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The facts about
Single-Payer Health Care

Diverse Groups Oppose Single Payer

The New York Health Act would establish a single payer, government-run healthcare system. The legislation is very concerning for people from a broad range of groups, including those who would be most negatively impacted: hospitals, unions and employers. The New York Health Act would require $250 billion in new taxes each year while taking away patient choice.

Full list of coalition members opposed to single payer


The Business Council of New York State
The Business Council of New York State represents 2,400 member companies, local chambers of commerce, and professional and trade associations.

“The legislation lacks specific details except one thing, a $250 billion price tag. That, coupled with the loss of private sector jobs is a steep sacrifice. We believe there are better solutions as we support the Governor’s call for a comprehensive fact-based study on the issue,” said Heather Briccetti, President and CEO of the Business Council of New York State.


Food Industry Alliance of New York State
The Food Industry Alliance advocates for 800 supermarket chains, independents, convenience stores, wholesalers and co-operatives.

“While the idea of affordable universal access to quality healthcare is laudable, the New York Health Act is anything but,” said Mike Durant, President and CEO of the Food Industry Alliance. “The price tag of this legislation would nearly double the current state budget and impose significant new taxes on businesses, including the retail food industry. Our members are an integral component to every local economy in this state. Implementing this unaffordable legislation will simply upend our state’s economy. Albany should focus on measures that expand healthcare options at a reduced cost.”


NYC Hispanic Chamber of Commerce
The NYC Hispanic Chamber of Commerce is the only city wide Hispanic Chamber dedicated to the success of Hispanic businesses and the communities they serve.

“We support the goal of making sure all New Yorkers have access to quality health care coverage,” said Nick Lugo, president of the NYC Hispanic Chamber of Commerce. “The New York Health Act single payer proposal, which would be paid for through huge tax increases – including a payroll tax where employers would be required to pick up 80% of that cost – is the wrong approach. It would be devastating to our members and, in turn, to the people and communities they serve.”


NFIB New York
The NFIB New York chapter advocates on behalf of small and independent business owners.

“Imposing an Albany-run healthcare system that will cost tens of billions more for taxpayers including small businesses, will only further disadvantage Main Street and our entire state’s economic competitiveness. New York should learn from the experience of other states that have explored and abandoned single-payer healthcare because of its immense cost burden, and instead focus our collective effort on continuing to seek innovative and cost-effective ways to expand healthcare options and make health coverage more accessible for all New Yorkers.”


Coalition Member:

Suburban Hospital Alliance of New York State
The Suburban Hospital Alliance of New York State is a consortium of 51 not-for-profit and public hospitals advocating for better health care policy for all those living and working in the nine counties north and east of New York City.

“We are committed to efforts aimed at providing health care coverage to all New Yorkers,” said Kevin Dahill, president and CEO of the Suburban Hospital Alliance. “It is increasingly clear that the New York Health Act single payer proposal is not a feasible approach and that the conversation needs to focus on realistic solutions.”



Greater New York Hospital Association
Greater New York Hospital Association  – RAND Report on Single Payer for New York Raises Major Concerns – August 6, 2018

“In a letter to members, GNYHA President Kenneth E. Raske said, ‘the massive cost of implementing and maintaining NYHA is prohibitive. And we are already deeply concerned about a potentially huge income drain on New York: the new Federal limitation on state and local tax (SALT) deductibility.’ ”


In The News

Single payer analysis highlights payment cuts to state’s hospitals

The impact of single payer on New York hospitals
Empire Center

Single payer would be death of NY’s best hospitals
NY Post

Single payer health care would cost some Western New York hospitals
Manhattan Institute


Coalition Members:

New York State Professional Fire Fighters Association
The New York Professional Fire Fighters Association (NYSPFFA) represents 18,000 men and women working full-time as members of municipal fire departments across the state. NYSPFFA advocates on behalf of members who serve in 107 local unions, 41 counties and in the boroughs of New York City.

Uniformed Firefighters Association of Greater New York
The Uniformed Firefighters Association of Greater New York advocating for 25,000 active and retired NYC/FDNY firefighters.  UFA is a non-profit advocacy organization representing the health, safety and interests of New York City Firefighters and the citizens they are sworn to protect.

