the program with nominations by the governor and legislative Democrats and Republicans.

“Although New York has expanded the availability of Medicaid and embraced the market under the Affordable Care Act, health care remains prohibitively expensive for too many New Yorkers,” Zebrowski wrote in his legislative rationale. “There is a major gap that middle-class New Yorkers fall into if they are not eligible for employer-sponsored health care or federal health plan tax credits on the exchange. . It’s time for New York to fill this gap with an affordable public options plan that all New Yorkers have the opportunity to purchase.


New York now joins Connecticut, Oregon, New Jersey and New Mexico among states with a public options plan currently pending in their respective state legislatures.

Washington State began offering a public option in 2020, but through February only 25 of the state’s 39 counties had public option plans available to their residents. In 2021, only 1% of people buying health care plans on the stock exchange chose the public option plan. A Kaiser Health Network report from February quoted State Rep. Eileen Cody, who sponsored the public option legislation, as saying it was difficult to create networks because the original legislation did not require hospital participation, although the Washington State Hospital Association said the majority of hospitals chose to participate.

The Kaiser Health Network notes that health care providers often oppose public option proposals because the public option concept relies on a base of lower reimbursement rates for medical providers, hospitals and others. providers, which will reduce their income. Private insurance companies tend to oppose public options because they offer lower premiums than private health care companies.

Nevada approved a public option health care plan in 2021 that will be available to consumers in fall 2025. To enter the market, the public option plan will need to undergo an actuarial study, then the state will have to seek a waiver from the federal government. Eventually, Nevada could become the second state to offer a state-run health care plan, following Washington in 2019.

According to the Associated Press. Critics of the bill decry price controls and fear that forcing doctors and hospitals to accept patients at a lower cost will cause them to leave the state and worsen the shortage of practitioners.

According to the Kaiser Health Network, Washington’s experience shows the difficulty of reducing health care costs while working within the current system.

“That’s sort of the big trade-off,” Aditi Sen, a health economist at the Johns Hopkins Bloomberg School of Public Health, told Kaiser Health Network. “You’re trying to reduce premiums enough to get people to sign up, but not so much that providers don’t participate.”

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