Legislature Must Reject Budget Proposals that Will Harm Patient Access to Needed Care
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Colleagues:
I delivered testimony this week to a joint Senate-Assembly hearing panel examining the Healthcare and Medicaid proposals in the 2026-27 Executive Budget. While my testimony highlighted some positive initiatives such as prior authorization reform and continuing fair telehealth payment, I also warned the State Legislature about the patient access to care consequences arising from the potential huge new cost imposition and steep drops in insurer payment that would be caused by various unfair Budget proposals singling out our state’s dedicated physicians.
Following is a transcript of my testimony:
I am Dr. David Jakubowicz, Director of Otolaryngology and Allergy at Essen Medical in the Bronx, Assistant Professor at Albert Einstein College of Medicine, and President of the Medical Society of the State of New York, representing more than 20,000 physicians, residents, and medical students across our state. Thank you for the opportunity to testify.
There are positive elements in this Budget. We appreciate the continuation of telehealth payment parity and the initial step toward limiting prior authorization to an annual process for certain chronic conditions. These are meaningful reforms.
However, the Budget also imposes significant new financial burdens on physicians while allowing further reductions in insurer payments. At a time when community-based practices are already disappearing, these proposals will accelerate consolidation, reduce services, and lengthen wait times for your constituents.
New York is already one of the most difficult states in which to practice medicine, largely due to extraordinary liability costs. In 2024, medical liability payouts in New York exceeded those of Florida and California combined — despite our state having only one-third of their combined population. Policies that further increase financial pressure will drive physicians to consider practicing elsewhere, worsening our access crisis.
We strongly urge you to reject the proposed $40 million assessment on the 16,000 physicians who receive Excess Liability coverage, which would require them to absorb half of that cost. This four- to five-figure annual charge per physician dismantles a decade-old compromise designed to partially offset New York’s uniquely high liability burden.
We also urge you to preserve access to high-quality on-call specialty care in emergency departments by maintaining New York’s Independent Dispute Resolution (IDR) process. Eliminating the ability to appeal Medicaid Managed Care disputes to IDR would once again tilt the system in favor of insurers at the expense of patients and physicians. Congress has recently scrutinized insurer practices nationwide. We ask the Assembly to do the same and reject this proposal.
Additionally, we ask you to again reject proposals allowing physician assistants to practice without defined physician supervision after 8,000 hours. In February 2024, we worked collaboratively to expand PA responsibilities in a thoughtful, patient-centered manner. We firmly believe that physician-led, team-based care — with PAs playing a vital and respected role — provides the safest and highest quality care.
Finally, please preserve the vetting role of county medical societies in recommending physicians for Workers’ Compensation participation. The challenge within Workers’ Comp is not the application process; it is inadequate reimbursement combined with extensive administrative burdens and delayed or denied payments that can stretch months or even years after complex care is delivered.
If enacted as proposed, this Budget will further destabilize New York’s physician workforce and undermine patient access to care. We respectfully urge you to reconsider these provisions.
Click here to watch the video of my testimony on YouTube.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
