Several years ago, the COVID-19 pandemic laid bare the dire implications of inadequate public health investment. As legislators and medical students, we witnessed these implications intimately, having spent weeks working in our communities and overcrowded emergency rooms in New York City (NYC). Today, we face different but familiar epidemics, of chronic disease, vaccine-preventable illnesses, and worsening disparities in maternal mortality. Yet, for the past five years, our state public health law has prevented upwards of $90 million per year from flowing to New York City to support public health initiatives.
The health of New Yorkers is once again under threat from a federal administration hostile to public health and health equity. Our experience training in and working with New York City’s hospitals has made clear for us the life-threatening consequences of insufficient support for our city’s public health infrastructure to every day New Yorkers. We must leverage every possible state-level asset to ensure that our city’s public health system is well-resourced and resilient against drastic funding changes at the federal level so we can continue caring for our most vulnerable populations. The first step is passing A2705/S4801 in the New York State Legislature.
Prior to 2019, the reimbursement rate for core public health services under Article 6 such as vaccinations, reproductive health and newborn services, infectious disease testing, overdose prevention among others, was 36% for all municipalities in the State. In 2019, then-governor Cuomo reduced the reimbursement rate for this program for NYC from 36% to 20%. He justified it in part by claiming that New York City receives greater federal funding for public health measures than any other county in New York State. Since January 2025, however, federal funding is tenuous at best, threatening to undermine healthcare and public health infrastructure even further. A2705/S4801 restores NYC’s reimbursement rate for these core services to 36%, bringing it on par with the rest of the state’s municipalities.
As medical students and elected officials in key posts on public health in the legislature, we regularly see and experience the downstream impacts of preventive healthcare and public health investment. During her rotations at children’s hospitals, Kathryn has seen babies and young children admitted to the hospital who are critically-ill from vaccine-preventable illnesses, and engaged in conversations with many parents hesitant to vaccinate their children following widespread misinformation during the COVID-19 pandemic. Since 2019, the rate of young children fully vaccinated against measles, mumps, and rubella has fallen from 99% to 85%. Public health initiatives that promote vaccine education and access are critical to curbing outbreaks and preventable illness and death.
Public health initiatives are also an essential component of NYC’s response to the ongoing opioid crisis and overdose epidemic. Community-Based Organizations (CBOs) provide evidence-based harm reduction services, like syringe exchange or naloxone training and distribution, that are reimbursable as core public health services under Article 6. Syringe service programs are proven to reduce the spread of bloodborne illnesses like HIV. Naloxone reverses opioid overdoses and has saved countless lives. However, lost public health funding since 2019 has resulted in tens of thousands fewer syringes distributed and a 40% decrease in the number of naloxone kits provided to CBOs. Further, these services are typically not available in mainstream healthcare settings. Kathyrn and Madeline have cared for people who use drugs and people with substance use disorder during all of their clinical rotations, but Madeline has observed that they are better received and have greatest access to harm reduction services at places like the nonprofit where she volunteers. The state public health fund outlined in Article 6 represents a key source of financial support for organizations providing these lifesaving interventions our patients need and deserve.
While restoring New York City’s reimbursement rate under Article 6 would require the state to allocate additional funding in its budget, this investment is both an economic and moral imperative. Investments in public health tend to minimize unnecessary or preventable health expenditures in the long-term. They also protect the most vulnerable among us from reductions in critical health services.
We believe that health is a human right and that all New Yorkers deserve quality care. Our state is already plagued by structural challenges in funding its healthcare system, producing a landscape of segregated care where people of color, undocumented immigrants, and low income individuals receive care at different institutions than others, or can’t access care altogether. Our city is home to over 40% of the state’s population and nearly 60% of its Medicaid enrollees, but its core public health services are currently reimbursed at a fraction of the rate allocated to all other municipalities across the state. If we truly believe in health equity, we must act now to ensure NYC receives its fair share. Passing A2705/S4801 in the state legislature is the first step toward protecting the health of all New Yorkers.
Gustavo Rivera is State Senator for the 33rd Senate District and is Chair of the New York State Senate Committee on Health. Jessica González-Rojas is Assembly Member for the 34th Assembly District and a member of the Assembly Committee on Health. Madeline Villalba is a medical student, board member of CPHS and a health equity research fellow based in Manhattan. Kathryn McHenry is a medical student and health equity researcher based in Manhattan.
The post In 2019, Governor Cuomo slashed New York City’s share of a state public health fund. Now is the time for Albany to restore equitable public health funding to our city. appeared first on EMPIRE REPORT NEW YORK 2025® NEW YORK’S 24/7 NEWS SITE.
