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2 Democratic states, NYC unveil plans to reshape their healthcare systems

As the future of the Affordable Care Act remains uncertain, two Democratic states and New York City have unveiled healthcare plans to reshape their individual healthcare markets and delivery systems.

Washington state and New York City both released plans Jan. 8 that would create public option programs and extend healthcare coverage to uninsured residents, while California's new governor released an executive order Jan. 7 that establishes a single-purchaser system for prescription drugs.

New York City Mayor Bill de Blasio announced the city's new public option plan, called NYC Care, Jan. 8 on MSNBC's "Morning Joe."

"We recognized that obviously healthcare is not just in theory a right, we have to make it in practice a right and we're doing something about that here in this city," de Blasio said on the political talk show.

De Blasio's plan is estimated to cost $100 million and will provide coverage for primary and specialty care to the 600,000 uninsured New Yorkers, according to the Democratic mayor. Under the plan, undocumented residents will be eligible for coverage, a point that was continually highlighted by de Blasio during both his TV appearance and a press conference later in the day.

NYC Care will be rolled out geographically across the city's five boroughs, according to a Jan. 8 statement. The Bronx will be the first borough covered by the new plan, and by 2021 NYC Care will be available to all New Yorkers.

Shortly after de Blasio made his announcement, Washington Gov. Jay Inslee unveiled a public option plan of his own. The Democratic governor announced plans to introduce legislation to create a public healthcare option in the state through Washington's Health Benefit Exchange.

State Sen. David Frockt and state Rep. Eileen Cody — both Democrats — plan to introduce the legislation during the upcoming legislative session, which begins Jan. 14, according to the governor's statement.

Both announcements came the day after California Gov. Gavin Newsom signed an executive order that would create a single-purchaser program for prescription drugs. The executive order, signed on the Democratic governor's first day in office, gives the state's Department of Health Care Services, or DHCS, the authority to negotiate drug prices for all 13 million beneficiaries covered under the state's Medicaid program, called Medi-Cal.

Currently, the DHCS has the authority to conduct negotiations for only 2 million Medi-Cal beneficiaries, according to the governor's office.

The executive order was part of a package of healthcare proposals and a second executive order the new governor signed. Included in the package was Newsom's first budget proposal, which contains a provision that would extend Medi-Cal coverage to undocumented young adults between the ages of 19 and 26. According to the Jan. 7 statement, California is the first state to propose this type of Medicaid policy.