A Magazine about the Hudson Valley’s local economy, published by Hudson Valley Current.

NEW YORK STATE OF HEALTH

By Anne Pyburn Craig

The first half of 2019 has been a busy time up at Empire State Plaza in Albany, where the New York State Legislature meets to do the people’s business. More bills were passed in the 2019 legislative session than have successfully been passed since 2006, and a great many of them were progressive legislation.

Those who’ve grown up in Albany’s shadow can be forgiven a bit of puzzlement. For decades, Albany’s claim to fame has been its exceptional dysfunction. Late budgets. Decisions made by the infamous “three men in a room” whose behavior didn’t seem to change even when their names changed. High profile corruption cases.

What changed? On Election Day 2018, Democrats retained their supermajority in the Assembly, gained eight seats in the state Senate (considered the last Republican stronghold in state-level politics and controlled by them for 71 of the last 74 years) and swept all statewide races. 

Some of the groundwork was laid in the primary season. Since 2011, a group called the Independent Democratic Congress had been siding with the Republicans in return for heaping helpings of pork and perks.

Voters grew tired of this, and insurgent campaigns arose to challenge the eight IDC members. Six of them were defeated at the primary level, despite the fact that the IDC (perhaps seeing that the writing on the wall was in blue ink) disbanded in spring 2018, vowing to re-align themselves with the Democrats. In return, Democratic leadership agreed to support the former IDC senators against primary challenges. This turned out to be too little, too late, and all but two were eliminated.

When the dust settled from the general election, Democrats had a 40-23 majority in the upper chamber and a 106-44 majority in the Assembly, along with a firm hold on the state’s executive branch. Legislative priorities that had been unachievable for years were suddenly within reach.

The results are striking. “Albany, of all places, has provided a glimpse of what can happen when politicians believe that they owe the voters rather than the donors,” opined the New York Times Editorial Board at session’s end. “In November, Democrats won full control of the State Legislature by making some big promises. They’ve largely kept those promises, a heartening demonstration of public service that makes for a sharp contrast with Congress.”

All together the legislature passed over 300 bills, most of them reflecting progressive priorities; Governor Cuomo has signed 47 of these into law. Action was taken to shore up rent control, the state’s Minority and Women-Owned Business Enterprise Program was strengthened, farm workers must now be paid overtime past 60 hours a week, and cash bail can no longer be required of people who stand accused of misdemeanors and low-level nonviolent felonies.

Some bills stalled. Banks are still allowed to finance private prisons, solitary confinement in prisons will be allowed for up to 30 days, not 15; voter registration is still not automatic. The last example perhaps demonstrates how tenuous the process can be. The automatic voter registration bill was hung up because of a typo.

None of the bills that failed to pass were voted down, meaning that they will likely be reintroduced next session. They simply didn’t make it all the way through the process. To become law a bill must be proposed in the Senate, reviewed in committee, passed on the Senate floor, passed in the Assembly, and then signed by the governor.

Here’s a look at some outcomes that will impact the well-being of Hudson Valley residents in important ways:

RELIGIOUS EXEMPTION ELIMINATED FOR VACCINATIONS

With New York starring in a series of stories as the epicenter of the largest outbreak of measles in the United States since 1992, legislators rapidly opted to become one of five US states that no longer recognizes the religious or personal belief exemptions from mandatory vaccinations (along with West Virginia, Maine, California, and Mississippi).

This one has people—quite a few of whom embrace many of the legislature’s other newborn laws—talking about leaving New York. Some legislators cited the fact that no prohibition on vaccination is to be found in the foundational doctrine of any mainstream religion, hardly surprising given that those doctrines were written long before the advent of vaccines.

Vaccine-hesitant families cite spiritual beliefs that range from “God created my child with a perfect immune system” to “Putting my kids at risk in any way is against my religion.” Outrage is running high, and a vocal group that had been in Albany arguing against the bill exploded into cries of “Shame” when the vote was tallied. 

The issue is especially tender in the Hudson Valley, where many Waldorf School parents and like-minded souls believe that mandatory vaccination is an infringement on their freedom of choice, and our State Senator Jen Metzger stands to take considerable heat for her Yes vote. “We have read volumes of research,” writes an Ulster County parent whose name we’ll withhold due to the divisiveness of the issue, “studied numerous cases, and decided that the risks associated with vaccination side-effects that could potentially damage the health of our children forever are too great to ignore. In fact, we would have vaccinated against the most serious and communicable illnesses if we were given the choice. But we are not given the choice because we are forced to claim a religious exemption that precludes receiving any vaccinations at all in order to protect our children from the onslaught of the full, mandated regimen.”

A big issue for those who question the vaccine mandates is the fact that in the 1980s, the federal government—faced with a vaccine shortage—took on the liability burden that had previously rested on manufacturers and established a compensation fund for the vaccine-injured, paying out to those whose post-vaccination issues have no other clear-cut cause, and that unlike other medications, vaccines are not subjected to double-blind clinical trials with placebos (something the mainstream medical community says is impossible due to serious ethical considerations involved in leaving people unsure if they’ve been vaccinated or not). 

