With the Affordable Care Act under fire in Washington, Democratic lawmakers in Albany are pushing for a measure creating a single-payer system -- universal health care.
"We have an obligation to protect the 3.6 million New Yorkers enrolled in comprehensive health coverage enrolled through our state's exchange," said Senate Minority Leader Andrea Stewart-Cousins.
The bill is unlikely to pass in the Republican-led state Senate. Still, it's been a long-sought goal for Assembly Health Committee Chairman Dick Gottfried, who said its costs would be borne by the richest New Yorkers.
"Fortunately, New York has an enormous number of really wealthy people who will contribute a substantial part of the cost," said Gottfried (D - Manhattan), "and as a result, 98 percent of New Yorkers will be spending less than they are today."
In the short term, there's also concern a replacement bill for the ACA would defund Planned Parenthood. Democrats say they would push to have New York make up the difference if federal funds are cut.
"That's money that I can't imagine the state of New York couldn't and wouldn't make these programs whole," said Senator Liz Krueger (D - Manhattan).
Speaker Carl Heastie, meanwhile, believes the Legislature may have to return after the session concludes in June to respond to any health care changes on the federal level.
"Anything that has the potential to put our health care delivery in the state of New York in jeopardy is something we're very concerned with," Heastie said.
Of immediate concern is providing states with a lump sum for Medicaid spending -- a system known as block grants -- as opposed to an open-ended entitlement.
"Block grants ... are very concerning," Heastie said. "New York, I'd say, fared very well under the Affordable Care Act, so starting to dismantle that itself, I'd say, is very concerning to me here."
Not everyone believes Medicaid changes would be a problem. Republican Congressman John Faso, in a radio interview Wednesday, said New York could have more flexibility under proposed changes that would eliminate the waiver and amendment process.