Updated Analysis of the Economics of the
New York Health Act
November 2021
Prepared by Leonard Rodberg, PhD
Professor Emeritus of Urban Studies at Queens College/CUNY and
Research Director of the NY Metro Chapter of Physicians for a National Health Program.
Executive Summary
Recent economic analyses of the New York Health Act show that a universal, single-payer health care system is the only plan that will provide universal, guaranteed health care at less cost than the status quo.
Using CMS projections of health care spending and State income projections, we have updated earlier results to project the economic impact of the New York Health Act if it is fully implemented in 2025. The New York Health Act will generate net savings of $16.8 billion, or 4.8% of total expected costs, as compared with projections for the status quo. In answer to the commonly-asked question ”How much will the New York Health Act cost?”, the answer is that it will actually save nearly 5% of what we now spend.
Many also ask “How are you going to pay for it?” The answer is that, unlike in the current system, it will be paid for fairly in accordance with ability to pay. The sample progressively-graduated tax brackets and rates proposed in the earlier report (and widely distributed thereafter) will continue to fully fund the system.
The New York Health Act creates the New York Health plan which will provide coverage for every New York resident and every non-resident working full-time in New York, with no premiums, deductibles, or co-pays. Benefits will be comprehensive including primary, preventive, specialty, hospital, mental health, reproductive health care, dental, vision, prescription drug, medical supply, and long-term care (home care and nursing home). The Act will be financed through a progressively-graduated payroll tax that replaces premiums and all out-of-pocket expenses. (At least 80% of the payroll tax will; be paid by employers, with up to 20% of the tax paid by employees. Employers could agree to pay a higher percentage, for instance, through collective bargaining.) There will also be a progressively-graduated tax on non-payroll (investment) income.
In 2018, the nonpartisan RAND Corporation performed an economic analysis of this legislation. The principal findings of the RAND report were that the New York Health Act will cover everyone, improve benefits, eliminate cost-sharing, cost no more than New York is now spending, and provide savings for almost all New Yorkers.
Following its publication, this author performed an evaluation of the RAND report’s methodology which led to some modified conclusions, including a finding that savings will be considerably greater than RAND projected. This report updates and confirms those findings.