New York State Building & Construction Trades Council
Established in 1958, the NYS Building & Construction Trades Council currently represents over 200,000 unionized construction workers in New York State. Sixteen local building trades councils, 12 district councils and state associations, and 135 local unions represent the trades that build our roads, bridges, schools, and office buildings.

Sergeants Benevolent Association
The Sergeants Benevolent Association represents 13,000 active and retired sergeants of the NYPD.



Social Service Employees Union Local 371
“It’s going to cause some problems,” said Anthony Wells, president of Social Service Employees Union Local 371. “It’s not going to accomplish what they are seeking to do.”
City & State

District Council 37
“DC 37 has always supported universal health care, but we have serious concerns about various aspects of the bill as currently drafted, and we have expressed those concerns to lawmakers,” said Henry Garrido, director of DC 37, New York City’s largest municipal union.
Heartland Institute


In The News

City unions say they dread impact of single-payer proposal in Albany

Powerful NY Unions Could Complicate Push For Single Payer Health Care

Why Are These Labor Unions Opposing Medicare for All?
In These Times

Hurdles ahead for state single-payer healthcare
Albany Times Union


New York would need to impose massive tax increases totaling more than $250 billion each year to pay for the a government-run, single payer healthcare system. An independent analysis by the RAND Corporation determined that the single payer system would require the State to raise taxes by $139 billion each year – a 156% increase in what the State currently collects in taxes – quickly rising to $210 billion each year by 2031. These tax increases would be on top of the $82 billion already spent on health care. The required taxes will be even higher, because the estimate is based on a number of ambitious, if not unrealistic, savings assumptions. In addition, it does not include the cost of long term care expenses, one of the most expensive components of the healthcare system. Based on the RAND analysis, long term care would require another $42.7 billion, increasing the total new taxes to ore than $250 billion.

The single payer healthcare system would be funded through a payroll tax paid by both employers and employees, and a tax on non-payroll income such as interest, dividends, and taxable portion of pensions. As the NYHA would impose new payroll taxes, it would reduce individuals’ take-home pay, leaving less money in the pockets of most New Yorkers.

Proponents often conflate the cost of a single payer healthcare system and the taxes necessary to support spending required by that system. According to the RAND analysis, the cost of NYHA in 2022 is $309 billion, sharply rising to $460 billion in 2031. The NYHA would effectively double the entire State budge – costing twice as much as New York State currently spends on everything, including Medicaid, schools, public safety and transportation.


The NYHA would create an increase in demand for healthcare that will not be met. In fact, according to RAND, only about half of new patient demand may actually be met. A single payer system can cause long waits for appointments, doctors not taking new patients, and changes in providers’ recommendations regarding courses of treatment or constraints on technology and equipment.

Like your health insurance? Under the NYHA, private insurance will become illegal. Today, more than half of all New Yorkers receive coverage through their employer. These individuals would lose their coverage under a government-run system, taking away the ability of employers to effectively manage their healthcare costs while still subjecting them to massive tax increases. Organized labor currently negotiates for excellent healthcare benefits for its members. Both public and private union members would lose their collectively bargained healthcare benefits under the NYHA and would receive coverage under the government-run health plan instead.

The NYHA would eliminate Medicare as it exists today for seniors in New York by lumping them into the single payer healthcare program run by the State. Individuals covered by Medicare would lose their current Medicare coverage, including any Medicare Advantage program they have chosen.

Implementation of the NYHA is contingent on the State receiving waivers from the federal government to both revise the State’s current Medicaid wavier and include Medicare beneficiaries in the new system. The head of the federal Centers for Medicare and Medicaid Services has said the agency would deny waiver applications from states seeking to implement their own single payer system. It is almost certain that all of this could not be accomplished within two years of passage of the NYHA.


Savings from a government-run system are based on assumptions the RAND analysis dubbed “highly uncertain.” In order to achieve savings, the State would need to be able to implement a government bureaucrat-run healthcare system that is more efficient than a highly regulated private sector. RAND also said reducing payment rates for doctors, hospitals, drug makers and other providers is key to achieving any savings.  Hospitals rely on increased private sector health insurance payments to subsidize inadequate government payments from Medicaid and Medicare. Reducing, or even eliminating those subsidies will place financial constraints on hospitals, and may force many of them to reduce services and push doctors to move out of New York.

The NYHA’s supporting economist estimates that New York will lose 150,000 jobs if the bill is implemented, approaching the job losses experienced during the Great Recession.

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