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Must single-payer health care come with higher taxes?

Some newly elected state Senate Democrats want New York to adopt a single-payer health care system, but that may put them at odds with other Democratic Senators who do not want to raise taxes.

For several years, a plan to enact single-payer health care in New York, known as the New York Health Act, has been approved in the State Assembly, but was blocked by Republicans in the state Senate. In 2019, Democrats may finally have the votes to approve a plan in the Senate. But even its most enthusiastic supporters are saying the measure needs to be rewritten, and they say they’ll hold hearings and get more information from experts before they make a final decision.

Sen. Brad Hoylman, speaking after an organizational meeting for Senate Democrats on Nov. 26, said he thinks there is a way to find money for health care, as well as more money for public schools, in the over $130 billion state budget.

"Certainly there’s a way to protect the most vulnerable in our state," Hoylman said. "It’s a balancing act of looking at revenue and looking long term savings."

Senator-elect Alessandra Biaggi, who is a single-payer supporter, said that there needs to be more consideration of costs before going forward. Biaggi represents portions of Westchester County, where existing high taxes are a concern, as well as parts of the Bronx. She said she doubts the New York Health Act will be acted upon in the first months of the new session.

"No other state had done single payer," Biaggi said, in an interview with public radio and TV. "And if New York State is going to be the first one to do it, then we’ve got to do it in the right way. We need to take some time to be thoughtful about how we’re going to pay for it".

Bill Hammond, with the fiscal watchdog group the Empire Center, says there are a lot of unintended consequences that could result from a single-payer system in New York, including reduced revenues for hospitals, and the need for as much as $139 billion in new taxes, according to a study by the Rand Corporation.

"There’s a lot of misconceptions about how single-payer works, there’s a lot of wishful thinking about how much money would be saved and how much better things would be," Hammond said. "That’s not to defend the current system, there’s a lot of things that are wrong with the current system."

The leader of the Senate Democrats, Andrea Stewart-Cousins, who will be majority leader in January, has already said she does not want to raise taxes. But Stewart-Cousins said she does support renewing a temporary surcharge on millionaires when it expires in December of 2019, and she does not consider that a new tax.

Gov. Andrew Cuomo has voiced reservations about enacting a single-payer system. Stewart-Cousins hedged on her answer when asked if the Senate would pass a plan over the governor’s objections, and even a potential veto.

"I am hoping that whatever we do, we are not going to be worrying about vetoes," said Stewart- Cousins, who said she’s seeking a "collaborative" form of government.

Senator-elect Biaggi and other senators also back legalizing marijuana in New York, and she said that’s one option for raising revenue to pay for single-payer health care and other programs.

Karen DeWitt is Capitol Bureau Chief for New York State Public Radio, a network of 10 public radio stations in New York State. WBFO listeners are accustomed to hearing DeWitt’s insightful coverage throughout the day, including expanded reports on Morning Edition.