Building a Healthcare System That Works for Everyone

Guarantee healthcare regardless of income or employment

Tying healthcare to employment leaves people vulnerable whenever they lose a job, have their hours reduced, or become too sick to work. Federal funding cuts have made this insecurity worse. In July 2026, roughly 450,000 New Yorkers lost their Essential Plan coverage after federal cuts eliminated funding for the expansion and the State did not replace the lost revenue. Restrictions based on immigration status and new federal work-reporting and eligibility requirements will cause many more people to lose Medicaid.

Coverage also means little if an insurance company can prevent someone from seeing a trusted provider or deny the treatment their provider recommends. These decisions should be made by patients and healthcare professionals, not insurers.

The New York Health Act would provide universal public coverage without premiums, deductibles, copays, or restrictive provider networks. Coverage would no longer depend on employment, income, immigration status, or navigating an insurer’s administrative requirements. The system would instead be funded according to ability to pay.

Make care available in rural and underserved communities

Having insurance does little good when the nearest provider is far away, is not accepting patients, or is excluded from an insurance network. Rural practices also struggle under payment systems that do not account for the cost of serving a widely dispersed population.

These gaps are most dangerous during an emergency. EMS personnel begin lifesaving care before a patient reaches the hospital, yet rural ambulance coverage is increasingly unreliable as volunteer ranks shrink and reimbursement fails to cover staffing and operating costs. When one agency cannot respond, neighboring services have to travel farther, increasing wait times across the region. New York should reimburse ambulance services enough to keep crews staffed and vehicles on the road while helping neighboring communities coordinate coverage. The State should also identify where essential healthcare services are missing and direct funding to bring those services into the community.

Build and retain the healthcare workforce

New York cannot reduce wait times without enough people to provide care. When positions remain vacant, existing staff take on more patients and longer hours. This drives burnout and turnover, leaving communities with even fewer providers. Upstate and rural practices face an additional challenge recruiting people who are carrying substantial educational debt and may struggle to find affordable housing nearby. Workforce programs should make it financially possible to train for and remain in healthcare. Loan forgiveness should be paired with adequate compensation, and state investments should be directed toward the professions and communities with the most serious shortages. Training more people will accomplish little if the conditions of the work cause them to leave.

Remove financial barriers to becoming a mental-health provider

Students training to become social workers and other mental-health professionals often complete hundreds of hours of unpaid fieldwork while also paying tuition. Students who cannot afford to work without wages may reduce their course load, take on additional debt, or leave the field entirely. This narrows the workforce just as the need for mental-health care continues to grow. Required field placements should be paid, and scholarships should help students enter areas with severe provider shortages. Removing these financial barriers would expand the workforce and make it possible for people from a wider range of economic and cultural backgrounds to enter the profession.

Help New Yorkers age safely at home

Medicare does not generally cover ongoing help with daily needs such as bathing, dressing, preparing meals, or moving safely around the home. Private long-term care insurance is unaffordable for many people, while Medicaid coverage often requires people to exhaust much of what they have saved. Families are left trying to fill the gap, sometimes reducing their work hours or leaving their jobs to provide care. New York needs a public long-term care benefit that people contribute to during their working years and can rely on when they need support. Home care and palliative care should be available before a family reaches a crisis. Care workers should also be paid enough to remain in the field, so that the promise of aging at home is supported by people who are actually available to provide the care.

Make prescription drugs affordable

The price a patient pays for medication is shaped not only by the drug manufacturer, but also by pharmacy benefit managers that decide which drugs an insurance plan will cover and how much pharmacies will be reimbursed. These negotiations are largely hidden from patients. The result can be higher out-of-pocket costs and payments so low that independent pharmacies lose money filling prescriptions. Negotiated savings should reach patients at the pharmacy counter, and pharmacies should be reimbursed for both the cost of obtaining a drug and the work required to dispense it safely. Manufacturers should not be allowed to withdraw an affordable medication simply to replace it with a more expensive version. The system should be structured around getting medication to the patient, not maximizing what each intermediary can collect along the way.