Special Projects Fund

Project Title

Modeling the Impact of a Single-Payer System in New York State

Grant Amount


Priority Area

Special Projects Fund

Date Awarded

December 19, 2017


Outside New York State






Despite the failures of Congress to repeal the Affordable Care Act, it is unclear whether new repeal and/or replace bills will be put forth in the future.

During a time of uncertainty, states are ramping up alternative reform proposals, including single-payer systems. Single-payer bills have been considered in California, Nevada, and New York State. In New York State, the New York Health Act (NYH) has gained traction in Albany. The intent of the NYH is to provide no-cost coverage to every New Yorker with no out-of-pocket costs and no network restrictions. In 2017, NYHealth awarded the RAND Corporation a grant to conduct an objective, independent, and rigorous economic analysis of the NYH.

Under this grant, RAND estimated the economic impact for various stakeholders from implementing the NYH, relative to the current system. The analysis addressed a range of issues, including how a single-payer system would affect the utilization of health care services; whether administrative and drug and device costs would change; how much taxes would need to increase; any net savings or costs for employers and New Yorkers of different income levels; and the net costs to federal, State, and local governments. A final report summarizing the results and methodology was published and briefing events were convened in Albany and New York City for policymakers and other stakeholders.

Read the analysis.