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HEALTH CARE Some good, bad and ugly

The big question with single-payer health care in New York state has always been how to pay for it.

Democrats in Albany should keep that question in mind as they hold hearings on the New York Health Act during the upcoming legislative session. Better yet, they should keep that question in mind as they watch Gov. Andrew Cuomo take action to close the existing $4 billion gap between budgeted costs and actual costs.

New York’s Medicaid system is bloated now because legislators will often approve legislation that adds new little bits of coverage to the Medicaid program while the governor has made promises that have blown up in his face, like committing to reimbursing Medicaid providers the costs of the state’s minimum wage hike or increasing Medicaid rates for hospitals and nursing homes. Rather than deal with the problem head on this year, the governor chose to postpone Medicaid payments from March to April, punting $1.7 billion from one year to the next.

Medicaid is budgeted to cost New York state roughly $25 billion in 2019-20 — though we know the real cost is roughly $29 billion. A 2019 Rand Corp. study provided the good and the bad for the New York Health Act. First, the good from the Rand report. The New York Health Act is estimated to reduce the number of uninsured to zero because all state residents would be covered by the state plan or by primary coverage from other federal programs. Overall health care spending would decrease by 1% in 2022 and fall by about 3% by 2031 when compared to health care spending now.

Now, the bad from the Rand report. While total health care spending would decrease, state spending on health care would increase about 500 percent, with state spending on health care increasing from $34.1 billion to $172.5 billion in 2022.

Now, the ugly, provided by common sense — something backers of the New York Health Act are lacking right now. New York is $4 billion over a $25 billion Medicaid budget, and no one knows what programs will be cut to stay within budget or how much taxes and fees will have to be increased to pay the bill. Common sense says the act should be dead in the water right now given that it will increase the state’s spending on health care by 500%.

When was the last time common sense won an argument in our state capital?

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