Four years after the COVID-19 pandemic, health workers who continue to endure the duress of insufficient staffing levels met with state lawmakers on Tuesday to demand more funding for health staff and restore proposed Medicaid cuts before the release of the Legislature's one-house budgets early next week.

As lawmakers start to focus on serious budget talks amongst themselves, they have difficult choices to make about what they want to change from Gov. Kathy Hochul's $233 billion executive spending plan.

"The gaps that make patients have to pay more out-of-pocket should not be there," said Aretha Morgan, a nurse of 32 years who works at New York-Presbyterian Hospital in New York City. 

Hundreds of health workers with labor unions, including the New York Nurses Association and 1199SEIU, pressured lawmakers in the state Capitol in Albany on Tuesday to demand they prioritize health staff and hospitals in the next budget that deadlines April 1. They rallied to increase Medicaid reimbursement rates 16%, and for more funding for distressed hospitals they argue will improve the quality of care and make facilities safer.

"Again, health care is a right," said Morgan, who sits on NYSNA's board of directors. "Everyone is supposed to be able to come into a hospital."

Lawmakers have started to conference the details of the Legislature's separate counter proposals to Hochul's budget expected to be released Monday.

Health workers Tuesday pushed lawmakers for more funding to boost nurses' education, loan forgiveness and recruitment programs, fixing issues with Tier 6 in the state pension fund and sufficient support to prevent the closure of hospitals and maternity wards.

Assembly Health Committee chair Amy Paulin is pushing her colleagues to include health workers' desired changes.

"We have to make sure that the one-house budgets, and the final budget, includes what we need to get our hospitals, to get health care back on track, to make our hospitals fiscally solvent, to have workers supported," Paulin told Spectrum News 1 on Tuesday. "We know the devastation if we don't."

Paulin says Assembly Democrats largely support restoring much of the proposed $1.2 billion Medicaid cuts and changes to school aid funding in the governor's budget.

"We have a lot of work to do," the assemblywoman said. "At the end of the day, your health is paramount to anyone's success and their happiness, so we have to make sure make the system whole."

Many Democratic lawmakers stood with nurses Tuesday, rallying in favor of increasing New York's Medicaid reimbursement rates, which would also boost pay for workers.

Newly minted Assembly Labor Committee Chair Harry Bronson supports the increase, and says the state must penalize health facilities that do not meet safe staffing ratios mandated under state law.

"We have to that we enforce safe staffing in our hospitals and in our nursing homes so that our workers aren't overworked, and that they have the support team around them that is necessary," Bronson said.

To date, the state Health Department has cited 15 hospitals for violations of the state's safe staffing law, which took effect Jan. 1, 2023.

"As these cases may be the subject of an ongoing investigation, we cannot comment further at this time," DOH spokeswoman Cadence Acquaviva said in a statement Tuesday.

Hospitals found in violation of the law are required to submit a corrective action plan to the department, and to establish clinical staffing committees to create and submit minimum staffing plans. The plans must be implemented upon department approval.

Failure to comply may result in fines, up to $2,000 per citation, and any other related civil penalties, according to the department. 

Bronson also stands against Hochul's proposed Medicaid cuts, and underfunding hospitals which are often the largest employer in a community.

"We need to be investing in those systems, for the workers, for our families and patients, as well as to our economy," Bronson said.

Last week's updated budget consensus shows $1.3 billion more in tax receipts than expected, but it's unclear how that extra revenue will be spent.

State budget officials Tuesday said the extra $1.3 billion was placed into the financial plan, and how it will be used will play out during negotiations between the governor and legislative leaders later this month.

"The governor knows the Legislature will want to establish their own priorities in the budget," state Budget Director Blake Washington told reporters Tuesday. "We're happy to partner on those things where we all align; they'll want to improve upon some of the things in the budget."

But health workers and state lawmakers alike said while many areas of the budget take priority, other investments will not show a return if New Yorkers aren't healthy and cannot access the care they need throughout different stages of life.

"You can give so much money to everything else, but at the end of the day, if you don't have good health, you don't have anything," Morgan said. "Your health is everything."

*Editor's note: This story corrects an earlier version. An increase in pay for nurses is not one of NYSNA's lobbying priorities. Some lawmakers at the rally have additional priorities for the budget in which they noted higher pay for health staff.