1. Affordable Health Care

The evidence: 27 million Americans are uninsured; a number is projected to rise as federal rollbacks accelerate. Nearly 1 in 4 working-age adults are underinsured — with cost-sharing so high that 57% skip or delay necessary care (Commonwealth Fund, 2024). In NY-12, 29,300 residents depend on enhanced ACA tax credits; if those expire, premiums rise $80 a month. Every $1 invested in Medicaid generates an estimated $1.50-$2.00 in economic activity (Medicaid and CHIP Payment and Access Commission). CBO estimated in 2019 that a Medicare buy-in option at age 60 would cover approximately 4-5 million additional Americans. 

Protecting existing coverage is necessary but not sufficient. I will make permanent the enhanced ACA subsidies and defend Medicaid from block grants, per-capita caps, and work requirements. I will add dental, vision, and hearing to Medicare, expand the Medicare Savings Program by raising income thresholds and eliminating asset tests, and defend New York's Section 1115 Medicaid waiver, which authorizes $3 billion for housing, nutrition, and transportation as health interventions. These protections safeguard coverage millions of New Yorkers depend on today. The structural path to universal coverage is progressive Medicare expansion. I will introduce legislation to lower the eligibility age from 65 to 60 as a first step toward 55 and ultimately a system that covers everyone. Lowering to age 60 creates a coverage option for people who retire early or lose employer coverage — and removes older, higher-cost enrollees from the ACA risk pool, reducing premiums for younger families. Each step toward a lower eligibility age builds the political and fiscal case for further expansion. 

3. Primary Care For All

The evidence: Countries with stronger primary care systems have better health outcomes and lower costs (Starfield, Shi & Macinko; OECD). In the U.S., Community Health Center (CHC) patients have lower rates of preventable hospitalization and ER use than comparable patients without a primary care home. Federal funding per CHC patient has fallen from $138 to $107 since 2020 in real terms, and nearly half of all CHCs ran negative margins in 2023. The infrastructure exists and is proven — it is chronically underfunded. 

In NY-12, 30,000-37,000 residents are uninsured, Hispanic residents are nearly three times as likely to lack coverage as White residents, and routine appointments take 2-4 weeks. Nationally, 75 million Americans live in federally designated primary care shortage areas, a shortage associated with higher rates of preventable hospitalizations and avoidable ER use. I will introduce the Free Primary Care for All Act — to support existing CHCs so they can meet patient needs and to expand CHC sites, with strategic placement in underserved communities — including Ryan Health and Housing Works in our district. Specifically, I will legislate to: increase Section 330 grant funding indexed to inflation; raise Medicaid reimbursement rates so HCs can pay competitive salaries, the primary barrier to recruitment and retention; expand the National Health Service Corps and create a National Public Service Corps

combining salary support and loan forgiveness; fund 2,000 additional NP and PA training slots annually; and require states to grant full practice authority to NPs, PAs, and Certified Nurse-Midwives currently blocked by state law. I will also reverse the $8 billion in Medicaid DSH cuts that took effect October 1, 2025 — New York's safety net hospitals received $2.1 billion in DSH funding in FY2022 — with another $16 billion in cuts scheduled.