ADVOCATING FOR THE NEW YORK HEALTH ACT

(A. 4738/S. 4840)APRIL 4TH - ALBANY

1) Travel Logistics/ Schedule of the day

2) What to do before, during, and after the meeting with your legislators

3) Policy and Politics of the New York Health Act

WHAT DO I NEED TO KNOW?

LOGISTICS /SCHEDULE1) Register at nyhcampaign.org or contact katie@pnhpnymetro.org

2) Catch the bus from NY Metro area:• 7:00am Bronx • 7:00am Manhattan (Penn Station)• 7:00am Manhattan (Washington Heights)• 7:00am Brooklyn (Barclays Center)• 7:00am Westchester• 5:00am Long Island

3) Coming from outside NYC? Register and we will be in touch about transportation options! Carpools coming together around the state!

SCHEDULE FOR THE DAY 9:00am - Registration, Coffee and Bagels @ Emmanuel Baptist Church, 275 State St, Albany, NY 12210

10:15am - Briefing for the day (same location as registration)

11:30am - Rally for universal health care at West Capital Park!

1 - 3:30pm - Meetings with legislators on the New York Health Act

7:00pm – Back in NYC

SEE THE MAP IN YOUR MATERIAL PACKET

PRO TIPS• Pack a lunch to save money or plan to eat at the

food court or at the food trucks outside.

• Security: You will have to pass through metal detectors and have any bags scanned through an x-ray machine. Sharp objects, such as pocket knives and nail clippers will not be allowed into the building.

• Time: You will likely have to go through security to get from the press conference to your meetings. Please allow at least 20 minutes for security delays.

 

WHAT TO WEAR?

WHO WILL I MEET WITH?• We are working on finalizing the schedule and teams now. You will

have the meeting schedule a few days before lobby day, and there will be time to meet with your group on the bus or in advance of your meetings to strategize.

• You will receive a background sheet with a photo of the representatives you are scheduled to meet with as part of your lobby materials.

• Meetings targeted Senators who have not yet or only recently cosponsored, Assembly Members who did not vote for the bill in 2016, and Republicans.

• You may be meeting with a staff person if the legislator is not available. This can be as important or sometimes more important because of the influence staff has on positions the legislator takes.

• Make sure to note who you met with on the lobby visit report form and get their business card for follow up.

MEETINGS CONT’D• Meetings usually last between 15 and 30 minutes, but

sometimes longer!

• Most meetings will be in the office of the legislator, in the LOB (Legislative Office Building) or the Capitol Building (CAP) – See the map

• Sometimes meetings will be noted as “off the floor”• This means that you will go to the Assembly or Senate

Chambers and request the legislator meet you outside to hold the meeting in the hallway

• You will ask the Sgt of Arms to request the member’s meet with you as scheduled and they will pull the member of the floor. It’s a different kind of meeting, maybe you will have only 5 minutes so be prepared to make the ask up front and quickly

ORGANIZING YOUR TEAMWhen you meet with your team, take a few minutes to decide who will take on the following roles:

• Who will facilitate the meeting and make sure it stays on track?• Aim to include constituents in your meetings.• Who will share a personal story?• Who make the “ask” of the legislator or staff person?• Who will take notes and submit the report back form?Make sure you have the legislator packet to give to the legislator or his/her staff. These packets will be available at the morning briefing.

Plan to debrief after the meeting with your group.

TALKING POINTS1) We as New Yorkers are concerned about our health care security. Recent events in Washington D.C. show that the lawmakers do not understand how to protect people’s health care. Even though the ACA is still the law of the land, Republicans in Congress may find new ways to defund and undermine Medicare, Medicaid, Planned Parenthood and the ACA.

2) The New York Health Act is the only way to guarantee all New Yorkers have access to the care they need (extending coverage to the 1 million currently uninsured), and it would cost less than what we currently spend.

 

3) The New York Health Act will allow people to access care when they need it instead of rationing based on ability to pay – a practice which leads to very poor health outcomes.

