ICYMI: We spoke last night on CapTon to Sen. Gustavo Rivera, the Bronx Democrat who is currently the ranking minority member of the Health Committee and also the co-sponsor, along with Assembly Health Committee Chair Dick Gottfried, of the New York Health Act, which would establish a universal, single-payer health care system in New York – something no other state (or the nation, for that matter) has managed to do.

Single payer was a very big issue in the 2018 election cycle. Everyone from the governor on down was asked for their position on this issue, and a number of incoming members of the Democratic Senate majority made universal care a central issue in their respective campaigns.

The trouble is, as erstwhile Democratic gubernatorial primary candidate Cynthia Nixon found out, this is a very expensive proposition, and no one has figured out how to pay for it yet – except to say that eventually, the money currently being spent on things like premiums and out-of-pocket costs would be shifted to pay for a single payer system.

Incoming Senate Majority Leader Andrea Stewart-Cousins, who, along with all her fellow Democrats, co-sponsored the New York Health Act, has insisted that she doesn’t support the idea of higher taxes in the state and is sensitive to the needs of upstate and suburban areas where that’s of particular concern. She has not yet committed, as leader, to a timeline for when a single payer bill gets to the floor for a vote.

Whenever that does happen, we know one thing for certain: The legislation will not be identical to the one passed for several years running by the Democrat-controlled Assembly.

Rivera told us last night that he and Gottfried will soon be introducing a new version of the New York Health Act, that will include “changes” based on conversations that the two lawmakers are having with “stakeholders,” who were previously reluctant to engage on this issue because they knew the Repiublican-controlled Senate would never take it up.

Rivera would not provide any details of what the new legislation would look like, saying only:

“This is the bottom line…We know this is a fundamental change in the way that we would deliver care in the state of New York, and we want to make sure that if we do it we do it right…We know that this is an incredibly complicated piece of legislation because we are changing a fundamental way of how we deliver care, and it would be a model not only for the state but for the entire country. We have a lot of work left to do to make sure we get it right.”

When asked whether the new legislation would address the key issue of how to pay for a complete state takeover of healthcare, Rivera pointed out that a number of studies have determined that doing so is indeed feasible and may actually save money in the long term. Of course, these are completely hypothetical, since no other state has managed to accomplish this feat before.

He also pointed out that even if the bill were to pass in its current form today, it would still take several years for regulations to be promulgated in order for it to be implemented, which gives lawmakers time to wrestle with the how-to-pay-for-it problem.

I noted that perhaps the biggest hurdle to all this is Gov. Andrew Cuomo, who has repeatedly expressed skepticism that a single payer system would ever be established in New York, though he supports the idea, conceptually speaking.

Rivera acknowledged that many people are skeptical, but that hasn’t changed his fundamental belief that the current system is broken and needs to be changed. And, so far, he noted, no one else has come up with any potential solutions other than the one he and Gottfried are advocating.

“We start with the moral question, which is whether we believe that if somebody is sick, regardless of whether they’re wealthy or not, they should be healthy,” Rivera said.

“We believe that this is the case. So, we have to design a system that actually achieves this. And we’re going to do it, which again, is going to change based on the conversations that we have had with stakeholders, who have already pointed out, as you’re going to see in the version of the bill that comes in January, some things in the bill that need to be thought about a little bit more.”

“But the bottom line is we believe the system is broken,” he continued.

“We want to move forward with a system that actually provides care for everyone, and is fiscally responsible. Even though I might be some downstate lefty, I want you to understand that we want to make sure that we do not bankrupt the state. We do not want to do that. What we want to do is to provide care for everyone while providing a fiscally conservative system, which is what this would do.”

For the record, Rivera is not yet the Health Committee chair, since Stewart-Cousins hasn’t made any committee assignments yet. There was a brief dust-up earlier this month over a Facebook post in which Rivera used an expletive to brag about how he’s going to be a chairman.

He admitted he had used inappropriate language one his private Facebook page, which one of his Republican colleagues – he said – then ran with. But Rivera was also unapologetic about the incident, explaining that he was merely excited about the prospect of being in the majority.