Health Care

Lawmakers introduce latest version of single-payer health care bill

The bill’s sponsors have tweaked the 30-year-old legislation in a bid to attract support from public sector unions who currently oppose it.

Assembly Member Amy Paulin speaks at a press conference in Harlem announcing the reintroduction of the New York Health Act.

Assembly Member Amy Paulin speaks at a press conference in Harlem announcing the reintroduction of the New York Health Act. Rebecca C. Lewis

The legislative session may be over for the year, but the work of lawmakers hasn’t stopped. 

State lawmakers on Friday introduced the newest version of the New York Health Act, a 30-year-old piece of legislation that would establish a single-payer health care system in New York state. The latest draft of the bill includes changes meant to address concerns from public sector unions that have resisted the bill – and a new Assembly sponsor.

The newly reintroduced bill includes a handful of tweaks compared to old versions, but the most significant ones are in direct response to public sector unions like District Council 37 and CSEA which are afraid the New York Health Act would take away hard-fought benefits for its members. “We’ve added language to ensure that they would get 100% of the benefits that they currently have,” Assembly Member Amy Paulin, the new sponsor in the lower chamber, said at a press conference announcing the new bill. “So that’s a big shift. They didn’t ask us for it, but we know that that is one of their primary concerns, so we have added that to the bill.” Specifically, the new language ensures that the cost-sharing structure in place for public sector union members and their employers would stay in place under the New York Health Act, and the union members would retain all the same health care benefits they previously negotiated for.

Longtime state Senate sponsor Sen. Gustavo Rivera said that he, Paulin and former Assembly Member Richard Gottfried, the original bill sponsor, have been willing to have conversations with the public sector unions about the bill, but the public sector unions have still opposed the New York Health Act even after the sponsors included changes to the 2019 version meant to assuage fears. “What we’re saying is like, ‘Listen, you’ve told us that these are concerns that you have… very well, this is language that addresses that,’” Rivera told City & State. He said that he and Paulin did not reach out to leaders of DC37 or CSEA before reintroducing the bill – Paulin said that since becoming Assembly Health Committee chair in January, she has only had a chance to speak with supporters of the bill – but that “there’s always an open door.”

Although now retired from the Assembly, Gottfried was also at the press conference, continuing his involvement on legislation that would be his legacy if approved. He told City & State that he had drafted the new public sector union language years ago. “For a long time, we kept waiting for them to say, ‘Yeah that language is okay,’” Gottfried told City & State, noting that public sector union leaders wouldn’t need to pledge their support in order to get the language added.  “We finally got tired of waiting and just added it to the bill.”

Rivera said that he had originally expected to see the New York Health Act reintroduced after the state budget got approved in early May, but it wound up taking a little longer, in part because Paulin wanted to make sure she was completely up to speed on all the nitty gritty details of the bill. “I’m more of an in-the-weeds kind of legislator, and I needed to get there,” Paulin said, adding that Gottfried has been “extraordinarily helpful” with that. After the legislative session ended, Paulin ended up having a five-hour Zoom call with Rivera and Gottfried to learn all the ins and outs of the legislation. For his part, Gottfried said he plans to continue helping in any way he can, despite his retirement. “Some people do crossword puzzles for fun, I like bill drafting for fun,” he said.

Organized labor is split when it comes to support for the New York Health Act. Major public sector unions have opposed the bill, but many politically powerful private sector unions have thrown their support behind it, including those representing health care and medical professionals. “As a nurse of over three decades, I know that health care is a human right,” New York State Nurses Association President Nancy Hagans said at the Friday press conference. “And that to guarantee comprehensive, quality health care to all residents of New York… we have to pass the New York Health Act.” The coalition of supporters also includes 32BJ, 1199SEIU, Communications Workers of America and the Retail, Wholesale and Department Store Union.

The bill’s prospects are unclear. The New York Health Act passed the Assembly several times in the past, though not since Democrats regained control of the state Senate in 2019. Although past versions have technically had enough co-sponsors to pass in the state Senate and Assembly, it has not come up for a vote in either chamber since a Democratic majority in the upper house gave the bill a real chance at becoming law.