Retired New York state Assembly Member Dick Gottfried, who chaired the Assembly Health Committee for 35 years, said there’s an enormous learning curve for lawmakers who take on this challenge.

“I remember when I became health chair, it very quickly became clear to me how little I knew,” he told Capital Tonight. “And that was true of everyone in the Assembly but (former Assemblyman) Jim Tallon, the health chair (at the time), who we relied on a lot.”

Assemblymember Amy Paulin, who took over the position in January, echoed his sentiments.

“I don’t even know what I don’t know, so yes. Every day I learn things,” she said. “At the end of the process, I’ll let you know how steep it was.”

Health care issues like Medicaid represent over 40% of New York’s almost $230 billion state budget, and there are a variety of groups pushing for either pay hikes, or cost of living adjustments.  

“I think that the health budget is a deficit budget, it’s not a surplus budget,” Paulin said of Hochul’s spending plan. “There are some takings which then look like additions.”

One example is the 340B program which allowed for hospitals and community health centers to negotiate with drug companies. Find more on 340B here. 

“It was delayed last year in the budget. We do not see that delay again and so therefore, that’s generating a lot of extra money to the state, but it’s taking away a lot of money from the health care providers,” she said. “The additional 5% Medicaid increase across the board is really that money.”

As part of her health care budget, Hochul included a 5% increase in Medicaid reimbursement rates for providers. 

Another issue Paulin has taken on is protecting — and growing — the wages of home care workers. 

There was a $3 an hour increase for home care workers in last year’s budget. But this year, advocates argue that the governor is threatening that increase by proposing to hike the minimum wage across the state. Advocates say Hochul’s proposal reverses last year’s wage increase, and returns home care workers to the minimum wage, and Paulin agrees.

“It’s important to understand that if someone is coming into your home and taking care of a family member, you want them to be of the greatest integrity, the greatest skill and a real support. So, you have to pay them,” she said. “And it can’t be the same as working in…some of the minimum wage employers. It’s got to be higher.”