New York’s health insurance premiums have risen well above the national average, imposing a huge financial burden on New York residents. Unfortunately, the New York government recently approved another round of substantial premium rate hikes for almost all private health insurers operating in New York state.

Why are premiums so much more expensive than the national average? New York imposes taxes on your hospital bill, on your health insurance contract, on the premium you pay and on health insurance companies.

According to an independent analysis of the state budget, New Yorkers paid more than $6.5 billion in health-care taxes in 2024, making this the fourth-largest source of tax revenue behind state income taxes, sales taxes and business taxes.

New York also requires that every insurance policy include over 45 mandated coverages. Thus, for example, senior citizens are forced to buy coverage for birth control, infertility treatments, sex change operations, abortions and a host of other expensive coverages that they neither need nor want.

You might be surprised to learn that Medicaid is funded in part by both the state government and county property taxes. New York Medicaid now costs more than Texas and Florida combined. Over one-third of your county property tax bill could be used for Medicaid, and over 40% of the entire state budget is allocated to Medicaid costs each year.

But even the most compassionate New Yorkers should be frustrated by New York’s inefficient and bloated Medicaid program. Despite its huge cost, New York has one of the lowest Medicaid reimbursement rates in the nation, so all that money is not going to doctors, nurses and other caregivers.

According to a report from the Office of the New York State Comptroller in September 2025, New York spent an estimated $1.2 BILLION for Medicaid coverage for people who did not even reside in New York state. The level of fraud and abuse is truly shocking.

More than half of New Yorkers experienced at least one health-care affordability burden in a single year, whether that meant avoiding care, skipping medication or struggling to pay medical bills. Even worse, nearly three out of four New Yorkers worry they won’t be able to afford health care in the future. We need a different approach.

First, New York should repeal health-care taxes, which no longer serve their intended purpose and drive up the costs of health-care premiums.

Second, we must repeal insurance regulations and mandates that drive up insurance costs while preventing insurance competition (and lower premiums). We need to restore competition and patient choice. That means protecting access to local providers, reducing barriers for health-care professionals to practice here and letting patients choose care based on quality and price, not bureaucratic rules.

Third, we should change the law in New York to require that only U.S. citizens receive New York tax dollars for health care; we should also permit local district attorneys to investigate and prosecute Medicaid fraud and abuse.

Fourth, we need to invest in primary care. Too many people use the hospital system as a substitute for primary care, further driving up costs.

Health-care policy can be, and should be, compassionate, but it should also be affordable, accessible and straightforward; a health-care system that works for patients, respects taxpayers and makes it easier, not harder, for New Yorkers to get the care they need.

Assemblyman Andrew Molitor represents the 150th Assembly District, encompassing all of Chautauqua County.