Bond Benefits Consulting, Inc August 28, 2018

Buffalo Niagara Partnership Andrew Cuomo 2018 2018 Cynthia for New York
The Business Council of New York P.O. Box 4105 25 Chapel Street, Suite 700
State, Inc. New York, NY 10163 Brooklyn, NY 11201
Business Council of Westchester
Capital Region Chamber of Commerce
Dear Governor Cuomo and Ms. Nixon,
Centers Health Care
Chemung County Chamber of
On behalf of a broad group of organizations representing employers,
Commerce healthcare providers, labor unions, health plans, and brokers that are
Columbian Mutual Life Insurance
committed to ensuring access to high-quality and affordable health care
Company for all New Yorkers, we are writing to express our concerns about
proposals to create a government-run, single payer health care system in
Consiliarium Group, LLC
our state.
Corning Area Chamber of Commerce
Dupli Envelope As you may be aware, recently the RAND Corporation issued an
Employer Alliance
analysis for the New York State Health Foundation of the New York
Health Act, which would establish such a system. While the report
Greater Central New York Association
of Health Underwriters
suggested that such a system could be feasible, it would require massive
tax increases. Further, the analysis assumed that significant reductions
Greater Rochester Chamber of
in payments to doctors and hospitals would be necessary to achieve the
Commerce
projected savings and the state would be able to obtain the necessary
Hematology Oncology Associates of
waivers from the federal government,—assumptions that the report
Central New York
called “highly uncertain.” A closer look at these assumptions
The Hilliard Corporation
underscores the concerns about a single payer system.
Matt Industries
National Federation of Independent
Massive Tax Increases: The proposal would require a tax increase of
Businesses $139 billion in the first year alone, a 156% increase in what the state
currently collects in taxes, and up to $210 billion by 2031. These tax
New York Health Plan Association
increases would be on top of the $82 billion New York already spends
New York State Association of Health
on health care. There’s no guarantee New Yorkers — individuals and
Underwriters
businesses — would accept the extreme tax increases. Authors of the
New York State Building &
study noted the potential for tax avoidance, including changes in
Construction Trades Council
investment decisions or wealthier people or employers moving out of
New York State Conference of Blue
the state, saying even a small number of people or businesses leaving
Cross and Blue Shield Plans
the state could cause the tax base to collapse.
North Country Chamber of Commerce
Pathfinder Bank Cuts to Provider Payments: The savings from a government-run
system would come from reducing the reimbursement rates the state
Perry & Carroll Inc.
pays doctors, hospitals, drug makers and other providers. Hospitals have
Rockland Business Association
already voiced concerns about suppression of reimbursement for
Sergeants Benevolent Association providers by state programs. Further, the RAND study noted that as a
The Agency result of lower provider payments, doctors may relocate from the state.
Uniformed Firefighters Association of
Greater New York
Unshackle Upstate
Welliver McGuire, Inc.
Uncertain Federal Approvals: The state would need to receive waivers from the federal
government for both New York’s current Medicaid program and to include Medicare beneficiaries in
the new system. The Centers for Medicaid and Medicare Services has already signaled it will not
grant such waivers for state-based government-run health care proposals.
The RAND report stressed that none of these assumptions are guaranteed. Even if they were
realized, the impact of moving from our current health care system to government-run health care
would be monumental.
Individuals who like their current coverage — including Medicare beneficiaries, individuals with
union or employer-based coverage, and individuals enrolled in the Essential Plan — would lose their
coverage, as a government run health care system would limit options available to New Yorkers.
Even with massive tax increases, patients may still have to wait longer for treatment and there is no
guarantee that they would be able to see the doctor or specialist of their choice.
It is important to remember that New York has been a leader working to achieve universal coverage.
Over the past four years, the number of uninsured New Yorkers has been cut in half from 10% in
2013 to less than 5% today. This is due in large part to the state’s efforts to implement the
Affordable Care Act and the investments that have been made to reform how care is paid for and
delivered.
A government-run, single payer health care system would undo all that New York has already
achieved. The focus now should be on measures to provide coverage to the 5% of state resident who
are uninsured and making health care more affordable without damaging the health care system and
disrupting coverage for those who are covered. Our organizations stand ready to work with you in
working to realize the goal of universal coverage for all New Yorkers.
Sincerely,
Heather C. Briccetti. Esq.

President & CEO

The Business Council of NYS