A recent CSS survey revealed that nearly two-thirds of New Yorkers delayed or skipped care last year due to cost. About 70 percent of respondents faced at least one health care affordability burden, and 80 percent worried about affording care in the future. Over the past three decades, New York’s health care spending has tripled. Hospital care is the single biggest contributor to this spending, rising twice as fast as income and four times as fast as inflation over the past decade. These rising hospital prices are impacting payers, employers, unions, and especially patients, and are resulting in rising premiums, out-of-pocket costs, and medical debt. Between 1997 and 2024, 53 New York hospitals closed across the State and have not been equitably distributed based on the State’s population, contributing to disparities in access to hospital care. The State’s expensive, fragmented, and inequitable health care system arose from policymakers’ decisions in the 1990s to move to a market-driven health care system—learn more in a new CSS report, “Why is Health Care in New York So Unaffordable and What Can be Done to Fix It?”. 

Steps that New York can take now to address the State’s health care affordability crisis:

1. Adopt system-wide reforms.

• Establishing an independent Office of Health Care Affordability to address hospital closures and consolidations, limit health care spending growth, and promote high-value care.
• Creating a functional, public-facing All Payers Claim Database to help policymakers track health care cost growth and allow consumers to compare prices.

2. Impose targeted pricing reform.

• Adopting the Fair Pricing Act (S705|A2140) would set price caps for routine services at hospital outpatient departments, at around 150% of Medicare rates. This would save New Yorkers $213 million in reduced out-of-pocket costs, and 86 percent of New Yorkers support it.
• Developing a hospital-specific cost review entity to limit hospital cost growth.

3. Establish a primary care spending target.

• Enacting the Primary Care Investment Act (A1915A|S1634) would require insurance carriers to increase spending on primary care each year until they reach a target of 12.5 percent. 79 percent of New Yorkers support this.