SULLIVAN COUNTY, NY — As local governments across the state of New York are grappling with funding rollbacks and rising health care costs, some lawmakers have begun to discuss possible alternative solutions to their health care woes. This includes legislation that would replace the current health care system with universal single-payer health care for New Yorkers.  

The New York Health Act (NYHA) is sponsored by Assembly Member Amy Paulin (D,WF-88) in the Assembly and Sen. Gustavo Rivera (D,WF-33) in the state senate. It would create universal health care coverage in New York State, paid for by a progressive payroll tax. 

According to information published by the Campaign for New York Health, the bill would cover hospital care, physician services, prescription drugs, dental, vision, hearing, mental-health care, long-term care, maternal care, reproductive care and drug abuse treatment while eliminating monthly premiums, deductibles, co-pays, prescription drug costs, supplemental insurance plans and co-insurance.

“The New York State constitution states: ‘The protection and promotion of the health of the inhabitants of the state are matters of public concern and provision therefor shall be made by the state and by such of its subdivisions and in such manner, and by such means as the legislature shall from time to time determine,’” the bill memo reads. “All residents of the state have the right to health care.”

It continues, “To address the fiscal crisis facing the health care system and the state and to assure New Yorkers can exercise their right to health care, this legislation would establish a comprehensive universal single-payer health care coverage program, funded by broad-based revenue based on ability to pay, for the benefit of all residents and employees of the state of New York.”

Assembly Member Paula Kay speaks at a January 22, 2026 open house for the Highland Health Initiative.

RR photo by Liam Mayo

State lawmakers discuss NYHA

Federal budget rollbacks and New York’s struggle to fill in the shortfalls have reignited conversations about the New York Health Act (NYHA). During the summer, Assembly Member Sarahana Shrestha (D,WF-103) held seven town halls across her district to discuss NYHA. Shrestha said that the current difficulties many people are facing in regards to health care are systemic problems that are at their worst right now.

“450,000 people were kicked off of the essential plan, and everybody’s health care plan has just been going through changes they don’t understand,” Shrestha said to the River Reporter. “It really feels like the crisis is at its peak right now.”

Shrestha also said the bill would help health care workers, especially those in more rural areas or working at smaller, independent practices.

“Primary care physicians who are trying to do a small family practice, they don’t have time to do all of this paperwork just to get paid,” Shrestha said. “They should be able to devote their time to seeing patients, giving them care, and not use all of their time and resources fighting with insurance companies, so it makes a big difference to people who actually work in the health care sector.”

Shrestha also invited former assembly member and the original sponsor of the bill Richard Gottfried to her town hall in New Paltz to help answer questions about NYHA. In an interview with the River Reporter, Gottfried spoke on the importance of the bill, and the financial burden that health care places on New Yorkers.

“For millions of New Yorkers in any given year, you know, including... for people who have health coverage, somebody in their household in a given year goes without needed health care because they can’t pay for it, or they suffer financial hardship to pay for it,” Gottfried said. 

“Health care spending is the number one source of bankruptcy in New York and across the country,” Gottfried said. “That’s why surveys find that a huge percentage of New Yorkers are concerned about whether they can pay for their health care, and a huge percentage of New Yorkers have a terrible opinion of health insurance companies, and we’ve got to do something about that.”

County manager Joshua Potosek sits in a September 17 meeting of the Sullivan County Legislature.

RR photo by Liam Mayo

Single-payer in Sullivan

During a September 10 meeting of the Sullivan County Legislature’s Health and Human Services Committee, chair of the committee Catherine Scott brought up the legislation and suggested that it would fix several problems with health care that the county is facing. 

The county could also see significant savings if the state implemented the health care system that the New York Health Act proposes. According to Scott, the county could save over $40 million if the NYHA was implemented.

Sullivan County Manager Joshua Potosek weighed in, saying that he remembers during Gov. Andrew Cuomo’s term that a group from Massachusetts presented a model that showed that due to the structure of county governments, moving to a single payer system would ease the financial burden on the county, adding that “from a strictly county government perspective, it was wildly financially beneficial to us because of what we’re paying for today.”

According to information from Sullivan County Management and Budget Commissioner Anna Novello, Sullivan County budgeted $33,644,060 in county employee health care costs and $20,601,867 in Medicaid costs for 2026. Novello did say that those numbers don’t represent the savings the county could theoretically see because they do not include the cost of the new payroll tax that would be instituted under NYHA.

Furthermore, in an interview with the River Reporter, Assembly Member Paula Elaine Kay (D-100) said she was interested in co-sponsoring the legislation, but said that due to the impacts on local governments including the county, she is waiting for the county to act. Scott urged the legislature to sign a letter, saying that if NYHA were adopted it would cut through bureaucracy around health care, save the county money and increase coverage.

Still, the committee needed more information about the bill before it would act. Legislator Amanda Ward had questions about how it would affect other sectors. Legislator Brian McPhillips said that he wanted to learn more about the bill, saying that as a diabetic who has run into problems with the insurance industry, he didn’t want to take away individuals’ medical liberty.

“To know that I’d be potentially affecting somebody else’s medical freedoms, I would just want to have a little more research on it,” McPhillips said. “If I could just have some time.”

Ken Walter speaks on the question of a county executive at a March 19 meeting of the Sullivan County Legislature.

RR photo by Liam Mayo

During a meeting of the county legislature’s health and human services committee listeners heard more about the bill. During the October 1 meeting, members of the Campaign for New York Health presented information on the legislation, and urged Sullivan County to support it. 

“I understand how hard it is to be in your seats. I understand how hard and undesirable it is to be able to have to give hard news to your community and have to make hard choices that you know negatively impact your community,” Melanie D’Arrigo, executive director of the Campaign for New York Health said during the presentation. “This is such a gift, really, to be able to sit in your position and deliver not only these savings but the best healthcare in the entire nation.”

However, some members of the public strongly object to the legislation. Linda Yehl, who spoke at public comment after the presentation, said she was “totally against this.” She feels that her insurance is fine, and that New York shouldn’t change that just so they save money.

Other advocates have also urged the legislature to act on it, including Ken Walter, a member of the Senior Legislative Action Committee (SLAC), who spoke up at the September 10 meeting. He said that “we should have the same kind of care that New York State legislators have, and nothing less.”

Star Hesse, another member of SLAC, has been an outspoken advocate for the NYHA. She said that she believes the time is right for movement in Albany, and that support is high. Hesse encouraged people to reach out to their local legislators and lawmakers and encourage them to support the bill.

“This has been in the works for a very long time, and until recently there was not enough support from the Albany legislature to get this very vital bill passed,” Hesse said. “But now with all that’s going on in the world… I guess the situation has gotten bad enough that the general public is starting to demand this kind of coverage.”