 

4) The New York Health Act has passed the Assembly in 2015 and 2016 with large majority support. We expect it to pass again this year in the Assembly.

 

5) The Senate is only 4 Senators away from having a majority of the Senate behind this bill. 

6) Now is the time for the New York State legislature to listen to the people—and the growing movement for this bill—who want a health care system that guarantees access to care as a public good, that is affordable, that is good for patients, seniors, business, nurses, doctors, and hospitals. It is time to pass the New York Health Act.

THE “ASK”1) Will you cosponsor the New York Health Act?

• If they say yes, ask them to fill out the form and submit it to Assembly Member Gottfried or Senator Rivera.

2) If they won’t cosponsor at this time, ask “will you vote for it when it in the Assembly when it comes up again this session?” or “will you vote for it in your Senate Committee when it comes up for vote in the future?”

3) If no to both 1 and 2…ask why not?• Note the concerns from the representative on the report

back form in your packet• Do not feel you have to have all the answers. Take note

and make sure they know we will follow up with them. Practice saying, “Good question. We will get back to you on that.”

FOLLOW UP• Submit the lobby visit report back form in your

packets• Send a thank you note by email • Send follow up information based on your

conversation• Consider staying in touch and forwarding

important information regarding the issue as it comes up

POLICY & POLITICS OF THE NEW YORK HEALTH ACT

1) Healthcare is under attack2) Many people still uninsured 3) Healthcare costs keep going

up

ACA IS LAW OF THE LAND – BUT WHAT’S NEXT?

Source: Census Bureau 2016. NYS Dept. of Health 2016

MILLIONS REMAIN UNINSURED NATIONALLY

Millions

Note: The uninsured include about 5 million undocumented immigrants. Source: Congressional Budget Office

2010 2011 2012 2013 2014 2015 2016 2017 2018 20190

20

40

60

80

53 54 55 56 56 56 56 57 58 58

3732

26 2526 26

53 53

4136

30 29 29 29

Before the ACA

ACA 2010

ACA Post-Supreme Court

UNDERINSURANCE IS NOW THE NORM

2006 2007 2008 2009 2010 2011 2012 2013 2014 20150%

10%

20%

30%

40%

50%

60%

70%

16%*21%*

35%*40%*

46%*50%* 49%*

58%*61%* 63%*

6% 8% 9%13%

17%22%

26% 28%32%

39%

10%* 12%*

18%*22%*

27%*31%*

34%*38%

41%*46%*

All Small Firms (3-199 Workers)All Large Firms (200 or More Workers)All Firms

* Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: These estimates include workers enrolled in HDHP/SOs and other plan types. Average general annual health plan deductibles for PPOs, POS plans, and HDHP/SOs are for in-network services. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2015.

MORE AND MORE WORKERS FACE DEDUCTIBLES OF $1,000 OR MORE (SINGLE COVERAGE)

Persistent Racial Health Disparities Exist

0

1000

2000

3000

4000

5000

6000

7000

8000

9000 USSWIZNORNETHGERCANFRASWEAUSUKNZ

80 83 86 89 92 95 9836

893

3799

139

090 10

0

2

4

6

8

10

12

14

16

18

20 USFRANETHSWIZGERCANNZUKNORSWEAUS

IT DOESN’T HAVE TO BE THIS WAY.

Note: $US PPP = purchasing power parity.Source: Organization for Economic Cooperation and Development, OECD Health Data, 2013 (Paris: OECD, November 2013).

Total expenditures on healthas percent of GDP

$8,508

$3,182

17.7%

8.9%

Average spending on health per capita ($US PPP)

WHAT MAKES THE DIFFERENCE?Unlike in the US -- in every one of these countries, government has a central role in:• Funding the system• Overseeing and regulating benefits and pricing• Guaranteeing universal coverageOur own experience with federally-run Medicare shows the beneficial effects of a government-funded and regulated system: • Reliable, predictable financing• Slower cost growth• Transparent decisionmaking

THE ANSWERWe can do better, through a

system where government has a central role and can cover

everyone at less cost.

