April 22, 2026

The Honorable Kathleen C. Hochul 

Governor of New York State 

New York State Capitol Building 

Albany, NY 12224

The Honorable Andrea Stewart-Cousins

Majority Leader, New York State Senate

Legislative Office Building, Room 907

Albany, NY 12247

The Honorable Carl E. Heastie 

Speaker, New York State Assembly 

Legislative Office Building, Room 932 

Albany, NY 12248

Members of the New York State Assembly

Legislative Office Building

Albany, NY 12247

Support for the “Primary Care Investment Act” (S1634/A1915A)

Dear Governor Hochul, Majority Leader Stewart-Cousins, Speaker Heastie, and Members of the New York State Legislature,

We, the undersigned primary care providers from across New York State, urge the passage of the “Primary Care Investment Act” (S1634/A1915A). Every day, we see the consequences of a health care system that underinvests in primary care – patients unable to access timely care, worsening health outcomes, and rising costs across the system.

We are consistently overburdened with patients in need of care, and the reality is that there are not enough providers to meet that need. This causes long wait times for appointments, contributes to administrative burden, and causes burn out.

Patients are unable to get timely appointments with providers every day, causing them to forgo care for conditions that inevitably turn into emergencies.

Primary care is the foundation of a high-functioning, equitable health care system. It is the only part of the health system proven to improve life expectancy, reduce inequities at the population level, and reduce costs. Yet despite its central role, primary care remains chronically underfunded. In the United States, only 5–7% of total health care spending is directed toward primary care services, even though primary care accounts for approximately 35% of all health care visits annually. This imbalance has real and devastating consequences for patients and providers alike.

New York is facing a primary care crisis. More than 4.8 million New Yorkers live in federally designated primary care shortage areas, and 66% of residents report delaying care due to cost. These barriers disproportionately impact marginalized communities, deepening long-standing racial and economic inequities. Black and Latino New Yorkers experience significantly higher rates of preventable hospitalizations and premature death compared to their white counterparts – outcomes that are directly linked to inadequate access to primary care.

When patients cannot access timely, preventive care, they become sicker and are forced to seek treatment in hospitals and emergency departments, which are far more expensive and less effective for managing chronic conditions. An average emergency room visit costs approximately $1,200, compared to $300 for a primary care visit. That is a fourfold cost difference. These avoidable costs place a significant burden on our state’s health care system, which already exceeds $300 billion annually while delivering only average health outcomes.

The “Primary Care Investment Act” offers a clear, evidence-based solution. By requiring health plans to increase investment in primary care to at least 12.5% of total health care spending, this legislation will rebalance the system toward prevention, improve access, and reduce long-term costs.  

Research consistently shows that strengthening primary care leads to better outcomes and lower costs. Increasing the supply of primary care physicians by just one per 10,000 people is associated with 11% fewer hospital visits, 7% fewer surgeries, and 5.5% fewer emergency department visits. States that have made similar investments have seen measurable success. For example, Rhode Island’s regulatory reforms which included a targeted increase in primary care spending led to a 14% reduction in total medical spending over the first four years measured, and an increase in the primary care workforce.

Beyond cost savings, investing in primary care strengthens communities. Access to high-quality primary care is a key social determinant of health and plays a critical role in the educational and economic stability of families. It also supports a sustainable health care workforce by reducing burnout, improving retention, and attracting new providers to the field.

New Yorkers deserve a health care system that prioritizes prevention, equity, and value. The “Primary Care Investment Act” is a necessary step toward achieving that vision.

We respectfully urge you to pass S1634/A1915A, the “Primary Care Investment Act,” this session. 

Sincerely,

The undersigned health care providers from the state of New York:

Vera Antonios, MD New York, NY

Natalie Asbach, DMSc, PA-C, Jericho Road Community Health Center Buffalo, NY

Steve B Auerbach, MD, NYS American Academy of Pediatrics New York, NY

Damilola Babalola, Metro Community Health Centers, Staten Island Staten Island, NY

Marek Balutowski, MD, Institute for Family Health New Paltz, NY

Nora Barmawi, MD, Boriken Neighborhood Health Center New York, NY

Alexandra Bautista, LMSW, Boriken Neighborhood Health Center New York, NY

Elizabeth Beals, MD, MS, Weill Cornell Pediatrics, MSK Kids New York, NY

Karen A. Becker, MD, Montefiore, NYS Academy of Family Physicians Bronx, NY

Rachel Berman, MD, MPH, NYS American Academy of Pediatrics Bronx, NY

Winter Berry, DO, American Academy of Pediatrics Syracuse, NY

Wajihah Bhatti, NewYork-Presbyterian/Weill Cornell Medical Center New York, NY

Dr. Muhammad Bhutta, MD, Care for the Homeless Bronx, NY

Danny Birkhead, MD, NYS American Academy of Pediatrics New York, NY

Grace E Black, MD, University of Rochester Rochester, NY

Judlyne Brun-Alfaro, Care For the Homeless New York, NY

Kelsey Bryant, Mount Sinai New York, NY

Joan Budd, MD, FAAP, Retired, American Academy of Pediatrics Bronx, NY

Anthony Burdo, MD, Jericho Road Community Health Center Buffalo, NY

Neil S Calman MD, FAAFP, CEO Emeritus, Institute for Family Health New York, NY

Steven J.I. Chang, ANP, MSN, MPH, Harlem United New York, NY

Linda L. Clark, MD, MS, Clark Preventive Medicine Services Rochester, NY

Margaret Connor MD, University of Rochester, Golisano Pediatrics Rochester, NY

Isaac Dapkins, MD, CMO, DIO, The Family Health Centers at NYU Langone New York, NY

