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New York State Department of Health
New York State Insurance Department


Health: Claire Pospisil 518-474-7354, ext. 1
Insurance: Andrew Mais 212-480-5262

Report Compares Four Comprehensive Reform Proposals and Their Impact on Health Insurance Coverage in New York

The New York State Departments of Health and Insurance today announced the release of a study showing how four proposals to reform the State’s health insurance system might achieve quality, affordable coverage for all New Yorkers. The study was mandated by the State Legislature.

The Departments of Health and Insurance contracted with the Urban Institute to determine the cost and coverage implications of four health reform proposals: (1) the Public-Private Partnership proposal that simplifies and expands existing public programs and reforms private health insurance; (2) New York Health Plus, Assemblyman Richard N. Gottfried’s proposal that gives all New Yorkers an option to enroll in Family Health Plus; (3) Public Health Insurance for All, a single payer public health insurance option; and (4) the Freedom Plan, an option that relies on regulatory flexibility and tax credits. The Public-Private Partnership proposal is similar to the proposal now being debated in Congress.

“New York is ahead of most states because we have already taken smart incremental steps toward universal health insurance coverage. While any additional actions must take into account our current fiscal situation, New York has already expanded coverage for nearly every child in New York, streamlined eligibility for public programs, reduced hospital reimbursement rates and invested in primary and preventive care,” said Governor David A. Paterson. “This comprehensive analysis by the Urban Institute provides valuable insight and will inform the health care reform debate in Washington. I look forward to continuing to work closely with President Obama and Congress to ensure that working families have the health insurance they need and deserve at an affordable price.”

“Under Governor Paterson’s leadership, critical health insurance reforms have been advanced, but we still have much more work to do to create a high-performing health care system that addresses the needs of all New Yorkers,” said State Health Commissioner Richard F. Daines, M.D. “More than 2.5 million New Yorkers do not have health insurance coverage. Uninsured New Yorkers experience worse health outcomes because they lack access to preventive and primary care. This study offers valuable insight into certain reform methods that could potentially provide all New Yorkers with the health coverage they need and deserve.”

“The recession has taken a heavy toll on New Yorkers and the State budget. For too many, loss of a job means loss of insurance coverage. Affordable, quality health coverage is a business issue. Small businesses are the engine of growth. Providing health insurance makes small businesses competitive, allowing them to attract and keep good employees. Under Governor Paterson, New York has already taken important steps to ensure greater access to quality, affordable health coverage. The Urban Institute’s study provides a roadmap for reform options so that we can build on what we’ve done and fix the holes in our health insurance system,” said Acting Insurance Superintendent Kermitt Brooks.

The Urban Institute’s study shows:

  • Three of the four proposals modeled cover all New Yorkers:  Public Health Insurance for All, New York Health Plus and the Public-Private Partnership. The Freedom Plan leaves 13.3% of New Yorkers uninsured, a small reduction from the current 15.8% uninsured. 
  • There is minimal change in employer-based coverage under the Public-Private Partnership and the Freedom Plan proposals. However, under New York Health Plus, employer coverage drops significantly, and under Public Health Insurance for All, employer coverage ends altogether. 
  • The market for individuals to buy coverage directly ceases to exist under the Public Health Insurance for All and the New York Health Plus proposals. Individual coverage increases under the Public-Private Partnership and the Freedom Plan.
  • Public health insurance programs, which currently cover 21.4% of the population, would continue to serve significant numbers of New Yorkers under all four proposals, ranging from 100% under Public Health Insurance for All to 21.7% under the Freedom Plan. 
  • Government spending on health care for the non-elderly currently accounts for $28.5 billion of the $83.9 billion spent on health care in New York. Under each of the four proposals, government spending increases – by 202% under the Public Health Insurance for All proposal (total $86.3 billion); 119% under New York Health Plus (total $62.5 billion); 25.3% under the Public-Private Partnership model (total $35.8 billion); and 9.6% under the Freedom Plan (total $31.3 billion). 
  • The net government cost per newly insured varies from a low of $2,663 for the Public-Private Partnership proposal to a high of $21,287 for Public Health Insurance for All. The cost per newly insured for New York Health Plus is $12,508, and the Freedom Plan is $6,605.   
  • Post-reform expenditures by employers and individuals also vary widely. Under Public Health Insurance for All, employer and individual spending is eliminated. New York Health Plus reduces both individual and small employer spending. Individual spending remains constant under the Public-Private Partnership proposal while small employer spending drops slightly. The Freedom Plan increases individual spending, but somewhat reduces small employer spending.   
  • Aggregate health care spending – the amount of new spending across the health care delivery system by all payers including government, employers and individuals – increases the most under New York Health Plus, followed by the Public-Private Partnership proposal. The Public Health Insurance for All proposal has the lowest aggregate increase in health care spending of all proposals that achieve full coverage, and the Freedom Plan results in the lowest increase in aggregate spending, but does not achieve coverage for all New Yorkers.

Last week the Governor issued a report, Transforming New York’s Public Health Insurance Programs: Expanding Access, Improving Quality and Controlling Costs, which cites how New York’s Medicaid program has been reformed through the reduction of inpatient rates, investment in primary and preventive care and ambulatory care services, and by providing incentives to practitioners who work in medically underserved areas and meet patient-centered medical home standards that advance integrated and coordinated care.

The full text of the Urban Institute’s study, as well as the Transmittal Report from the Departments of Health and Insurance may be accessed on the Partnership for Coverage website (, as well as on the websites of the Department of Health ( or Department of Insurance ( To view Transforming New York’s Public Health Insurance Programs: Expanding Access, Improving Quality and Controlling Costs, please visit For more information, contact the Insurance Department Press Office at (212) 480-5262 or the Health Department Press Office at (518) 474-7354 ext. 1.


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