NEW YORK HEALTH ACT

A4738/S4840• UNIVERSAL COVERAGE: EVERYBODY IN,

NOBODY OUT!• COMPREHENSIVE BENEFITS• NO FINANCIAL BARRIERS TO CARE: NO

DEDUCTIBLES OR CO-PAYS• FUNDED BY PROGRESSIVE STATE TAXES

ALONG WITH EXISTING FEDERAL AND STATE FUNDSCOVERS EVERYONE -- COSTS LESS!

Passed in 2015 & 2016

• Every resident of NYS covered• No barriers due to age, sex,

income, wealth, employment, or health status

• No regressive insurance premiums

• No payments at time of service• No deductibles, no co-pays

Eligibility

• Primary & Preventive Care• Inpatient and Outpatient

Hospital Care• Prescription Drugs• Dental, Vision, & Hearing Care• Free choice of doctor, including

primary care physician (PCP) and specialists, and hospital

Comprehensive Benefits

• All providers paid in full by New York Health, with no charges to patients

• New reimbursement methods will be developed to replace fee-for-service payments

• Rates negotiated with provider organizations

Provider Reimbursement

• Progressive graduated payroll premium: • 80% employer, 20% employee

• Graduated premium on non-wage income for high-income earners

• Federal Medicare and Medicaid funds• NY Health pays Medicare Part B premiums & local share of Medicaid

98% of New Yorkers Will Pay Less*

*Friedman, 2015, http://www.infoshare.org/main/Economic_Analysis_New_York_Health_Act_-_GFriedman_-_April_2015.pdf

Financing

Covering Everyone - Saving Money!Additional CostsCovering the uninsured and poorly-insured +1.4%Elimination of cost-sharing +3.9%Enhanced Medicare & Medicaid fees +3.8%SavingsReduced insurance administrative costs -9.9%Reduced physician & hospital admin costs -7.2%Bulk purchasing of drugs & devices -5.7%Reduced fraud -1.9%

-24.7%

Source: Economic Analysis of the NY Health Act, Gerald Friedman, April 2015

4.011.210.826.0 -28.6 -20.7-16.3 - 5.4 -71.0

2019 $B

Total Costs +9.1%

Total Savings Net Savings -15.6% - 45

New York Health is Affordable and Sustainable

• Eliminates burden of unnecessary, wasteful administrative costs

• Unified, simplified funding allows control and planning of future costs

• Unified purchasing lowers drug and equipment prices

• Coordinated planning of investment allows savings on facilities & equipment

WHO SUPPORTS SINGLE PAYER?New York Health has been endorsed by a long list of organizations , including the New York State AFL-CIO, SEIU 1199, the New York State Nurses Association (NYSNA), Local 32BJ SEIU, NY State United Teachers (NYSUT), United Federation of Teachers (UFT), UNITEHERE! Local 150, UFCW Region 1 and Local 1500, Communications Workers of America District 1 and Local 1180, IATSE Local 1, United Auto Workers 9 & 9A, the Retail, Wholesale & Department Store Union (RWDSU), RWDSU Local 338, UFCW, the Doctors Council SEIU, the Committee of Interns and Residents SEIU, United University Professions, IATSE Local 1, Utility Workers of America Locals 1 and 2, Restaurant Opportunities Centers United, Make the Road/New York, VOCAL-NY, ACT UP/NY, African Service Committee, Harlem United, Housing Works, New York Communities for Change, MetroJustice of Rochester, Metro NY Health Care for All Campaign, New York Immigration Coalition, the New York State Academy of Family Physicians, the New York State American Academy of Pediatrics, and the Public Health Association of NYC (PHANYC), Commission on the Public's Health System (CPHS), Statewide Senior Action Council, the Green Party, the Working Families Party, Citizen Action, along with 92 state legislators.

