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Policy Project
The Step Two Policy Project is a policy think tank that focuses on issues involving health, behavioral health, and human services in New York. Our goal is to make complicated subjects more understandable to general readers, while providing detailed insights for people who work in the health policy field.
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The Affordable Care Act at the Brink – Part II: Evaluating the HSA Construct
Time will tell whether the Democratic strategy of holding out for a clean extension of the enhanced PTCs will be successful. Engaging with the Senate on the HSA construct as reflected in the Crapo/Kennedy Senate Bill could give Democrats a better opportunity to reshape aspects of the bill in order to mitigate the areas of greatest concern, while improving the chances that the country does not take a giant step backwards in terms of the total level of federal subsidies for hea

Paul Francis and Adrienne Anderson
Dec 29, 2025


The Affordable Care Act at the Brink
The purpose of this Issue Brief is to clarify the terms of debate about the enhanced PTCs and the future of the ACA. We will supplement this paper as the enhanced PTC debate evolves in Congress.

Paul Francis and Adrienne Anderson
Dec 9, 2025


How Many New Yorkers Will Become Uninsured Due to the One Big Beautiful Bill Act?
PDF available: Introduction The One Big Beautiful Bill Act (OBBBA) represents one of the most consequential shifts in federal health policy in recent years. The Congressional Budget Office (CBO) estimated that over 10 years, the OBBBA would result in $990 billion in reduced Medicaid spending and cause 10 million Americans to lose health insurance coverage, with more than half of them losing coverage by 2027. [i] The Appendix of this Issue Brief shows the CBO’s anticipated co

Paul Francis and Adrienne Anderson
Nov 12, 2025


Creating a Healthcare-Focused Artificial Intelligence Public-Private Platform for New York State
Enhancing Access to AI Tools for Healthcare Providers Across New York PDF version: Key Takeaways This paper proposes establishing a healthcare-focused, AI public-private platform to enable broader access to AI’s benefits in patient care, outcomes, and operational efficiency, and to help close the technological divide among healthcare entities. New York State has two important precedents for a new public-private platform involving health information technology and AI: the

Sally Dreslin
Oct 15, 2025


The Importance of Immigrants in New York’s Healthcare Workforce
The intersection of recent federal healthcare and immigration policy changes will have a significant impact not only on the recipients of government-funded healthcare services and on non-U.S. citizens residing in New York, but also on the immigrants who comprise New York’s healthcare workforce.

Sally Dreslin
Aug 4, 2025


The Law and Practice of Assisted Outpatient Treatment, Involuntary Removal, and Involuntary Admission in New York State
Together, court-mandated outpatient treatment and involuntary removal and hospitalization represent a safety net for individuals who fall through the cracks in the system of voluntary care, often cycling through hospitals, jails, and shelters.

Adrienne Anderson
Jul 7, 2025


Linking School-Based Health Services and Community Schools to Address the Needs of Students and Families
Community Schools represent an integrated educational approach designed to transform traditional schools into community hubs by offering comprehensive services and supports to students and their families. Linking school-based health services and Community Schools is a low-barrier, high-impact approach to improving educational and health outcomes for students, and to better engaging families and the surrounding community in supporting student success.

Sally Dreslin & Adrienne Anderson
Apr 24, 2025


Democratization of Analysis: An Exercise in Accessing and Visualizing New York Health Data
This paper and the related recent data exercise illustrate the resources that could be developed from existing health delivery system data.

Step Two Policy Project
Mar 10, 2025


Reforming Care Management for Adults with Behavioral Health Needs in New York Medicaid
The purpose of this Brief is to describe the existing care management infrastructure in New York and trace its evolution.

Adrienne Anderson
Jan 22, 2025


The Future of School-Based Health Centers in New York
School-Based Health Centers (SBHCs) represent a relatively small but important component of the healthcare safety net in New York.

Sally Dreslin
Dec 19, 2024


(Part 2 of 2) Healthcare in Rural New York: Current Challenges and Solutions for Improving Outcomes
Accompanied by the Disparities in Rural and Urban Mortality: New York State Chartbook by Adrienne Anderson Policy Brief: Chartbook:...

Sally Dreslin
Oct 1, 2024


(Part 1 of 2) Healthcare in Rural New York: Current Challenges and Solutions for Improving Outcomes
In this Policy Brief, we examine some of the wide-ranging health challenges that New York’s rural communities are facing...

Sally Dreslin
Oct 1, 2024


State Healthcare Cost Growth Benchmarks
This paper discusses a strategy that a growing number of states are pursuing to constrain growth in healthcare costs...

Adrienne Anderson
Jun 26, 2024


An Inflection Point for Health Information Exchange in New York
Health Data and Information Series #3 Introduction Health information exchange (HIE) is already an indispensable part of the healthcare...

Sally Dreslin
Apr 30, 2024


An Analysis of the FY 25 Executive Budget and Legislative Proposals for Financially Distressed Hospitals
Funding for financially distressed hospitals is one of the two “burning houses” in the FY 25 Health budget...

Paul Francis
Mar 13, 2024


A Review of the Managed Long-Term Care Issues in the FY 25 Executive Budget
Governor Kathy Hochul introduced her Executive Budget for State fiscal year 2024-25 (FY 25) on January 16, 2024...

Paul Francis with Sally Dreslin and Adrienne Anderson
Feb 21, 2024


Using Health Data and Information to Better Measure the Affordability of Healthcare
The lack of comprehensive health data, information, and policy analysis infrastructure in New York hampers the ability of policymakers to...

Sally Dreslin & Adrienne Anderson
Jan 25, 2024
S2P 2024 State of the State Brief
...we were very pleased to see the number of proposals in the 2024 State of the State (SOS) that dovetail well with our areas of interest...

Paul Francis
Jan 12, 2024


The Challenge of Financially Distressed Hospitals in New York
Technology and medical progress are disrupting the hospital industry, enabling more procedures to be performed outside of the hospital...

Paul Francis with Sally Dreslin and Adrienne Anderson
Dec 29, 2023


Categories of Health Data and Information
Health Data and Information Series #2

Step Two Policy Project
Dec 14, 2023
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