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Under the federal health care law approved by President Obama and Congress, states must set up their own health care exchanges to be ready when all Americans are required to buy health insurance plans beginning in 2014.
Governor Cuomo and legislative leaders agreed on a framework for the health exchanges at the end of the legislative session, in June, but it fell part in the final days of the legislative session when some conservative State Senators said they did not want to vote to advance what they call “Obamacare”. It was expected that the Senate would return in the fall to finally pass the legislation, but there are signs now that that may not happen.
Tracey Brooks is with Family Planning Advocates, the lobby group for Planned Parenthoods, which operate health clinics for women, many of whom have limited insurance. She says the opposition from Senators is based solely on politics, and is, in her words “a sad state of affairs”.
“This is just silliness,” said Brooks, who says there are enough votes among republicans and democrats in the Senate for the agreed upon bill to pass.
“It’s time for the Senate to come back into session and pass the legislation,” she said.
Brooks says the exchanges will help the state’s uninsured, as well as small businesses who currently can’t afford to provide health insurance.
She says if the legislature does not act by September 30th, it won’t qualify for a second round of federal funding to help pay for the exchanges and startup costs.
“That federal money is not a bottomless pit,” Brooks said. “It’s first come, first served”.
The Senate, led by Republicans, is expressing new reservations about implementing the health care exchanges, based on policy differences, not political opposition. A spokesman for Senate Majority Leader Dean Skelos, Scott Reif, says Senators are taking a “cautious, wait and see approach”, and have concerns that the federal program could result in New Yorkers paying $3.75 billion dollars more in taxes to the federal health care system.
An analysis by the Senate Finance Committee finds that under the federal health care changes, the Medicare pay roll tax will increase for upper income New Yorkers, earning $250,000 a year or more for married couples or $200,000 or more for single filers. Under the federal plan, a new Medicare tax will be imposed on investment income and real estate transactions.
The analysis reasons that, because there is a larger number of higher income earners in the state, New Yorkers will be paying disproportionately to fund health care in other states.
Blair Horner, with the American Cancer Society, says there are other concerns to keep in mind. He says if New York lawmakers do not act, the federal government will set up the health exchange for the state anyway, and the legislature will have less control over how the exchanges are structured.
“The more you kick the can down the road, the greater the likelihood that you are going to run into problems,” said Horner.
And he says it’s important to get it right.
“Unlike a lot of other things that happen around here, if you do this badly, real people won’t get health insurance,” he said.
There is still some time left or New York State to implement the exchanges. They don’t need to be in place until January of 2013, and there are two more dates to qualify for more federal assistance, at the end of December, and in June of 2012.