Ulster County Executive Mike Hein Issues Executive Order To Address The Most Pressing Potential Public Health Threat Facing The Residents Of Ulster County

Posted March 13, 2017

Repeal Of The Affordable Care Act And The Proposed Replacement Is Expected To Have A Dramatic Impact On Public Health And The County Budget


Kingston, NY -- Ulster County Executive Michael P. Hein today signed an Executive Order that will result in a report that highlights the public health impacts of the repeal of the Affordable Care Act (ACA) on residents of Ulster County. The Order comes as the stage is set at the national level for a passionate debate about the merits of the law, and the impacts if the law or its provisions are repealed or replaced with a bill that results in detrimental changes to the health care system and public health.

The Executive Order empowers Ulster County Commissioner of Health and Mental Health Dr. Carol Smith to direct the County’s resources toward assessing public health and fiscal impacts of key provisions in the Affordable Care Act that will be affected. “Dr. Smith and I share a firm belief that the potential repeal of the Affordable Care Act is one of the most pressing public health threats facing our community,” said Ulster County Executive Mike Hein. “When confronted with an issue such as this, it would be irresponsible not to act.”

“I heartily commend County Executive Hein for bringing attention to the profoundly negative impact that the repeal of the Affordable Care Act will have on the health and wellness of the people of our community,” said Ulster County Commissioner of Health and Mental Health Dr. Carol Smith. “It is critical that the people of Ulster County are made aware of the serious issues associated with repeal of the Affordable Care Act and have their voices heard.”

Dr. Smith continued, “I have advised the County Executive that it is my belief that the most imminent threat to public health for the residents of Ulster County is the repeal of the Affordable Care Act and the proposed replacement in its current form.  Over 1 million New Yorkers face significant loss of health care coverage under the current House plan, over $4.5 billion will be shifted to state, local governments and hospitals, and $400 million in tax credits will be lost for New Yorkers to purchase health insurance.  In addition, the ACA Prevention and Public Health Fund, that had supported core public health programs at local health departments such as ours, will be cut. This fund also represents 12% of the budget of the Centers for Disease Control and Prevention.  More than $900 million that is spent on keeping the nation safe from a variety of communicable diseases would be lost.  Among the CDC programs at risk are Heart Disease and Stroke Prevention, Diabetes Prevention, Childhood Lead Poisoning Prevention, Epidemiology and Laboratory Capacity, and Immunization programs.  Cutting the Prevention and Public Health Fund, without a comparable, well thought out replacement plan would seriously harm the public’s health, and would limit our capacity to respond in the event of an infectious disease outbreak.”



Upon taking office in 2009, County Executive Hein set the ambitious goal of making Ulster County the healthiest County in New York State. Since then, the County has made extraordinary improvements in health outcomes, rising in the Robert Wood Johnson health rankings from 35th of the State’s 62 counties in 2011 to 16th in 2016. “To achieve our goal, efforts on multiple fronts are required, including partnerships between local government and local health providers as well as sound state and federal policy that support improved health outcomes,” said the County Executive. “The dramatic changes to the Affordable Care Act’s provisions that are being considered threaten to derail our hard-earned progress by making it harder for our citizens to access the health services and supports they need to live healthy and productive lives.”

“We know that national Medicaid expansions enabled through the Affordable Care Act resulted in millions of individuals acquiring insurance who otherwise could not afford it,” said Commissioner of Health and Mental Health Dr. Carol Smith. “And while health insurance remains costly, a repeal of the law threatens to cause real harm to our most vulnerable residents, who under recently proposed legislation would see an increase in their share of out-of-pocket insurance costs.”



As part of its annual budget, Ulster County is responsible for $60 million in costs for County residents who rely on Medicaid to afford basic health services. “That amount could drastically increase and have a direct negative impact on local property taxpayers,” explained Burton Gulnick, Jr., Ulster County Commissioner of Finance. “The law recently proposed in Congress threatens to force states and counties to choose between providing care to our most vulnerable residents or protecting taxpayers from the increasing burden of high health care costs,” he continued.



County Executive Hein has used Executive Orders judiciously and recognizes that this important tool of the Executive has broad impacts on the lives of County residents. “I am proud of our past Executive Orders, which have pushed Ulster County to the forefront on critical issues of statewide and national importance,” explained County Executive Hein. 

Past Executive Orders include: 

  • An order to “Ban the Box,” which impacted not only the County, but all towns, villages and school districts in the county that prohibited potential bias on employment applications (Executive Order No. 2-2014); and
  • An order banning the use of fracking waste fluid (Executive Order No. 1-2012); and 
  • Two orders – one in 2014 and one in 2016 – requiring that 100% of the County’s electricity is purchased from renewable energy sources (Executive Orders No. 1-2014 and 1-2016). 


Given the uncertainty about the Affordable Care Act’s future and the wide-ranging impacts that repeal is expected to have, County Executive Hein recognizes the magnitude of this issue and the grave risk to public health it represents.  “The national debate about the future of the Affordable Care Act is critical to the health and well-being of our communities, and I believe it is my duty as an elected official to help our local, state and national leaders fully understand exactly how these decisions affect the lives of our Ulster County residents,” concluded County Executive Hein.


Pursuant to the directives contained in the Executive Order, the Ulster County Commissioner of Health and Mental Health has scheduled a public forum for Tuesday, March 21st at 6:30pm in the Legislative Chambers of the Ulster County Office Building located at 244 Fair Street, 6th floor in Kingston.  All residents are invited to attend.


(845) 340-3800