The document discusses health care policy and the legislative process in New York State. It begins by outlining the three branches of government in NYS and how bills are formulated. It then describes key stages of the NYS budget process and how an idea becomes law, from bill drafting to gubernatorial approval. The document also discusses the New York Health Act, which would establish a single-payer health care system, and perspectives both for and against the Act. It concludes by noting criticisms of the dysfunctional NYS legislative process and questions around whether the Health Act should become law.

1. Health Care Policy in New York State
The Legislation Process
To: Prof. Forney
FR. Ketesha Gordon
November 7, 2016

2. Legislative Process
 NYS has three branch in the government
 NYS boroughs are represented by a 63 member
Senate, and 150 Assembly members.
 No law cannot be created in NYS without being
adapted by legislature in the form of a bill.
 Bill formulation is an important part of the
legislative process in NYS.
 Legislature during the legislative session spends
half of the week in Albany and the other half
with their local districts.
 The Executive budget

3. NYS Legislative Process: Executive Budget
 The NYS constitution requires the governor to
submit a budget plan along with any
legislation to the legislature yearly.
 Once adopted the governor is left with the job
of implementation while the process is
overseen by the legislature.
 NYS BUDGET PROCESS includes these key
stages:
 Official Start (Aug-Oct )
 Executive Budget (Nov-Jan)
 Public hearing (Feb)
 Legislature alter budget (Mar)
 Back to governors desk
 Division issue a comprehensive enacted budget
report (final Version).

4. Formulation Process: How an “Idea”
becomes a “Law”
 Idea the starting point for public policy process.
 Bills Need sponsorships in order for it to be
introduced.
 Bill drafting.
 Bill drafting commission then draft the bill.
 The introduction and revising office.
 Bill is then entered into the legislative retrieval
System (LRS).
 Standing Committees evaluate bills.
 Public hearing agenda of bills are reviewed by
committees.
 Legislative Calendar
 Senators Desk
 Bills reaching third reading status
 Bills amended are left in its amended form and with
its original number.
 Vote is taken after debate and explanations.
 Assembly process is the same as the senate
 Governors Desk
 Signed bill are classified as law, and rejected bills the
ones not signed are vetoed.
 Vetoed bills can still become law
 Out of session bills
 Conference Committees
The final process of the legislative
process are new public laws, and
changes to existing ones.

5. New York Health Act
 “The Act” is a part of the universal health
care bill passed the Assembly on May 27th in
New York.
 If this act becomes law citizens will no
longer need premiums, co-pays, deductibles,
or limited provider networks.
 Single system funded by the state and based
on income and the ability to pay.
 The act will amend the public health law and
the state finance law in order to establish NY
health.
 This act will allow 98% of New Yorkers will
spend less for health care and the state would
save over $70 billion.
 This Act saves $45 billion for NYS even they
fail to eliminate deductible and increase
Medicaid reimbursements.

6. Perspective for “The Act”
 Against “The Act”
 New Yorkers argue that the single payer system is not
the best approach to obtain universal health care.
 Having a single payer system is not the key to
universal health care; in fact, this system will
minimize the involvement and responsibility of
individuals and families.
 Krugman's states that individuals will have no place
in choosing systems of care and financing, and only a
faint voice when dissatisfied.
 Many believe that this system would cause major
disruptions to millions of New Yorkers who currently
have coverage through employment.
 In favor of “The Act”
 Believes that our health care system is deeply
damaged. Everyone is trying to make a dollar off the
sick and injured.
 Mrs. Gonzalez states that only under this system of
universal access to care that is based on quality for
all, and not on the ability to pay, social status, or
other impediments will there be enough resources
directed to proper care for patients.
 New Yorkers and resident need a single payer system
that would generate equal access to care that is fairly
funded.
 This act is being backed Assembly member Gottfried
and State Senator Bill Perkins.
 We deserve health coverage for all of us, paid for
based on our ability to pay, not on what the market
will bear.
 Some foundation are NYS Nurse’s Association,
Doctors council SEIU, SEIU 1199.
 This single payer system guarantees quality health
care that cuts cost, has no limitations, or complex
billing and is open to all, cover all aspects of the
medical bills.

