President Barack Obama’s health care reform battle may be in limbo in Washington, but state officials are still preparing for dealing with what would be a massive change to health care delivery in New York.

 

Albany’s first hurdle is deciding who will oversee the process of putting the reforms in place—a tricky decision that shows how laborious and politicized the reform process could become.

Assuming a bill of some kind passes, and most think it will even with the results of the Massachusetts Senate special election, lobbyists are asking New York legislators to create a special commission to help guide the implementations, which are expected to take thousands of staff hours and cost hundreds of millions of dollars. But many legislators are lukewarm on that idea, hoping to use existing structures and staff to maintain efficiency and tight control as they do the overhaul.

“There have been suggestions about setting up some sort of entity to work on federal implementation,” said Assembly Member Dick Gottfried, chair of the Health Committee, in December. “Whether that might make sense for New York or whether it could turn into just another panel that doesn’t accomplish much, I don’t know.”

Gottfried said that with the debate in Washington still up in the air, there are too many moving parts to predict what is needed.

The huge task of implementation could be a long-term drain on the Health Department as well as the state budget. So far, the federal government has not offered much funding to ease the transition. Appointing some third-party experts to guide the state through a rough period could help ease public anger, as with the 2005 Berger Commission on closing hospitals.

So with the passage of a bill potentially weeks away, industry and consumer advocates are poised to start a marathon scrutiny of Albany’s reaction. They say that a committee with well-planned ground rules would be the fairest forum for their ideas.

Some envision a panel of experts that meets monthly or bimonthly while others have suggested more casual meetings.

“The state should be setting up some kind of task force or planning strategy groups of diverse interests to plan for implementation, as soon as possible,” said Judy Wessler of the Commission on the Public’s Health System. “And when I say diverse institutions, I mean consumers and advocates and labor representatives, as well as institutions. You need voices to say what can work and what can’t work, and to say who gets hurt or helped by particular provisions.”

Politicians and insiders said there would be no lack of input even without such a group, since health policymakers keep their doors open to lobbyists.

And some health policy experts say that health reforms are simply too big a job for lawmakers to risk delegating.

“I think the state would not give that responsibility up,” said one top health official. “Assistance, yes, but I cannot imagine the state investing authority in another body.”

However, it is the scale of the reforms that others say calls for a wider, coordinated collaboration between people in and outside government.

“We all know that it’s going to be tremendously tricky and difficult,” said Bill Van Slyke of the Healthcare Association of New York State, although his group has not asked for a formal committee. “We’ve been talking to them and sharing our concerns about the legislation generally, and our wish to share in the process.”

The legislation, whatever its final shape, could require more electronic record keeping, new insurance laws and new types of Medicaid reimbursements, transforming the state’s health care system.

Some legislators remain skeptical of ceding control of the implementation of the bill to a third party. Tom Duane, chair of the Senate Health Committee, is not one of them, and he has been pushing the idea of collaboration between government, industry leaders and advocates.

“We absolutely have to have a stakeholder group to provide direction on implementation of federal health care reform in New York State,” Duane said in a statement. “All voices must be heard.”

Claudia Hutton, the director of communications for the state Department of Health, said the state has other options. Right now, she said, Albany’s priority should be to pressure the federal government to fund the transition and set a reasonable timetable.

“You can also put money in for dedicated staff; you could arrange for a joint task force of the governor’s office and the Assembly and Senate committees,” she said. “Just because it’s difficult doesn’t mean we can’t do it.”