Testimony of Andrew Pallotta, Executive Vice President, New York State United Teachers, to the Assembly Committee on Health, Richard N. Gottfried, Chair, on New York Health Legislation. January 13, 2015.
Chairman Gottfried and honorable members of the Assembly Health Committee, I am Andrew Pallotta, Executive Vice President of New York State United Teachers (NYSUT). NYSUT represents more than 600,000 education and health care workers statewide. In addition to representing our in-service employees, we also represent the interests of over 160,000 retirees.
We are greatly appreciative of your invitation to appear here today to speak about the very important topic of single-payer universal health care.
NYSUT represents 16,000 professional registered nurses and other health care professionals working in public and private health care settings. Our health care members work in hospitals, clinics and through home health care agencies and also include physicians, visiting nurses, therapists, lab personnel, school psychologists, and registered professional school-based nurses throughout New York state.
Our interest in appearing here today is multi-layered. Our health care workers want all residents to have the ability to access quality health care services. Our members working in schools and college campuses want our state's poorest students and their families to have access to quality health care services so they arrive at school each day healthy and equipped to learn. Our retirees, who tend to be our most medically vulnerable and fragile members, want affordable prescription medication and access to immediate health care.
NYSUT strongly supports legislative efforts that provide health care to all Americans regardless of ability to pay. To this end, in 2011, our membership voted on and adopted a resolution to support the expansion of the Health Reform Act to include Single-Payer Universal Health coverage.
As you are aware, the Federal Affordable Care Act (ACA), enacted in 2010, implemented many measures aimed at reducing the number of uninsured or underinsured individuals in our country. New York state recently announced that since November 15, 2014, 225,000 people, who were previously uninsured, enrolled in a health plan through the state's health exchange during the second enrollment period.
While the ACA made great strides in decreasing the number of uninsured individuals and families, more must be done. Obtaining health insurance coverage is not the only obstacle to accessing health care; the out-of-pocket cost of using health insurance is another deterrent for some. The Commonwealth Fund recently released a report on health insurance cost and found "Americans are paying more out-of-pocket health care now than they did in the past decade." (#1) Some of the costs incurred were a result of high deductibles by those whom had employer provided insurance.
Out-of-pocket expenses, such as copayments, coinsurance, and deductibles serve as a disincentive for the many who need to access health care. The Commonwealth Fund reported that insured adults with high deductible coverage either delayed or avoided needed health care significantly more than those with lower deductibles. Health insurance is intended to provide a financial means to access health care in a timely manner so as to prevent and treat conditions before they progress. Unfortunately, high deductibles, copayments and other out-of-pocket expenses, born by enrollees, serve as an incentive to delay treatment and inevitably lead to more costly treatment.
A CBS poll on the cost of health care reported by the New York Times also found that readers were avoiding or delaying health care treatment due to cost. "While the Affordable Care Act mandates the coverage of certain screening services at no cost to patients, any resulting treatment means money out of pocket." (#2)
New York Health would provide every resident of the state with access to health insurance at no cost. Providing insurance to all New Yorkers at no cost will remove any financial barriers to seeking medical treatment. As educators, we see firsthand how a healthy child is better prepared to successfully perform in the classroom. As health care professionals, we know the benefits, financial and personal, seen by those who seek preventive medical care and treatment for chronic conditions. New York Health will not only decrease the number of uninsured and underinsured individuals, it also has the potential to vastly improve the health of all New Yorkers.
Many collective bargaining negotiation sessions have stalled due to discussions over health insurance coverage for active and retired members. Under New York Health, employees and employers would pay an assessment to fund the overall program, which can be collectively bargained with employers agreeing to pay most of, or the entire employee's share. While New York Health would limit the bargaining table discussion of health coverage to the assessment, it is our hope that all active and retired public employees would retain, without disruption of services, the full range of coverage and benefits they currently enjoy. In many cases these benefits are the result of collective bargaining concessions such as the deferral of wages.
We firmly believe that access to quality health care should be a right for all residents. We are concerned, however, that funding for New York Health could be repurposed and used for other initiatives, limiting the services covered or requiring enrollees to pay out of pocket. Safeguards would need to be put in place to ensure that these funds are not redirected or the program is not restructured to shift costs to residents through the use of deductibles, premiums and co-payments. It is important to our membership that the implementation of New York Health is done in a manner which provides these safeguards.
In conclusion, we realize that the prospect of providing health care for those who cannot afford it at the expense of the taxpayer is objectionable to some people or that some voters may consider the issue a political landmine. As the issue of single payer moves forward, we strongly urge all policymakers to convene a public dialogue to ensure that critical issues such as access to participating providers and facilities are fully vetted so that those with existing coverage transition seamlessly.
Thank you for the opportunity to testify today. NYSUT applauds you, Assemblyman Gottfried, for undertaking this important issue.
1. The Commonwealth Fund: "Too High a Price: Out-of-Pocket Health Care Costs in the United States." September-October 2014, page 1
2. New York Times: How the High Cost of Medical Care is Affecting Americans, December 18, 2014