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Brigid Bergin: It's The Brian Lehrer Show on WNYC. I'm Brigid Bergin, Senior Reporter in the WNYC and Gothamist newsroom, filling in for Brian Lehrer today. Yesterday, Brian talked to my colleague, WNYC, and Gothamist reporter Jon Campbell, about the new legislative session just getting underway in Albany. Today, we're going to dig into what we know about the governor's agenda so far this year.

Her big State of the State address is coming up Tuesday, where she'll lay out more of her priorities, and she's been giving daily previews of a few items, including consumer protections, how reading is taught in schools, and maternal health. Joining me now to tell us more about those items, and what else to watch for next week, I'm joined by Grace Ashford, New York Times reporter, covering New York State politics and government. Grace, welcome to WNYC.

Grace Ashford: Hey, Bridget, thanks so much for having me.

Brigid Bergin: Listeners, are you familiar with Governor Hochul's proposals on maternal health, teaching, reading, or the consumer protections that include limiting insulin copays, and protection for medical debt? Do you have a question for our guest, Grace Ashford of The New York Times? You can call or text us at 212-433-WNYC. That's 212-433-9692.

Grace, let's start with the governor's announcement yesterday, and work backwards. She's proposing new legislation to address what she's calling a crisis in maternal health. This is how she introduced her plan.

Governor Hochul: Our infant mortality rates, not going down, but actually went up, and that is so shocking. Mothers and babies are dying unnecessarily across the nation, and right here in New York. This can only be called a crisis, and as the first mom governor, this is personal. I've been there.

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I'm committed to taking action to fix it.

Brigid Bergin: Grace, can you talk about the health risks she's addressing there, which are especially stark for Black women?

Grace Ashford: Yes, absolutely. What we just heard there was, yes, the governor acknowledging that this is a problem in New York, but also nationwide, that rising rate of infant mortality is something the CDC noted in one of its most recent reports. What the governor really said was that, in a nation like the United States, where we consider ourselves to be advanced and innovative, that this is just not acceptable, and that it demands a response from every level of government. She was very clear.

Here in New York, she's laying out a six-point plan to combat that, and as you noted, the risks-- In New York, we don't have the highest rate of maternal mortality in the nation, but we do have examples all the time, where women and their children are dying in preventable ways, and those risks are especially high for women of color. The governor has laid out, as I said, a six-point plan.

The key piece of this is that, she is introducing what would be a first in the nation for a state, a proposal that would allow for 40 hours of prenatal leave, so that women can go visit the doctor as they need to many, many, many times over the course of a pregnancy without needing to take time off work, or use other leave, or without having their job, potentially, be at risk.

Brigid Bergin: Wow. Did I hear you say that New York would be the first state to do this, to offer this paid leave for prenatal healthcare?

Grace Ashford: That's true. Yes. This does not exist at a state level. Washington, D.C. has aversion in D.C., but this does not exist in any other state yet, and like all the other proposals that we're going to be talking about, this is something that the governor is putting some effort behind, but will require the support of the legislature. Both the Assembly and the Senate would need to get on board, in order to make this a reality.

Brigid Bergin: Would this actually work? If this is enacted, how would people use this potential new benefit?

Grace Ashford: She's laid it out as an expansion to the existing paid family leave that is available to New York State. That is something that women can use after pregnancy, or pardon me, after birth, and it also can be used in other ways as well. Currently, in order to use that, you have to wait seven days to actually get those benefits, which, if you're trying to go to the doctor right away, that obviously doesn't work.

Also, because it's a limited amount. Any time you take before the baby's born, is time you can't take after the baby's born, which also is an incredibly important time. This would be a separate bucket of time, 40 hours for use throughout the pregnancy that would be available to women. The real reason that the governor said that this was important is that, she said the data shows that access to healthcare is one of the most important factors, in terms of making sure that both mothers and babies are healthy, and make it through birth, and onward successfully.

Brigid Bergin: She's also proposing to encourage the use of doulas. That's something that's come up from the mayor as well. How would that work? What would that entail?