7. Impact of dysfunctional aspects of NYS legislative process
 NYS period of time between the bill introduction and its
final passage by both chambers is very short.
 Changing the Senate and Assembly rules can repair the
process without any new legislations or amendments.
 Five key weaknesses are:
 Bills are not discharged from committee for full chamber
review;
 Committee system does not serve any purpose or function
as it should;
 Majority Leader and Speaker have control of legislative
calendar;
 Legislators are prevented from reading, considering,
debating, and amending any bills before voting;
 Conference committees are hardly used.
 This requires the members of both chamber to work out any
differences.
 This system introduces many bills that might never become
law.
 Committees in both chambers do no draft reports
explaining the purpose or intent of a bill.
 Not enough debate, no amendments, and insufficient
reviews in committees or on the floors.
 The message of Necessity in NYS legislative process is not
used for its proposed purpose. And the spending is not
transparent.
 Failed representation
 Unproductive government without deliberativeness
 Unreachable government
 No public accountability
 Inadequacy
 Courts without leadership
 Legislation may never reach the floor or be delayed
for years, especially if it needs support of legislators to
pass.
 Legislators cannot adequately represent their voters
interest because they are often shut out of the
legislative process in the most important stages.
 Changes need to made to the process in NYS to make
it more effective, purposeful, more available and
responsible to the voters.

8. State and Federal Similarities
 Health policy is a joint federal and state level
responsibility and policymaking is equal at any level.
 In NYS the committee on health care in the assembly
are
 In NYS senate the committee on health care are
 Ways and means and the financial committees have
major health policy jurisdiction.
 Federal and state process are similar in many ways
 states and federal government are limited and each
governmental body has subjects that only they can
make law.
 Federal legislations cover laws pertaining to
 State legislations covers laws pertaining to

9. Conclusion
 State legislation is power given to the state to rule
over the citizens living in that state.
 The state level is not higher than the federal process,
and in a dispute, the federal legislation would still
have the upper hand.
 The legislation process in NYS is dysfunctional
because majority of the power is given to the
Assembly and Majority leader.
 “The Act” should pass Senate and eventually
become law in NYS. This act will help every single
new Yorker receive affordable health care.
 Countries such as Canada, and the U.K. have low
GDP when it comes to health care spending and they
use a single payer system and seem to be doing well.
 If republicans are elected into power, they might try
to overturn the ACA. If the ACA is overturned
federally, then the Act might never become law.
 Many believe that they will never be able to gain
control of all three; however, democrats can still
prolong any legislation to repel the ACA
 Questions:
 Do you agree that the Legislative process in
NYS is broken?
 Should the Health Act become Law?

10. Reference
References
Gottfried, R. (2016). HealthCare-Now. Retrieved from New York Assembly Passes Universal
Healthcare Bill: https://www.healthcare-now.org/blog/new-york-assembly-passes-
universal-healthcare-legislation/
How a Bill becomes a Law . (n.d.). Retrieved from New York State Senate :
https://www.nysenate.gov/how-bill-becomes-law-1
Krugman, P. (2016, Jan 18). The New York Times. Retrieved from Health Reform Realities:
http://www.nytimes.com/2016/01/18/opinion/health-reform-realities.html
Longest , B. B. (2010). Health Policymaking in the United States. Chicago, IL: Health
Administration Press.
New York State . (2016). Retrieved from The budget Process:
http://www.budget.ny.gov/citizen/process/process.html
Stengel, A., Norden, L., & Seago , L. (2008). Still broken New York State Legislative Reform
. Retrieved from Brennan Center for Justice :
http://www.brennancenter.org/sites/default/files/legacy/publications/Still.Broken.pdf
Titus, M. (n.d.). NY Assembly . Retrieved from The Legislative process and You :
http://assembly.state.ny.us/member_files/031/20030310/