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An estimated 44.3 million people in the United States, 16.3 percent of the population, do not have health insurance. With the devolution of health care responsibilities to the states, legislators are exploring innovative ways to address this issue. New York recently passed progressive legislation to provide access to health care for nearly a third of the state’s 3.2 million uninsured residents. The Health Care Reform Act (HCRA) 2000 also protects 250 straining hospitals and health centers through a $9 billion dollar budget allocation.
HCRA 2000 commits resources to provide quality health care. It makes important changes in the financing, delivery and availability of health care to New Yorkers. Among its programs and priorities:
- The legislation guarantees $1.3 billion in annual subsidies to hospitals for indigent care, graduate medical education and a massive expansion of Medicaid eligibility for the working poor over the next 3 years.
- Medicaid will be expanded through the Family Health Plus program, building on the
existing Child Health Plus program to cover lower income, uninsured adults.
- Through a provision of stop loss coverage, a new streamlined health insurance benefits package for small business will be supported by the state.
- Subsidies will be provided for working individuals without insurance and their families and for people with their own health insurance.
- Other new initiatives will include mental health programs, tobacco use prevention and control programs, school based health clinics and a Medicaid fraud line.
- New funds will continue to support existing programs including Elderly Pharmaceutical Insurance Coverage (EPIC) program, rural health funds, Emergency Medical Services, the AIDS Drug Assistance Program, poison control centers, cancer services and HIV services for pregnant women.
A unique coalition of labor organizations including the Service Employees International Union (SEIU) and hospital supporters organized local and national campaigns to build support for the health care legislation. Citizen advocacy groups such as Citizen Action of New York mobilized public support. And it worked. In a bipartisan consensus, —the senate vote was 52-0—HCRA 2000 became law
and creates an innovative financing system to support a wide range of health services. Funding for the program comes from a variety of revenue sources, including:
- A 55 cents per-pack tax hike on cigarettes, an important public health measure. Especially for young people, research shows that an increase in the cigarette tax reduces consumption of cigarettes.
- $375 million in proceeds from the state’s settlement with tobacco companies.
- The continuation of an 8.18 percent surcharge on certain health care services.
Locally, HCRA 2000 addresses the financial strain counties face. Taxpayers will benefit significantly from important Medicaid cost containments that translate into more than $1 billion in savings for county governments. Due to HCRA 2000, local governments will receive more than $350 million annually in tobacco settlements and $7 million more each year due to increases in the cigarette sales tax. The savings will be passed down to taxpayers and businesses.
New York has been a model, motivating force for state health care reforms across the country. New York State Representative Kevin Cahill (Flemming Fellow 2000) anticipates other states following "The most significant component of HCRA 2000 was the initiation of Family Health Plus. This is the greatest step in a decade toward universal health care in New York State, and perhaps the nation. The last
innovation of such magnitude was when New York instituted Child Health Plus, a program later copied by several states, which eventually became the model for federal support of such programs across the nation."
For more information on health care, visit StateAction.org
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