Two years ago last week, I wrote in the Daily News about how then-Governor Andrew Cuomo was pushing a costly change to insurance law on behalf of a hospital group that had supported his campaign through a fund-raising loophole.

The name of the governor has changed since then, but otherwise much the same column could be published today.

Cuomo’s “pay and pursue” proposal, as I wrote in March 2021, aimed at “requiring health insurers to pay hospital claims without verifying in advance that the treatment was medically necessary — a routine check that insurers use to avoid waste and control costs.”

Hochul’s version has been renamed “pay and resolve” and applies only to emergency care and emergency-related admissions. Otherwise, it’s the same concept in a new package.

In 2021, I wrote: “The opposition to this ‘pay and pursue’ plan includes not just insurers, but also employers and labor unions who argue that it will further drive up the state’s health premiums, which are already among the highest in the U.S.“<

Ditto for today.

Back then, I noted that the Greater New York Hospital Association – an influential group behind Cuomo’s proposal had “quietly contributed more than $1 million to his reelection campaign in 2018.”

GNYHA did just the same for Hochul in 2022 – albeit in the lower but still eye-catching amount of $940,000.

In each case, the cash flowed to the state Democratic Party’s “housekeeping” account, which operates under a notorious loophole in the state’s campaign finance laws. Such accounts can legally accept contributions of any size – with no limit on the dollar amount – and disclose their finances only twice a year, in January and July.

For both Hochul and Cuomo, this meant that the voting public had no way of knowing about GNYHA’s largess until the election was over and the beneficiaries had been sworn into office.

In another parallel, Hochul, like Cuomo, wants to include the pay-and-resolve legislation in the state budget. When legislators finally pass the spending plan that was due April 1, pay-and-resolve would be buried among thousands of other issues to be debated and voted upon as a package. In that context, it would get little if any scrutiny, and lawmakers who support other parts of the budget would be hard-pressed to say no.

There are a couple of differences between 2021 and now: Whereas Cuomo tried to insert the language in last-minute, closed-door negotiations with legislative leaders, Hochul publicly proposed the change in January as part of her executive budget. The Assembly and Senate left that provision out of their one-house counter-proposals to Hochul’s budget. Now the governor is lobbying to get it added back in, in alliance with GNHYA, the Healthcare Association of New York State and other hospital groups.

A second difference is that Cuomo, then serving his third term as governor, had a longer history with GNYHA. In 2018, for example, he helped the group by orchestrating a Medicaid fee hike that was the focus of a front-page expose in the New York Times.

When the pandemic struck in 2020, Cuomo was following GNYHA’s advice when he directed nursing homes to accept COVID-positive patients and engineered a controversial liability waiver for health providers.

Hochul, for her part, is developing a relationship of her own.

Last September, her emergency order aimed at alleviating health-care staffing shortages included little-noticed insurance-related changes that had been requested by GNYHA.

Earlier this year, she vetoed a bill expanding the rights of plaintiffs in wrongful death lawsuits, a measure that was opposed by hospitals, among other groups.

And this year’s budget – in addition to pay-and-resolve – offered plenty for Hochul’s six-figure contributor to appreciate, including a 5 percent across-the-board Medicaid rate hike and $1 billion in new health-care capital funding.

Hochul differs from Cuomo in some ways, stylistically and otherwise. But when it comes to hospital policy, she’s falling into an all-too-familiar pattern.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

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