Ashley DeLuca, DO, Jericho Road Community Health Center Buffalo, NY

Pamela Diamantis, MD Bronx, NY

Julia Donahue, FNP, Montefiore Medical Group Bronx, NY

Susan Drucker, MD, Northwell Queens, NY

Lisa Eiland, MD, NYS American Academy of Pediatrics Chapter 3 New York, NY

Arielle Elmaleh-Sachs, MD, MS, Family Health Centers at NYU Langone Brooklyn, NY

Regina Estela, Independence Care System New York, NY

Guilaine Evariste, FNP, Boriken Neighborhood Health Center New York, NY

David Fagan, MD, FAAP, Cohen Children’s Medical Center-Northwell New Hyde Park, NY

Hannah S. Famiglietti, MD New York, NY

Alexandra Fayne-Frederick, MD, NYS American Academy of Pediatrics New York, NY

Kadian T Forbes, FNP, Care For the Homeless Bronx, NY

Katherine Fox, MS, FNP-BC, Jericho Road Community Health Center Buffalo, NY

Christel Francois, Care For the Homeless Bronx, NY

Sean Frey, MD, MPH, University of Rochester School of Medicine Rochester, NY

Suzanne Friedman MD, Columbia University New York, NY

Matthew Gannon, NYC Department of Health and Mental Hygiene Queens, NY

Eric G. Gayle, MD, FAAFP, President & CEO, The Institute for Family Health New York, NY

Caren Gellin, NYS American Academy of Pediatrics Rochester, NY

Margaret Glausser, MD, Institute for Family Health Bronx, NY

Myron Glick, MD, Jericho Road Community Health Center Buffalo, NY

Grayland Godfrey, MD, NYS American Academy of Pediatrics New York, NY

Steven J Goldstein, MD, FAAP, NYS American Academy of Pediatrics Queens, NY

Arnaldo Gonzalez-Aviles, MD, Care For the Homeless Bronx, NY

Peter Gordon, Columbia University New York, NY

Abigail Grainge, FNP-BC, PMHNP-BC, Jericho Road CHC Buffalo, NY

Haley Griffin, MD New York, NY

Jesse M. Hackell, MD, FAAP New York, NY

Jill Halterman, MD, University of Rochester Rochester, NY

Lisa Handwerker, MD New York, NY

Ada Hass, MD, Northwell Health Pediatrics Queens, NY

Carla Henke, MD, Jericho Road Community Health Center Buffalo, NY

Neil E Herendeen, MD, NYS American Academy of Pediatrics Rochester, NY

Dr. Tawana Hill, DO, Care For the Homeless New York, NY

Dr. Elizabeth Hohl, DO, University of Rochester Medical Center Rochester, NY

Kimberlee Hoyt-Folaron, SNAPCAP IPA, LLC Buffalo, NY

Sandra Jee, MD, MPH, FAAP, University of Rochester Rochester, NY

Lauren Jen, MD, FAAP, NYS American Academy of Pediatrics Bronx, NY

Kara Jordon, MD, FAAP, NYC Health & Hospitals/Bellevue Hospital New York, NY

Jeff Kaczorowski, MD, FAAP, NYS American Academy of Pediatrics Rochester, NY

Mitchell Katz, MD, President & CEO, NYC Health + Hospitals New York, NY

Hannah Keppler, MD Bronx, NY

Tariq M Khan, MD, FAAP, American Academy of Pediatrics Jamestown, NY

Saema Khandakar, MD, American Academy of Pediatrics, NYC H+H Brooklyn, NY

Betty Kolod, MD, MPH, Physicians for a National Health Program-NY Metro New York, NY

