Health Coverage Options for NY

Approximately 2.5 million New Yorkers don't have health insurance. The number has been rising and will undoubtedly continue to rise as hundreds of thousands of jobs disappear in the current recession. Even those who remain employed risk losing their employer-sponsored plans as companies cut benefits or shift more costs to workers (and in the case of lower paid workers, the costs can become prohibitive).

A new study commissioned by the New York State Health Foundation and conducted by the Mailman School of Public Health at Columbia University looked at five plans for expanding health care in New York that were proposed during statewide hearings last year. The plans examined in the study include:

• a single-payer or “Medicare-for-All” plan that would replace all current insurers with one, publicly financed system and provide comprehensive coverage to all State residents with no costsharing or deductibles;
• three different “building block” plans that would expand government-sponsored programs, create individual buy-in options, and include an option for individual mandates; and
• a market-oriented reform plan that would loosen State health insurance regulations, establish a high-risk pool, and expand private coverage mechanisms.

The single-payer plan would fully solve access to health care, but also is the most costly: roughly a net $5.8 billion increase to the New York State budget. The market-oriented plan would be the cheapest to New York -- $280 to $440 million -- but would make the smallest dent in the problem of uninsured.

CAVEATS from the report:

All of our estimates refer to what spending and coverage would have been in 2004 had these proposals been enacted at that time. They are not intended to be a forecast of future costs. Our simple model does not produce estimates of the distribution of cost across various stakeholders beyond government.

CAVEAT from me: you get what you pay for.