Single-payer in New York State?

If Democrats pick up just one seat in the State Senate, the legislature could pass a single-payer healthcare bill. Whether the governor would support it is a different matter.

The New York Health Act would provide universal coverage to all New Yorkers with no premiums, copays or deductibles. The costs would be borne by a large tax increase, but a RAND study released in August concluded that the plan would save the system approximately $15 billion or 3.1 percent by 2031.

The Assembly has passed the bill numerous times, but it’s been languishing in the State Senate, where Democrats nominally hold a single-seat advantage but are effectively in the minority due to Senator Simcha Felder, a Democrat who caucuses with the Republicans. All other Democrats in the Senate support the bill.

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Local contests could play a decisive role in who controls the Senate next year. In the Hudson Valley, the retirement of two long-serving Republican senators — Bill Larkin in the 39th district and John Bonacic in the 42nd — has created a rare opportunity for Democrats. (All local Democratic candidates are on the record supporting the bill.)

If Dutchess County Executive Marc Molinaro, a Republican, defies the expectations of pollsters and wins the governor’s race, his position on the bill is clear: He would veto it. What Governor Cuomo would do is less clear. He has called it a “very exciting possibility” but said it would depend on the federal government playing ball. The Trump administration would have to issue a waiver to divert all federal funds now flowing to Medicaid, Medicare and Obamacare tax credits to the New York Health Act.