Grace Ashford: This actually builds on some legislation that came out of last session, where the governor made it available for women on Medicaid to have Medicaid pay for doula care, and also, to create this statewide directory of doulas, so that women can find doulas, if they [unintelligible 00:05:58] don't know where they are in their area. For those who don't know, doulas work with pregnant women and their partners to help ensure that their voices are met with inside the medical system, and in the hospitals, and wherever they choose to give birth.

The use of doulas has been correlated with much healthier births, and the reduced use of C-section, which we're going to be talking about later. Basically, I think the governor sees this as another way that we can support women through pregnancy and birth, and also make sure that their health outcomes are positive. The change in this proposal is that, she's going to remove an additional barrier to the use of doulas, which is, that she is going to make sure that women don't actually need to get a referral to use doulas. She would direct the health department to issue a standing order that would allow women to access doula care without that additional referral.

Brigid Bergin: Wow. Then, she also wants to eliminate the copays for pregnancy doctor's visits. Is that an expense that falls on the state, or on insurance companies?

Grace Ashford: We don't have a ton of information about how this would work. She said it wouldn't necessarily be across the board, it's for a couple of specifically qualified health plans, but, yes, I think you can consider it under the broader rubric of the governor to trying to reduce barriers to accessing healthcare for pregnant women.

Brigid Bergin: Right. You mentioned this, but she wants to reduce the number of unnecessary cesarean sections. How would she do that?

Grace Ashford: This is really interesting. She laid out some statistics in her press conference that recommended number of people who need cesarean sections, which obviously, can be a lifesaving intervention, but it's usually around 15%, roughly. In some instances, you'll see far, far, far more cesarean sections being done up to 30%. What she's seeing is that this is, perhaps, even medically unnecessary. There's a lot of reasons why cesarean sections might be used in places when they're not strictly needed.

The one that she specifically noted is that, they can be more expensive, and so doctors and hospital systems get paid more for that. What she's trying to do is, lay out a way to encourage doctors and hospitals not to perform cesarean sections when they are unnecessary. That includes both a monitoring component that would try to identify places where there are, perhaps, rare doctors who are abusing this, but also, she wants to change the financial incentives, so that it's not quite so attractive. There's not quite such a disparity between those two types of things.

Brigid Bergin: Sure. It feels like there's really a lot in this proposal. Is there anything else, anything that we've missed?

Grace Ashford: I think that those are really the broad strokes, and I think what is really interesting about this is, just how personal the governor has made it, as you played in your initial clip. I think she's making it really clear that this is a personal issue for her, as the first female governor, as the first mom governor, the first grandmother governor. That this is not something that she feels like-- Even if New York is not the worst state in the country, that this is something that she has no tolerance for, and wants to crack down on.

Brigid Bergin: Listeners, we want you to join this conversation. Do you have questions about Governor Hochul's proposals on maternal health teaching, reading, or consumer protections that include eliminating insulin copays, and protection from medical debt, or do you have a question for our guest, Grace Ashford of The New York Times? You can call or text us at 212-433-WNYC. That's 212-433-9692, and I'm speaking with Grace Ashford of The New York Times, who covers New York state politics and government.

Grace, on Wednesday, the governor focused on education and proposed overhauling how reading is taught across the state, calling it back to basics. What kind of change is she looking for there?

Grace Ashford: This is a really, really important change. Over the past few years, there's been an outcry driven by some really great reporting, and increasing evidence about the science of the way that children learn how to read, like, really, what is physiologically going on in their brains. For a long time, there were reading methods that were based on this notion that a lot of people learn to read.

They'll probably remember phonics. About 20 years ago, the governor sort of said that, there was this move to embrace a different approach that was focused on instilling a love of reading, and focused less on some of those hard skills. Unfortunately, the evidence that's come out since then suggests that, this doesn't work for all kids. While some kids are able to pick things up in a more holistic way, other kids need pretty direct instruction on how to decode words, what's called phonemic awareness, and literally just sounding things out.