Add your name at www.nyhcampaign.org

SINGLE PAYER SYSTEM COST

http://www.pnhp.org/facts/single-payer-system-cost

HOW MUCH WILL I PAY?

www.nyhealthact.com

WHY IS IT IMPORTANT TO YOU?Take a minute to think about why this issue is going to make a difference for you, your patients, your profession, your family, your country.

What about a time you didn’t receive timely care that you needed?

What about when you delayed care or never received care because of cost?

Personal testimonials are a very powerful tool in shaping people’s opinions. Remember:

“One person is a tragedy; a million is a statistic.”

See Sarah’s story at http://nyhealthact.com/

TALKING POINTS FOR CONSERVATIVE LEGISLATORS: PEOPLE LIKE HEALTH CARE

TALKING POINTS FOR CONSERVATIVE LEGISLATORS: TAX RELIEFCOUNTY GOVERNMENT PAYMENTS FOR MEDICAID • $7.8 billion from county governments across the state• Some upstate and western New York counties, such as Erie,

spend as much as 85% of property tax revenue on Medicaid. • WHAT WILL THE NEW YORK HEALTH ACT DO? “[end] the requirement for local social services districts to pay part of the cost of Medicaid and replacing those payments with revenue from the assessments under the [New York Health] revenue proposal.”2 This simultaneously terminates county Medicaid payments while providing Medicaid beneficiaries (and everyone else!) with better, more comprehensive coverage.

1New York State Division of the Budget. “FY 2015 Enacted Budget”.. https://www.budget.ny.gov/pubs/archive/fy1617archive/enacted1618/2016-17EnactedBudget.pdf

TALKING POINTS FOR CONSERVATIVE LEGISLATORS: BUSINESS IN FAVOR• Eliminates the cost and headaches of running a health

benefits program.• Eliminates conflicts with employees and unions over benefit

cuts, givebacks, etc.• Reduce the cost of providing health benefits.• Eliminates competition from businesses that don’t provide

benefits.• Produce a healthier, more productive work force.• Make health care costs controllable and predictable,

eliminating a major source of business uncertainty and barrier to planning.

• Over 100 businesses in New York State have endorsed this plan.

TALKING POINTS FOR CONSERVATIVE LEGISLATORS: OPIOID EPIDEMICA publicly funded system like the New York Health Act is significantly better designed to deal with epidemics like opioid addiction (prevention, treatment and rehabilitation)

• Removes significant barriers to accessing treatment, such as insurance company approval and financial barriers

• Allows for timely treatment

• Treatment plans developed between provider and patient, not insurance company bureaucrat

FRAMING THE ISSUE FOR CONSERVATIVES • Affordable: businesses will save $ as well as 98% of New

Yorkers

• Choice: Provides full choice of doctor or hospital to the patient

• Simple & Predictable: The funding mechanism provides predictable costs for businesses, something the private insurance system lacks

• Prevents “job-lock,” encouraging entrepreneurship

• A new documentary, FIX IT: Health Care at the Tipping Point, makes the case for businesses to get behind single-payer. You can find the link to the film in your resources packet. Watch it at fixithealthcare.com

MORE INFORMATIONCampaign for New York Health www.nyhcampaign.org

PNHP www.pnhp.org

PNHP NY Metro www.pnhpnymetro.org

Healthcare-NOW www.healthcare-now.org

Movies: fixithealthcare.com

thehealthcaremovie.net

AMPLIFY OUR MESSAGE• #MedicareforAll

• #PassNYHealth

• #EverybodyInNobodyOut

• See Social Media Toolkit at nyhcampaign.org/resources

• @NYHCampaign (TWITTER)

• www.facebook.com/CampaignforNewYorkHealth/

FURTHER PREPARATIONAfter viewing this presentation, take some time to review the FAQs and materials in your packets.

Remember, you don’t have to have all the answers. It’s important to be there and show your support, and any questions that come up that you don’t know how to respond to can be addressed at a later time.

Thank you!!!

QUESTIONS?

Katie Robbins, MPHExecutive Director

Physicians for a National Health Program NY Metro Chapter330-618-6379

katie@pnhpnymetro.org