December 21, 2006
Advocacy groups release plan to require universal health-insurance coverage in New York
A new proposal for universal health-care in New York, generated largely by hospital interests, urges New York to consider a combination of mandates on employers and individuals and increased taxpayer subsidies for government-funded health insurance programs to provide universal health-insurance coverage in New York State.
The proposal acknowledges that total spending on health insurance in New York would increase by some $4 billion a year. It does not specify who would pick up that cost or how.
The report, A Blueprint for Universal Health Insurance Coverage in New York State, was released earlier this month by the United Hospital Fund and the Commonwealth Fund.
"We explored a combination of voluntary public program reforms, premium subsidies to make coverage more affordable, a new group insurance purchasing mechanism, and employer and individual mandates," the report said.
"While these changes could be made individually, when implemented together they would achieve universal coverage and improve coverage options for the insured to provide a more stable health insurance system for all New Yorkers."
The proposal calls for implementing a series of reforms serially. These include:
- Steps to increase participation in existing taxpayer-funded
public health insurance programs.
- Expand eligibility to New York's Family Health Plus (FHP) for
- Allow low-to-moderate-income New Yorkers to "buy in"
to FHP with income-related premium assistance.
- Create a new statewide purchasing mechanism—an "Insurance
Exchange"—that would provide individuals with a choice
of additional coverage options at group rates.
- Impose one of two new mandated charges on employers that do
not offer health insurance coverage. One would be a "modest"
annual tax on employers that do not offer health insurance. That
assessment would be $400 per employee per year. The other would
be a "pay or play assessment" of 8 percent of payroll,
with a credit toward this assessment available for coverage offered.
- Require all individual New Yorkers to buy health insurance and offer income-related premium assistance.
The report estimates that its ideas could ensure health insurance coverage of 98 percent of New Yorkers, with a net added cost of just over $4 billion. It noted that some of this money could come from a reallocation of taxpayer dollars that now subsidize New York's hospitals. It also noted that proposed federal tax credits could offset premium costs for families.
But it also noted that achieving the full coverage scheme envisioned would require "new financing sources" – which the report did not specify.
The report notes that the ideas were modeled in part on a new health insurance policy approved earlier this year in Massachusetts. That plan, which was developed after a broad collaborative effort involving health insurers, businesses, advocacy groups, taxpayer advocates, and political leaders, is described in detail.