Vaccination advocates counter with the scientific consensus on herd immunity, the drop in infection rates that kicks in when 93 to 95 percent of individuals are vaccinated, and reference the elimination of killers like polio and diphtheria that has followed the implementation of vaccination programs.

With the new law in place, parents are required to get their children at least the first dose of each of the mandatory vaccines before they can be admitted to school, camp, or child care, and parents who hesitate to vaccinate in the first place are saying that’s way too much, way too fast.

One thing is certain: The public conversation has become extremely polarized, with more nuanced views such as those expressed by the parent quoted above going completely unheard in the din and no room for discussions about modified vaccine schedules—or any legitimate reasons a parent might have to distrust Big Pharma. Meanwhile, inspired most probably by a mix of profit potential and passion for public health, scientists are working on vaccines for seven more diseases: HIV, malaria, tuberculosis, Respiratory Syncytial Virus (RSV), Enterotoxigenic E. Coli (ETEC), Shigella, and Norovirus. It’s unclear which, if any, might eventually be added to the mandatory list.

LYME DISEASE RESEARCH FUNDED

A total of $250,000 will be devoted to efforts to find solutions and mitigation for this tick-borne and exceptionally nasty illness. According to the CDC, Lyme disease is the fastest growing vector-borne infectious disease in the United States, with the New York State Department of Health (NYS DOH) reporting that over 20,000 New Yorkers have Lyme disease.

The resolution of the State Senate authorizes $100,000 for continued support of the The Tick Project, a five-year research program of the Cary Institute of Ecosystem Studies, to determine whether neighborhood-based prevention can reduce human cases of Lyme and other tick-borne diseases. In addition to the $100,000 awarded to the Cary Institute, grants of $50,000 were awarded to the University at Stony Brook, for research; Cornell Cooperative Extension, for education and outreach; and Columbia Medical Center’s Lyme and Tick Borne Disease Research Center. The funds were secured as part of a budget appropriation targeted to general public health programs that had been included in the state 2019-2020 budget. 

“This funding will help support institutions and organizations that are doing invaluable work advancing our understanding of Lyme and ways to prevent it, as well as educating the public, which is one of the best forms of prevention,” said Senator Metzger, who has had the disease five times. “This is a public health crisis and it needs to be treated like one.”   

YOU’D BETTER NOT BE SMOKING THAT FOR FUN

Despite the apparent best efforts of Governor Cuomo, New York lawmakers ended up holding off on making New York the newest state to legalize adult use of marijuana without a medical card. (Illinois just legalized, making it the 11th state to do so.)

The bill was originally introduced as part of the state budget in March, and was derailed over concerns about economic justice for communities of color. (It’s been pointed out that big corporations shouldn’t be making a living from the herb while individuals are still serving time for attempting to do the same.) An amendment was offered in May that would have dedicated more of the projected tax revenue to communities of color, but the bill still didn’t make it to the floor by session’s end.

During the time that the bill was in play, noted drug warrior Kevin Sabet of Smart Approaches to Marijuana was an extremely visible presence in Albany. SAM, many of whose members are in law enforcement or addiction treatment fields, took the somewhat novel approach of describing legalization as solely pushed by “Big Marijuana,” which they claim is equivalent to Big Tobacco in terms of greed and potential harm. Their “Smart Approach” would involve decriminalization paired with legislation that mandates counseling and treatment for those caught with the Devil’s Lettuce.

As of June 10, polling indicated that New Yorkers support legalization, 55-40. The conversation will no doubt continue when the legislature reconvenes next year, but legislators did pass a “backup bill” that decriminalizes possession of up to two ounces (with no mandatory treatment attached) and automatically expunges past misdemeanor convictions for possession. At this writing, Cuomo had yet to sign the decrim bill into law, but it seems likely to happen. 

UNIVERSAL COVERAGE: A WORK IN PROGRESS

Another bill that didn’t make it to the floor is the New York Health Act, which has been kicking around Albany in one form or another for around 20 years. The blue wave meant that the bill received more serious consideration than it ever has in the past, but legislators ended up agreeing that doing it right would mean taking some time for further study.

Prior to the changing of the Senate guard from Republican to Democrat, the proposal had been passed by the Assembly and failed in the Senate by just two votes. 

This year, says Metzger, “we had a terrific 10-hour public hearing, which was really the first of what will be a number of hearings. The sheer magnitude of what is involved—it’s an unprecedented effort that would affect every single New Yorker and a large segment of our economy—means it has to be done with as much input as possible. Even if the New York Health Act had passed, it would have just established a framework; it would still take several years to flesh out and implement, to develop the structure we’d need to actually make it a reality.”

By no means are progressive legislators giving up on the idea. “Independent studies from the Rand Corporation indicate that the savings on administrative costs will be huge when we do get there,” Metzger says. “We always assume that the private sector does things more efficiently, but in health care that’s not the case. A medical practice has to have an entire staff dedicated to just getting claims processed. Primary care physicians I’ve spoken to favor this; they’d love to be able to focus on delivering care and not on bureaucratic nightmares.”

As proposed, the New York Health Act would cover vision, dental, and prescription drugs alongside doctors and hospitals. “A federal system seems to be even more years away, and people can’t wait,” says Metzger. “They’re going broke, and they can’t get the care they need.”