A lot of states, especially, in light of the pandemic, and the way that it affected children's education, have passed laws pushing for public schools to teach this kind of foundational skills based-- What they call the science of reading. New York had thus far not really acted on the state level. However, last year, New York City moved to change the way that it was teaching reading, and focus more on these skills, but New York state had done nothing, even as all these other states had passed legislation.

What we saw this week was the governor stood up and said, "Enough is enough. This is not something that we're going to tolerate anymore." She's introducing legislation, or asking the legislators to support a move that would require schools to attest that they are going to be embracing these science of reading curriculum by September of 2025.

Brigid Bergin: Have you heard much reaction to the proposal so far? Have teachers responded, or parents?

Grace Ashford: Yes. Thus far, it's been, I would say, generally well received. I think at any time when there's a loss of control of what is being taught in classrooms, I think that can be difficult for teachers because, obviously, they're often very passionate about their professions as well, and they care very deeply about ensuring the success of their students. By and large, I think the science has come down in a clearer way, even just recently, and this has been mostly supported, I would say.

Brigid Bergin: Grace, I want to read a couple of the texts that we're getting in, and get your reaction to it. First, the listener writes, "I have type 1 insulin-dependent diabetes. What happened with eliminating copays for insulin?" Can you help us answer that listener's question?

Grace Ashford: Yes. The governor has proposed this was something she proposed on Tuesday as part of her general consumer protection package. Yes, she would love to help listeners, just like the one who just wrote in. We don't have a lot more details on how exactly that proposal would work, and like the rest of the proposals, they will require the support of the rest of the legislature, so I would say, pay attention. There's a lot of people that this affects, and I think it's going to be an area to watch in the coming session.

Brigid Bergin: Another listener has a question about Hochul's plan for infant mortality. How does it address those who do not work, and don't have insurance? Are they included in part of her plan?

Grace Ashford: I would have to take a look at that. I don't have all the details on that right now, but I would say that, broadly, there are a lot of different elements to that plan that are focused on wherever you access the medical system, if you are able to do so. Obviously, a lot of people, if they don't have insurance, are going to struggle to access the medical system in general. I'll have to take a closer look at that. Yes.

Brigid Bergin: Sure. Let's talk a bit about how she said she would address the problem of medical debt. What was her plan for that particular issue?

Grace Ashford: This is an area that the governor has been pretty focused on, and also was very invested in, in the last session. She passed a law, or she rather, she signed into law a piece of legislation that helped keep medical debt off of people's credit reports. Obviously, this is an issue that affects a ton of people, and the argument that she made is that, this is not always people's fault.

It's not your fault if you get sick, and that shouldn't affect your life forever. This proposal in this year builds on that. It would prohibit hospitals from suing people who make less than 400% of the federal poverty line, I believe, for unpaid medical bills. In practice, it shields those people who are the most vulnerable from the worst effects of medical debt.

Brigid Bergin: She focused on the buy now, pay later loan providers. Is that right? What's this industry, and how would she regulate it?

Grace Ashford: This is really interesting. Perhaps, you've even seen, when you go to buy something online, you get the option to put in your credit card information, or, "Oh, would you only like to pay for a piece of it?" Then, you can pay in installments. [chuckles] Obviously, potentially a pretty attractive option. What the governor has said that she would like to do, is to consider these for what they are, which is micro loans.

She would like the people who are offering them in the state to have to get a license, and she'd like her Department of Financial Services to really take a look at the services that they're providing. I think there's a lot of variation in this space, but as we've seen rising interest rates more broadly, we've also seen rising interest rates with these small little loans, and we've also seen late fees.

I think what is concerning to some advocates, and what the governor said she was concerned about is, the notion that sometimes maybe people are agreeing to things that they don't know that they're agreeing to, and then they could get hit with late fees later on. What she's looking for in the space is more oversight, and more regulation.

Brigid Bergin: Wow. Any other consumer protection proposals that I missed, that we should highlight for our listeners?

