Spitzer announced in January that his administration would develop a plan for affordable health insurance for everyone. The hearings, which are being conducted by the state Insurance and Health departments, will be held between September and December. At the same time, the state is seeking a consultant to analyze proposals.

A panel of experts will help the insurance and health commissioners, who are required to submit recommendations to the governor by May 31.

"We must ensure that we spend our health-care dollars efficiently and effectively so that every New Yorker can afford health insurance and access the quality of care they need to live longer and healthier lives," Dr. Richard Daines, health commissioner, said in a statement.

But the key question will be how New York pays for it.

"Really the trick is going to be, as we all understand, is how we finance it," said William Van Slyke, a spokesman for the Healthcare Association of New York State, which supports the concept of universal coverage.

"Everybody that's got a hand in this has got to be part of the solution," said Van Slyke, whose organization represents hospitals and health systems.

According to census data from 2006, 16.5 million New Yorkers have health-insurance coverage and 9.3 million of them are in employer-sponsored plans. More than 7.2 million people are in government health-care programs. About 400,000 people purchase insurance privately.

The New York Health Plan Association, which represent managed health plans, says the state should reform requirements for products in the individual and small-group health insurance markets to make them more flexible and look at the heavy use of taxes and surcharges to finance the system, spokeswoman Leslie Moran said.

Assembly Health Committee Chairman Richard Gottfried, D-Manhattan, said he would like "publicly sponsored, publicly funded coverage for every New Yorker." For 15 years, he has sponsored legislation in the Assembly to do that but it hasn't gone anywhere.

"I don't know, certainly, where the Spitzer administration will ultimately come out, but they go into this topic with more genuine interest in that kind of option than perhaps any governor in the country," he said.

Health care should be funded through the tax system and should not be a "market commodity," Gottfried said.

Senate Insurance Committee Chairman James Seward, R-Milford, Otsego County, has a different opinion, spokesman Duncan Davie said.

"Sen. Seward believes that we should utilize as much as possible the market that exists out there to make health insurance more affordable, as opposed to raising taxes" to fund programs and services that could duplicate what is already available, Davie said.

Seward sponsored legislation this year that would provide tax credits for small businesses and individuals who need health care and would make it easier for people to purchase high-deductible health-insurance plans coupled with health-savings accounts. Neither bill passed both houses.

United Hospital Fund President James Tallon, one of the experts, said capturing the 2.5 million uninsured people is urgent for the health-care system, and few issues are more important in economic development than health-care costs. The fund is a health-care research and policy group.

"Uninsured people are a huge structural flaw in the health-care system because they generate costs without a source of paying for them," he said.

Tallon's group, in conjunction with the Commonwealth Fund, released a report in December that outlined a long-term "blueprint" for universal health-insurance coverage in New York. The report said it would cost about $4.1 billion to expand coverage to almost all of the uninsured. Individuals, businesses, the state and the federal government would share costs. A mandate for individuals to obtain coverage would be necessary, they concluded. The Commonwealth Fund is a foundation that focuses on health care.

This year, the state expanded eligibility under Child Health Plus, made Medicaid enrollment simpler and agreed to allow employers to buy into Family Health Plus, all good first steps, Tallon said.

Massachusetts passed a law last year designed to bring about near-universal coverage. Everyone who can afford it is required to purchase health insurance.

Businesses that don't provide insurance to employees have to help pay for it, and the government provides subsidies to ensure affordability.

Other experts on the panel are Mark Scherzer, legislative counsel for New Yorkers for Accessible Health Coverage, which represents people with serious health needs; Stan Lundine, former lieutenant governor under ex-Gov. Mario Cuomo, a Democrat; and attorney Elizabeth Moore, a partner with Nixon Peabody and former counsel for Cuomo. The Web site for development of the plan is www.partnership4coverage.ny.gov.

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By CARA MATTHEWS
ALBANY BUREAU

Copyright © 2007 The Journal News