Health Care

Is it finally, finally the year for the New York Health Act?

Single-payer health care’s biggest champion, Assembly Member Richard Gottfried, will retire after the 2022 legislative session.

The New York Health Act would create a single-payer health care system in New York, the first of its kind in America.

The New York Health Act would create a single-payer health care system in New York, the first of its kind in America. Ryan Rodrick Beiler/Shutterstock

After 50 years in the state Legislature, Assembly Member Richard Gottfried has decided to retire after becoming the longest-serving state lawmaker in New York history. But he risks leaving office before seeing his signature bill get signed into law: the New York Health Act. Gottfried has sponsored the single-payer health care bill since he first introduced it 30 years ago, and while it has passed in his chamber on several occasions when Democrats didn’t hold a majority in the state Senate, it has never made it anywhere near the governor’s desk. 

Now progressive lawmakers and activists are making a final push to get the New York Health Act passed before Gottfried leaves office at the end of 2022. But despite significant support on paper, other lawmakers say the prospect of the Legislature and the governor reaching a consensus on such a massive undertaking seems too large a task for the upcoming session. 

Gottfried first introduced the New York Health Act in late 1991. The law would create a single-payer health care system in New York, the first of its kind in America. In its current iteration, the bill would almost completely eliminate private insurers in the state, banning them from operating within New York’s borders unless offering coverage not provided by the state, like cosmetic surgery. Insurance would come from the state, covering everyone regardless of employment, income or even immigration status. Funds would come from tax increases – significant ones – but people would no longer have to pay premiums, deductibles or copays.

The legislation first passed the Assembly in 1992, shortly after its first introduction. It would pass four more times in the Assembly between 2015 and 2018, but it never moved in the state Senate. And it hasn’t passed again since Democrats took control of both chambers in 2019, when approving the legislation would be more than symbolic. But with Gottfried’s retirement as something of a deadline, some lawmakers and single-payer advocates are ready to make the 30th anniversary of the bill the year it finally passes. “We HAVE to pass the NY Health Act for AM Gottfried retires,” state Sen. Jabari Brisport tweeted when the Gottfried news broke.

For his part, Gottfried is determined to bring single-payer health care to New York before he leaves office. “There is nothing more important to me legislatively than passing the New York Health Act (next) year,” Gottfried said in an interview. “I am hopeful and confident we can do it.” Although passing such massive legislation may seem like a heavy lift for a single year, Gottfried said that it just needs a push over the finish line. “The bill was not born yesterday,” he said. “People have been looking at it and working on it for 30 years.” 

The bill already has enough co-sponsors in both chambers to pass, which Gottfried considered a testament to the amount of input he and others have incorporated into the legislation from any number of stakeholders. And the state Senate Majority Leader Andrea Stewart-Cousins created a working group earlier this year to revise the legislation to build consensus in the conference. According to state Sen. Gustavo Rivera, who is senate Health Committee chair and senate sponsor of the New York Health Act, that’s a clear sign that leadership is committed to reaching consensus. “I can tell you that I am going to work, like, double as hard – if doubly is a word – doubly as hard to pass it this coming year,” Rivera said. “It would be the equivalent of giving (Gottfried) a grand-spanking new Rolex.” 

Organizers are also preparing to ramp up their efforts next session. “We feel like there’s never been a more important time to pass universal health care than two years into a pandemic that continues to impact New Yorkers,” said Ursula Rozum, co-director of the Campaign for New York Health. She said that the coalition will better coordinate with its partners to organize actions around the state. That includes left-wing heavyweights like Citizen Action and the Working Families Party, which helped secure progressive victories this year. “(We’ll be) really bringing together the advocacy organizations and the legislators as a united front,” Rozum said.

But that’s not to say the road will be an easy one. The legislation still faces opposition, notably from public sector unions who fear they will lose hard-fought health benefits under the bill. Although Gottfried said he has had ongoing conversations with labor leaders to address their concerns, it remains a hurdle. He cited opposition from unions as a “key concern” for Assembly Speaker Carl Heastie, whose spokesperson did not return a request for comment.

“It’s got a long way to go,” said state Sen. Diane Savino, who is not a co-sponsor. She added that the overall cost of implementation is still a concern – although proponents point to a Rand Corp. study that concluded it would create a net saving for the state – and the lack of coverage for those who work in New York but live outside the state is an issue. She said it would be “highly unlikely” for the New York Health Act to pass. 

Even among supporters, the prospect of passing the bill in 2022 seems like more of a pipe dream. “It will only move after there’s a strong enough consensus amongst our members, and currently we are far from unanimous on this crucial legislation,” Assembly Member Jeffrey Dinowitz said in a text. A co-sponsor and supporter of the legislation, he chairs the Codes Committee where the New York Health Act currently sits. He suggested it may go back to the Health Committee. “I think there’s strong support, but I think there’s some more work to be done,” he added.

Gottfried brushed aside such concerns, citing the decades of work that have already gone into making the bill what it is today. And unlike any past year, he said the governor is actually on board to discuss the details, if not offer an endorsement. “My main request was that I have the opportunity to go through the bill with her administration, with her people… and work through whatever specific concerns they have with the bill,” Gottfried said. “We’ve never been able to do that with the governor.” Hochul, who at an unrelated press conference on Tuesday declined to take a position on the New York Health Act or single-payer in general, agreed to at least that much.

Even if the bill doesn’t pass next year, Rozum said that Gottfried laid the groundwork over the decades for other lawmakers who can continue carrying the torch. “We know that Gottfried has been really supporting this growing bench of health care champions that can pick up the baton if we don’t win this year,” she said. Newer legislators like Brisport and Assembly Member Zohran Mamdani are among a new class of progressive lawmakers that have made the passage of the New York Health Act a priority.

Gottfried has served as a mentor to that new class of left-wing legislators who will carry on his work when he leaves office. Those include Assembly Member Yuh-Line Niou, who was elected before the more recent wave of democratic socialist victories. Like many of her colleagues on the left, she’s ready to make Gottfried’s dream a reality before his retirement. “Let’s do it for him.”