Grace Ashford: Yes, let me-- Well, the biggest one, I think, is we kind of touched on this earlier, but it would be an expansion of paid medical leave, and disability leave. Right now, that benefit is capped at $170 a week. That's been where it sat since, I believe, 1989. Obviously, the world has changed a lot since then, especially [chuckles] as far as a dollar goes.

What the governor is proposing is to actually peg it to the statewide average weekly wage. This is a measure that actually follows what people are actually getting paid. What that would be is actually an increase of from $170 to-- I think she said now it's closer to $1,250 a week. That's obviously a pretty significant change, if, in fact, she's able to get that done.

Brigid Bergin: Wow. Speaking of getting it done, she's proposing some big ideas, but presumably, the Senate and Assembly would need to pass these bills to make things happen. Have you heard any response from legislative leaders to these proposals, any signs that some things have more support than others?

Grace Ashford: Yes. I mean, I think with all of this, it's a little bit of a waiting game, in that, the governor is about to, as you said on Tuesday, lay out all of her proposals, all of her priorities for this session. The legislative leaders have their own priorities, and while a lot of those may align, they may have a different way of wanting to get there.

Basically, then what we'll do, and we'll watch throughout the session, is the way that these legislative leaders and the governor negotiate those priorities. I think issues like-- Especially, for example, maternal mortality, is something that both houses of government have made clear that is very important to them. It's just a question of where it fits in the broader package of things that leaders want to get done.

Brigid Bergin: I want to bring in Lauren from New York town, who was excited about some of the maternal health initiatives that we were talking about. Lauren, thanks for waiting. Welcome to WNYC.

Lauren: Oh, thank you so much for having me. I was part of a group that was organizing, and raising awareness for the high cesarean rates that we were experiencing here in the New York area, and really very concerned about the access for a vaginal birth after a cesarean, or VBAC. For moms who've had a previous cesarean, it was almost impossible to find providers who would provide, or give you access for a vaginal birth after one cesarean. We were feeling like, once you have a cesarean, oh, you always have to have a cesarean, that is isn't actually true, and having more providers give you access, and having the ability to have a trial of labor, would really bring that number down.

It is really challenging for people to find providers who, number one, actually believe that it's possible and safe, and that providing greater access to midwifery care, really can help in that space. Broadening that avenue for moms who are delivering, is a huge service. I'm hoping that, that becomes part of the equation. In addition to the doula care, I think that's an amazing new option for women, if Governor Hochul's policies can get passed. I'm very excited about that.

Brigid Bergin: Lauren, thank you so much for your call, some enthusiasm. I'm sure Governor Hochul would be glad to hear that. As we finish things off, I want to talk about Grace, just your assessment of the mood in Albany. As you said, we're in the negotiating phase of all of these big ideas. There are some reports that the Democratic leaders are maybe not as pleased with some of the bills that were vetoed by the governor last year. Does any of that carry over into this session?

Grace Ashford: Yes, so you're referring to, there were a couple of vetoes of bills that people were watching pretty closely at the end of last year. This happens a lot of years. There's always old wounds to lick, but as we begin the new session in Albany, really everybody's got to work together to get something done. There's only so much of holding onto those past that is going to be productive.

I think what we're seeing thus far from the legislative leaders is a real attempt to put the best foot forward for this next session. I think that the real other shoe we're ready to drop has to do, is just budgetary. Unlike the past few years that Governor Hochul has been in power, where there's been a good financial outlook, this year, we are seeing about a $4.3 billion budget deficit that they're going to have to fill. What that means is, cuts or scaling back of new ideas. I think that's really where the rubber is going to meet the road. Cautious optimism, but also a lot of work to be done.

Brigid Bergin: Wow. Well, speaking of a lot of work, you are going to be very busy next week, I imagine. [crosstalk] [chuckles] We'll stay tuned on Tuesday for the full State of the State speech, but we're going to leave it here for now. Thank you, Grace Ashford. New York Times reporter covering New York State politics and government. Great to have you on the show.

Grace Ashford: Thanks so much Brigid, it was great to be here.

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