Connie Kostacos, MD New York, NY

Catherine Krafft, MD, MHPE, CLC Rochester, NY

Nathaniel Kratz, MD, FASAM, New York Presbyterian New York, NY

Allana Krolikowski, MD, CEO, Jericho Road Community Health Center Buffalo, NY

Ian Kronish, MD, MPH, Columbia University Irving Medical Center New York, NY

Marian Larkin, MD New York, NY

Lori Legano, MD, NYU Grossman School of Medicine New York, NY

Edward D Lewis, MD, FAAP, American Academy of Pediatrics Chapter 1 Rochester, NY

Katherine S. Lobach, MD, FAAP, Montefiore Einstein Bronx, NY

Andrea Maritato, MD, Institute for Family Health New York, NY

Stacey Martinez, MD Queens, NY

Marcia Mauger, MD, Samaritan Family Health System Watertown, NY

Sonya M. Maxwell, Metro Community Health Centers New York, NY

Samuel T. Merrick, MD, New York Presbyterian Hospital New York, NY

Mihaela Mihai, Chief Operations Officer, Apicha CHC New York, NY

Andrea Milne Wenderlich, MD, MS Rochester, NY

Christopher Monson, MD, NYS American Academy of Pediatrics Rochester, NY

Charles E. Moon III, MD, FAAP, Icahn School of Medicine at Mt Sinai New York, NY 

Juleisi F Moreno, LMSW, Boriken Neighborhood Health Center New York, NY

Alex Movshovich, CEO, Community Health Initiatives, Inc. Brooklyn, NY

Dr. Elizabeth Murray, NYS American Academy of Pediatrics Rochester, NY

Joyce Mwangi, Care For the Homeless Bronx, NY

Nikita Nagpal, MD, MS New York, NY

Maryam Naqvi, FNP-C, Harlem United New York, NY

Kelechi Ngwangwa, NYS American Academy of Pediatrics Brooklyn, NY

Emmanuel Kofi Jackson Nsiah, Care For the Homeless Bronx, NY

Henrietta Okpala, DNP, Care For Homeless Brooklyn, NY

Sean O'Malley, MD, Child Health Care Associates Practice of Pediatrics Syracuse, NY

Sheila L Palevsky, MD, MPH, FAAP, NYS American Academy of Pediatrics New York, NY

Neil A. Pasco MD, Union Health Center New York, NY

Sanjivan Patel, MD, FAAP, DABOM, American Academy of Pediatrics New York, NY

Parasram Persad, Care Found Here Clinic New York, NY

Susruth Pinnamaneni, DO, Institute for Family Health Hyde Park, NY

Caroline Rath, PA, MPH Erie County, NY

Dr. Kate Reil, DACM, LAc Brooklyn, NY

Philip A. Remillard, MD, Child Healthcare Associates Syracuse, NY

Susanne Rendeiro, FNP, Apicha Community Health Center New York, NY

Elizabeth Ring, NP, Institute for Family Health New York, NY

Catherine Rizzo, NP, Mount Sinai New York, NY

Stephen Rodgers, NP, Care For the Homeless Bronx, NY

Shannon Sanda, MD, Rochester General Pediatrics Associates Rochester, NY

T. Eric Schackow, MD, PhD, FAAFP, Ellis Medicine Schenectady, NY

Lisa Schaffer, FNP, Institute for Family Health New Paltz, NY

Gail Schonfeld, MD, FAAP, East End Pediatrics, PC East Hampton, NY

Warren M Seigel, MD, MBA, FAAP, FSAHM, NYC Health + Hospitals Brooklyn, NY

Dr. Shetal Shah, MD, FAAP, NYS American Academy of Pediatrics Valhalla, NY

Laura Jean Shipey, MD, FAAP, Accountable Health Partners Rochester, NY

Dabir Siddiqi, MD, NYU Grossman School of Medicine Manhattan, NY

Sara Siddiqui, MD, FAAP, American Academy of Pediatrics Huntington, NY

Dr. Shadman Sinha, MD, American Academy of Pediatrics Huntington Station, NY

Raymund Sison, MD, Apicha Community Health Center New York, NY

Martha Smith, MD, Pediatric Care Center, Institute for Family Health Kingston, NY

Victor Sta. Ana, MD, Institute for Family Health New York, NY

Rachael Stacom, ANP-BC, RN, MSCN, Independence Care System Bronx, NY

Tanya Stolper, MD, Boriken Neighborhood Health Center New York, NY

James Stoltzfus, MD, MPH, Jericho Road Community Health Center Buffalo, NY

Wayne S Strouse, MD, FAAFP, NYS Academy of Family Physicians Seneca Falls, NY

Monica Suarez, East Harlem Council for Human Services, Inc. New York, NY

Alicia A Supernault-Sarker, MD, MPH, FAAP, Jericho Road CHC Buffalo, NY

Kathryn Tanner, FNP, Montefiore Medical Group Bronx, NY

Carol Tegas, Finger Lakes Health Systems Agency Rochester, NY

Michael D. Terranova, MD, FAAP, NYS American Academy of Pediatrics Bowmansville, NY

Emely Torres, Institute for Family Health New York, NY

Maria Trusa CEO, Formé Medical Center and Urgent Care White Plains, NY

Kathleen Van De Loo, Medical Society of the County of Erie Buffalo, NY

Athina Vassilakis, Rangel Community Health Center New York, NY

Dr. Paul Violanti, Jericho Road Community Health Center Buffalo, NY

Eva Waite, Mount Sinai Medical Center New York, NY

Semone Walker, Westchester Community Health Center White Plains, NY

Kathleen Wania, American Academy of Pediatrics, Greece Pediatric Medicine Rochester, NY

Abigail B. Wiredu, FNP-BC, Care For the Homeless Bronx, NY

Michael Yin, Columbia University New York, NY

Katarzyna Zabrocka, American Academy of Physicians Bronx, NY