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An Assessment of the New York Health Act: A Single-Payer Option for New York State


RAND Corporation

Funding Area

Special Projects Fund


August 1, 2018

Special Projects Fund

A single-payer health care plan could expand coverage for all New York State residents, but would require significant new tax revenue, according to an NYHealth-supported analysis by the RAND Corporation.

A plan outlined by the New York Health Act, which has been considered by the New York State Legislature, is likely to increase use of health services as more people receive coverage. But the analysis finds that overall health care costs would decrease slightly over time if administrative costs are reduced and state officials slow the growth of payments to health care providers.

Key findings include:

  • Under the New York Health Act, total health care spending would be similar in 2022 as with the status quo and become 3% lower by 2031.
  • New taxes for health care would need to be about $139 billion in 2022 and $210 billion in 2031 to fully finance the plan. Under the status quo, the State is expected to collect about $89 billion in taxes from all sources in 2022; thus, the new taxes would be a 156% increase in total State tax revenue.
  • As payments for health care shift from premiums and out-of-pocket payments to progressive taxes, most households in New York could pay less and the highest-income households could pay substantially more. The shift in who pays more or less would ultimately depend on the design of the tax schedule.


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Download the related research brief.