New York Could Become the First U.S. State to Guarantee Healthcare for Every Resident

Cori Marshall had good health insurance. She still ended up with $6,000 in medical debt after a preterm labor scare forced her into a hospital outside her network. A bill moving through Albany right now could make that kind of bill impossible for any New Yorker, no matter their job, their income, or their insurance plan. Supporters say it would guarantee coverage for every resident in the state. Opponents say it could raise taxes without explaining who foots the bill for doctors and hospitals.

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The New York Health Act Would Erase Copays and Deductibles Statewide

The proposed New York Health Act (NYHA) would give every New York resident comprehensive health insurance with no copays, no deductibles, and no out-of-network costs. Coverage would include physical health, mental health, dental, vision, prosthetics, durable medical equipment, and ambulance services. The League of Women Voters for Broome and Tioga Counties recently held a presentation breaking down what the bill would actually change for residents, and why some healthcare workers have pushed for it for over three decades.

Assemblyman Richard Gottfried First Proposed This in 1991

Retired nurse practitioner Marita Florini has supported the NYHA since Assemblyman Richard Gottfried introduced it in 1991, according to the League of Women Voters. “There were so many people at the time who did not have adequate health insurance, or they were working three part-time jobs and had no health insurance,” Florini said. The bill has changed sponsors and details over the decades. One thing has stayed the same.

Florini Calls the Bill a “Win-Win” for County Budgets

Florini says the NYHA covers nearly every category of care a resident might need, while also projecting savings for county and school budgets. “When you have a bill like this that specifically covers physical health, mental health, dental, vision, prosthetics, durable medical equipment, ambulance services, and at the same time is showing a savings for county budgets, school budgets, et cetera, it’s a win-win,” she said. Not everyone in Albany agrees the numbers add up that cleanly.

Dr. Cori Marshall’s Coverage Still Left Her With Thousands in Debt

Dr. Cori Marshall, a family medicine provider at Sayre Family Practice, supports the bill both as a physician and a patient. Pregnant with twins, she had preterm labor scares that sent her to a hospital outside her insurance network. She paid roughly $6,000 out of pocket despite having good coverage. Marshall said the bill would have been far higher had her twins been born that day, before the NYHA could have stepped in.

Marshall Says the Bill Would Untie Insurance From Employment

Marshall says the NYHA’s biggest advantage is stability. Health insurance under the plan would not depend on a job or a spouse. “This gives you that steadiness where you’re not worried about changes in your life that would mess up what’s going on,” she said, describing how a divorce or job loss can currently strip away coverage overnight. Under the proposed system, insurance would travel with the person, not the paycheck.

Every Resident Covered “Based on Ability to Pay,” Says Small Business Manager

Susan Beckley, a small business manager in Tompkins County, said the NYHA would cover every New York resident based on ability to pay, regardless of age, wealth, or employment status. Funding would come through a payroll tax combined with federal money already flowing into Medicare and other low-cost insurance programs. Beckley said the structure would save school districts and municipal budgets significant money. State Senator Patrick Gallivan sees a different picture.

Senator Gallivan Warns the Bill Is Missing Key Financial Details

State Senator Patrick Gallivan says the NYHA fails to specify tax rates or income brackets for the higher earners who would pay more under the plan. “While some people might save money, many more would pay substantially more for coverage,” he said. Gallivan also pointed out the bill does not explain how doctors and hospitals would actually get paid. He called it irresponsible to launch a program this size without those answers settled first.

The Bill Sits in the State Senate’s Health Committee Right Now

The New York Health Act is currently before the New York State Senate’s Health Committee, sponsored by Senator Gustavo Rivera. If it clears committee and passes both chambers, New York would become the first state in the country to guarantee comprehensive healthcare to every resident regardless of job status or income. The bill has cleared the Assembly multiple times over the past decade. It has never gotten a vote in the Senate.

A Decades-Old Idea Now Rests on One Senate Vote

Three decades after Gottfried first raised the idea, the fight over the New York Health Act comes down to a familiar divide: guaranteed coverage against unanswered questions about cost and provider pay. Supporters point to families like the Marshalls, who had insurance and still faced thousands in debt. Opponents point to a funding plan built without disclosed tax brackets or provider payment terms. Both sides agree on one thing: this bill would change New York permanently if it passes.