Union Members Should Demand the New York Health Act
By Richard N. Gottfried, former New York State Assembly Member and sponsor of the New York Health Act
A recent post on The Wire: Powered by Educators of NYC by Peter Goodman opposes the New York Health Act, the bill to create universal, publicly-funded, publicly-accountable comprehensive health coverage (“single-payer”) for every New Yorker.
The Goodman opinion focuses a lot on the point that many details of the system are not spelled out in the bill. Of course not. Does a union contract name all the thousands of medical procedures and drugs the health benefit might cover and the price for each? But the bill spells out – in law – the key fundamentals that make clear that New York Health is the right choice for all of us, and far better than any other health plan, union or otherwise.
The NYHA specifies that anything covered by Medicare, Medicaid, state insurance law mandates, and any state or local public employee health plan will be covered for every New Yorker. This includes long-term care (home care and nursing home care). It’s dramatically broader coverage than any union health plan.
It guarantees no premium, deductible, co-pays, restricted provider network or out-of-pocket charges. The bill has strong enforceable language guaranteeing fair and adequate payment methodologies and rates.
All guaranteed by law, not at risk every time a union contract is re-negotiated.
The plan will be publicly-accountable, not run by an insurance corporation accountable to stockholders. The governor and legislators, and their families and friends, will all be covered by the plan, so they’ll have a keen interest in making sure it treats patients and providers as well as can be. And 20 million New Yorkers will benefit by being in the same plan.
The bill spells out that it will be funded by a progressively-graduated tax, based on ability to pay. For payroll income (anything subject to the federal FICA tax), the employer must pay at least 80% of the tax; the employer share could be more, especially through collective bargaining. (For state and local public employees, whatever percentage of the health benefit premium the employer currently pays, the bill requires the employer to pay at least that percentage of the NYHA tax for the employee, going forward.) The first $25,000 of a person’s income will be exempt from the tax; for Medicare enrollees, the first $50,000 of income will be exempt (acknowledging the federal money they draw into the system).
The tax will also apply to non-payroll income – e.g., dividends and capital gains – that is subject to the state income tax. That’s where really serious income is earned in our economy.
The exact brackets and rates will be set by the governor and legislature when the plan is ready to be implemented. That makes sense: today we don’t know what income levels and distribution, and health care prices, will be at that point.
Today, no one can tell any union member what their health plan will cost them or what the details will be in the next contract. Union leaders constantly say that every time they’re at the bargaining table, they have to choose between protecting the health plan or other wages and benefits.
Many studies by major consulting firms (e.g., RAND) and academics have analyzed state and federal single payer plans, including the NYHA. Almost all agree: the plan will produce billions in net savings over the current system. By eliminating insurance corporation bureaucracy, marketing and profit, cutting what health care providers spend fighting with insurance corporations, and slashing drug prices using the bargaining power of 20 million “covered lives,” NY Health will save almost $60 billion a year. After paying for long-term care and picking up out-of-pocket costs, the net savings will still be almost $20 billion a year.
Those savings, and the funding mechanism based on ability to pay, means almost every New Yorker will spend less than they now do for health care and coverage.
The article cites a report by a Canadian think tank called the Fraser Institute attacking the Canadian single-payer system. Fraser is a Canadian equivalent of the extreme right-wing Heritage Foundation (the people now hosting Project 2025).
The article expresses concern about the growing power of for-profit equity taking over health plans and health care providers. That’s a very important concern. It is made possible by the concentration of economic power exerted by a handful of huge health plans and pharmacy chains. We need a countervailing power serving the public interest. The answer is a universal publicly-run and publicly-accountable single-payer health plan – the NYHA.
Some unions say they support a universal health plan but say it should be done nationally. With the current climate in Washington, a national plan is not likely any time soon. And a plan enacted in New York will be more favorable to employees and patients than one enacted in Washington.
Richard N. Gottfried is an attorney who served as a member of the New York State Assembly representing portions of Manhattan. He also served as chair of its Committee on Health. Born and raised in NYC, he is a product of New York City public schools. Richard graduated from Stuyvesant High School.
He has strong roots in teaching and labor. His mother was a NYC high school math teacher from the early 1950s until she retired. She was a UFT member from its earliest days, and a Teachers Guild member before that. Richard learned about unionism as a child at the breakfast and dinner table. His mother-in-law was a Long Island high school English teacher and NYSUT member.
Editor’s Note: Learn more about the Campaign for the New York Health Act, here.
The Wire is encouraging Gottfried and Goodman to join a Talk Out of School or special Wire podcast to further discuss their differing opinions on unions sponsoring NYHA.
Here is Brooklyn chapter leader and subscriber Chad Hamilton’s recent related response to Peter Goodman:
Please never mind the double-post of right-wing doublespeak here in the comments section from Peter Goodman, a sycophant of Michael Mulgrew and Unity Caucus. The reality is that NYHA has a carveout for public labor unions which requires the employer to cover a minimum 80% of the payroll tax breakdown. A larger percentage, up to 100%, is subject to collective bargaining.
In addition to providing healthcare for all New Yorkers, NYHA will save money for at least 90% of all New Yorkers. NYHA is supported by some of New York’s largest labor unions, including 1199 SEIU, the New York State Nurses Association, Communications Workers of America, and the Retail, Wholesale and Department Store Union.
The UFT Delegate Assembly, the highest decision-making body of the UFT, resolved in May 2015 that, “The United Federation of Teachers strongly supports the New York Health Act as a way to improve public health, boost the state’s economy and ensure that the basic right of quality health care is enjoyed by all New Yorkers… The UFT will work toward passage of this important legislation.”
Instead of meeting and working with the sponsors of the NYHA bill to resolve any outstanding concerns, Michael Mulgrew unilaterally defies the will of the UFT Delegate Assembly, and by extension, the will of dues-paying rank-and-file UFT members. Michael Mulgrew and his Unity Caucus enablers are unfit for office, and UFT members will vote them out in May 2025.
You can learn more about the New York Health Act by reading the independent studies conducted by the Rand Corporation and UMASS, or by clicking on either of these links:
nyhcampaign.org. www.nysenate.gov/sites/default/files/article/attachment/5024_jackson_nyha_brochure.pdf
First, using Trump-like campaign language is not productive, my views are my own.
Dick has fought for a Medicare for All plan for decades, no state has adopted a similar plan.
The plan will cost billions and funding the plan is a baseline issue.
I asked what I thought was a simple question: what would the plan cost a teacher? With dense alghoryms and Artificial Intelligence I’m sure someone can produce a formula: punch in age, gender, family size and income and receive an estimate. Dick seems reluctant.
Will higher income folks, like teachers subsidize lower income folks? I have no idea.
And, contracts don’t address every item, they do address issues agreed upon by both sides, management and labor, and, contracts contain a dispute resolution process ending in binding arbitration. Dick says the plan puts items into law, if the plan administrators veer away what is the remedy? Going to court? A binding arbitration process is far quicker and more sensible.
I suggest an FAQ: select a stratified, random sample of end users, collect questions, test the answers, in other words build a constituency for the law.
The hesitancy is disturbing.
We vote to accept or reject our contracts, we’re asked to accept a dramatic change in our healthcare based on trust.
This is too important to trust without verifying.
Would Senator Gottfried address the Medicare Advantage plan that the City would dump retirees and their dependents into.