New York Lawmakers Approve Revised Health Package After Pataki, Legislative Leaders Reach Deal

New York lawmakers approved a multibillion dollar health care package early on Jan. 16 after Gov. George Pataki (R) and legislative leaders agreed on a bill that will raise salaries for health care workers while imposing much less severe cuts in services than originally proposed by the governor (Gormley, Associated Press, 1/16). Following late-night negotiations, Pataki, Assembly Speaker Sheldon Silver (D) and Senate Majority Leader Joseph Bruno (R) reached an agreement at 4 a.m. Jan. 15 on the package, which Pataki had negotiated for weeks with Dennis Rivera, the "powerful head" of New York City hospital workers' union, the New York Times reports. Under the deal, the 210,000 workers covered by 1199/SEIU will receive raises worth about $700 million over the next three years (McKinley, New York Times, 1/16). According to the Pataki administration, the total amount of the money for salary increases and worker retention for the state's health employees will come to $2.1 billion; in particular, nursing home workers will receive $505 million over three years and home health services and community health centers will receive $976 million over four years (Associated Press, 1/16). Upon announcing the agreement on the package -- "widely seen ... as a prelude to a political deal between Rivera and Pataki," who is running for re-election -- the governor addressed hundreds of health care workers whom the union had bused to the state Capitol in Albany and "quickly turned the rally into a campaign event [and] waded into the predominantly Democratic crowd," where he was "mobbed by happy nurses, orderlies and other hospital workers," the Times reports (New York Times, 1/16). "I know the health care system is under tremendous strain and needs help from Albany," Pataki said (Lovett, New York Post, 1/16). "He passes the bill, and we vote for him," DeVon Bligen, an employee at a Bronx nursing home, said (New York Times, 1/16).

A 'Big Gamble'
While the Senate and Assembly overwhelmingly supported the package, many lawmakers criticized both the process that led to the bill and its financing. Legislators have estimated that the multi-year agreement will cost $3.5 billion, but Pataki budget division spokesperson Kevin Quinn said last night that the administration "had no estimate for the package's total" (Associated Press, 1/16). The plan calls for a one-time cash infusion of most of the $1.1 billion the state will receive for the conversion of Empire Blue Cross and Blue Shield into a for-profit company. In addition, the state's cigarette tax will increase 39 cents to $1.50 to help pay for the package. But it also relies on Congress to increase federal Medicaid payments to New York to raise $2.1 billion over three years, a prospect "considered a long shot at best." One Republican state senator said, "That's one of the bigger gambles I've ever seen" (New York Times, 1/16). Lawmakers also criticized the secretive nature of the negotiations on the bill, which were initially conducted by Rivera and Pataki, who then took the deal to Bruno and Silver. "I was once told we wouldn't do business and enact ... billion dollar programs in the dead of the night," state Sen. Richard Dollinger (D) said, adding, "I'm dismayed" (Associated Press, 1/16).

Cuts Restored
Despite some initial concerns, the legislative leaders agreed to support the plan after several proposed cuts in health services were restored. For instance, Silver persuaded Pataki and Bruno to allow Medicaid beneficiaries who are disabled to maintain eligibility if they earn up to $44,000 a year. He also won an additional $13 million a year for walk-in health clinics (New York Times, 1/16). Senate Republicans, meanwhile, were able to secure $30 million for nursing homes that could be affected by "a new surcharge Pataki proposed in a bureaucratic maneuver" to obtain more federal Medicaid funds, Newsday reports. The final plan also does not include copayments for parents whose children need physical or speech therapy, something included in Pataki's original proposal (Rau/Palmer, Newsday, 1/16). In addition, pharmacists who provide drugs to poor seniors will only see a loss of $25 million a year in funding, $175 million less than originally proposed by Pataki. The package also requires doctors to pay for more malpractice insurance. And in a concession to Democrats who wanted to use the money from the Empire conversion to establish a foundation to cover the uninsured, the deal allocates about $50 million to study ways to reduce the number of residents without health coverage (New York Times, 1/16). Assembly Health Chair Richard Gottfried (D) conceded that the $50 million in funding was a "minimal" amount, but said that the "good pieces of this package, now that we've reworked it, far outweigh that disappointing piece" (Newsday, 1/16).