ALBANY, NY — A study commissioned by the New York State Health Foundation and performed by the RAND Corporation said the proposed single-payer health plan proposed in New York State is feasible, and would save the state healthcare system a bit of money.

The proposed New York Health Act (NYHA), which the has been passed by the state Assembly for three years in a row, would, according to a RAND brief (tinyurl.com/yaqakenc) “provide universal insurance coverage with no copays, deductibles, or premiums for all New Yorkers, regardless of immigration status, and would lead to higher utilization while lowering health plan and provider administrative costs—saving the system $15 billion, or about 3.1%, by 2031, compared to current policies, according to the report. The paper… is a boon for single-payer advocates because it shows most individuals and employers would save money over the long term. But the findings come with several caveats that could bog down any effort to pass and implement single-payer in New York, particularly if Republicans continue to wield power in Albany and Washington.”

One of the biggest hurdles will be getting the federal government to go along. In order for it to work, the federal government would have to grant permission for the state government to use all the money that goes to Medicare, Medicaid and Affordable Care Act programs to be redirected to NYHA. Given the current federal administration, that seems highly unlikely. In fact, the brief notes that recently the administrator of the Centers for Medicare and Medicaid Services said that California’s plan for single-payer is “unworkable” and similar plans are not likely to be approved by Washington.

The idea of single-payer universal healthcare has not been approved for the state to this point because Republicans in the Senate never warmed to the idea, and they never put it to a vote. This year there is a good possibility that the state Senate will switch to Democratic control, and if that happens there is a good chance NYHA would pass.

On July 25, New York gubernatorial candidate Marc Molinaro pledged to veto what he called “a $90 billion state government takeover of New York healthcare that would ban private health insurance coverage in the state and hike personal income taxes to rates as high as 16%” if he is elected governor.

Democratic primary candidate Cynthia Nixon, who is challenging Cuomo in the September 13 primary, has said she would sign NYHA if it passed.

Cuomo has been more conditional on adopting NYHA. Last year he called NYHA “an exciting possibility,” providing it doesn’t have any conflicts with the ACA. He also said it would be preferable to have the healthcare question settled at the national level.

The program would be paid for through increased income tax, and under one scenario, middle-income earners could pay taxes of about 15%, up from 5%. The trade-off would be that those people would no longer be making any payments to health insurance companies, and with no co-pays or deductibles, use of the healthcare system is expected to increase, resulting in a healthier population. For wealthier earners the percentage of income tax would be higher.

Businesses that currently offer employee health insurance payments could turn those into additional income to pay for increased income taxes, while businesses that don’t offer employee insurance would pay higher taxes.