ADVOCACY FOR THE NEW YORK HEALTH ACT

2016 STATEWIDE LOBBY DAYMAY 24TH - 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) Make sure you are registered at nyhcampaign.org or

contact Katie at katie@pnhpnymetro.org

2) Catch the bus in one of two places:• 7:00am Manhattan: 33rd St btw 7th and 8th Ave• 7:00am Bronx: 3544 Jerome Ave 

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 10:00am - Registration, Coffee and Bagels @ 1199/SEIU's Conference Room, 155 Washington Ave, Albany, NY 

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.

• 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 ON 5/24?• We are working on finalizing the schedule and teams now. You will have

the schedule a few days before 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.

• The planning team decided to target Senators who have not yet endorsed, Assembly members who did not vote for the bill, and Assembly members who voted for the bill but could use some extra support.

• 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?• Who will share a personal story?• Who make the “ask” or demands of the legislator or staff

person?• Who will take notes and submit the report back form?Make sure you have the legislator packet from PNHP NY Metro to give to the legislator or his/her staff.Plan to debrief after the meeting with your group.

WHAT ARE WE ASKING?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 Perkins

• If the meeting is going really well…ask if they will reach out to their colleagues who aren’t yet cosponsors?

• Will you appear at a community event to show your support?• How else can we help you build support for this issue in your district?

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

• Ask them if there are any groups that they think we should be working with in their districts to move them on this issue.

• 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

Why is this issue still so important to us?

1) Many people still uninsured2) Healthcare costs keep going

up, preventing people from getting the care they need, when they need it.

More than 2 million Uninsured in New York State(Population figures in thou-

sands)Medicare 2,750

Medicaid 5,300

ACA

ACA Marketplace Insurance 415Uninsured 2,052

Individual Insurance 270

Employer-based Insurance 8,500

Source: Census Bureau 2014. NYS Dept. of Health 2015

UNINSURED

MILLIONS REMAIN UNINSURED…

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

What’s Covered

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)

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. EVERY OTHER COUNTRY COVERS ALL THEIR CITIZENS, AND SPENDS HALF OF WHAT WE

DO.

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 coverage 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 PROBLEM, AND THE ANSWER

• The Affordable Care Act will not solve the central problem of our health care system: continually rising, unaffordable cost.

• We can do better, through a system where government has a central role and can cover everyone at less cost.

Health Care Reform in

New York State:New York Health Act

A5062/S3525• A SINGLE STATE FUND COVERS EVERY

RESIDENT: UNIVERSAL COVERAGE• COMPREHENSIVE BENEFITS• NO FINANCIAL BARRIERS TO CARE: NO

DEDUCTIBLES OR CO-PAYS• MEDICARE AND MEDICAID INTEGRATED INTO NY

HEALTH • FUNDED BY PROGRESSIVE STATE PREMIUMS

ALONG WITH EXISTING FEDERAL AND STATE FUNDS

COVERS EVERYONE -- COSTS LESS!

Passed 92-52 in 2015

Eligibility• 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

New York Health Act

Comprehensive Benefits• 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

New York Health Act

Provider Reimbursement• 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

New York Health Act

Financing• 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 MedicaidBottom line: Premium on $50,000 wages ~ 6%; current employer-based ins cost ~ 11% of wages

New York Health Act

Covering Everyone while 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

WHY BUSINESS SHOULD SUPPORT THE NEW YORK HEALTH ACT• 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.

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 A.5062 (Gottfried), S.3525 (Perkins) 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.

WHY SHOULD CONSERVATIVE DEMOCRATS & REPUBLICANS SUPPORT THE NEW YORK HEALTH ACT

• Affordable and Fair, businesses will save $• Choice: Provides full choice of doctor or hospital to the

patient, with no out of network fees or charges• 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

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. Personal testimonials are a very powerful tool in lobbying. Remember: “One person is a tragedy; a million is a statistic.”Illustrates shared values:We can have a system that uses money wisely, that prioritizes healthcare, that doesn’t bankrupt people just because they are unfortunate enough to get sick.

NEW YORK HEALTH• #BeyondACA

• #MedicareforAll

• #PassNYHealth

• #EverybodyInNobodyOut

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