Bill Text: NY A09029 | 2019-2020 | General Assembly | Introduced

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Bill Title: Enacts the Health Care Tax Reform Act; eliminates certain taxes and assessments on health insurance.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2020-01-10 - referred to ways and means [A09029 Detail]

Download: New_York-2019-A09029-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          9029

                   IN ASSEMBLY

                                    January 10, 2020
                                       ___________

        Introduced  by M. of A. GOODELL -- read once and referred to the Commit-
          tee on Ways and Means

        AN ACT to amend the financial services law, the tax law and  the  public
          health law, in relation to enacting the Health Care Tax Reform Act

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. This act shall be known and may be  cited  as  the  "Health
     2  Care Tax Reform Act".
     3    § 2. Legislative findings. The Legislature hereby finds that:
     4    (a) The affordability of health care and health insurance is extremely
     5  important  in  ensuring  that the maximum number of New York State resi-
     6  dents can obtain high quality affordable health care;
     7    (b) Health care and health insurance are currently subject to  several
     8  taxes that directly and indirectly increase the cost of health insurance
     9  coverage,  including  an annual flat tax on all privately insured people
    10  in New York State called the covered lives assessment  that  raises  the
    11  costs  to  health  plans by $1.1 Billion, a 9.63% sales tax surcharge on
    12  certain  hospital  based  health  services  that  costs  consumers  $3.6
    13  Billion,  a  1.75%  flat tax on all commercial health insurance policies
    14  that costs consumers $350 Million, and a gross receipts tax on insurance
    15  companies called a section 206 assessment that costs health  plans  $149
    16  Million a year;
    17    (c)  Collectively,  the taxes on health care and health insurance cost
    18  consumers a total of over $5 Billion in 2018, which  exceeds  the  total
    19  amount  of  taxes  paid  by corporations through the franchise taxes and
    20  exceeds all other types of taxes except for personal  income  taxes  and
    21  general sales taxes; and
    22    (d)  The  taxes  on health care and health insurance are fundamentally
    23  regressive taxes because the taxes are unrelated to a consumer's  wealth
    24  or  ability to pay, directly impact hospitalization costs at a time when
    25  consumers are facing some of  their  greatest  health  care  challenges,
    26  directly  increase  the cost of health insurance, and are counterproduc-
    27  tive to the public  policy  objective  of  making  health  insurance  as
    28  affordable as possible.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13935-03-9
        A. 9029                             2

     1    §  3. Section 206 of the financial services law is amended by adding a
     2  new subsection (g) to read as follows:
     3    (g)  For the fiscal year commencing on April first, two thousand twen-
     4  ty-one, the commissioner shall only collect eighty  per  centum  of  any
     5  assessments  collected  pursuant  to  this  section  in  the fiscal year
     6  commencing on April first, two thousand twenty,  and  provided  further,
     7  however,  that  for the fiscal year commencing on April first, two thou-
     8  sand twenty-two, the commissioner shall only collect sixty per centum of
     9  any assessments collected pursuant to this section in  the  fiscal  year
    10  commencing  on  April  first, two thousand twenty, and provided further,
    11  however, that for the fiscal year commencing on April first,  two  thou-
    12  sand  twenty-three, the commissioner shall only collect forty per centum
    13  of any assessments collected pursuant to this section in the fiscal year
    14  commencing on April first, two thousand twenty,  and  provided  further,
    15  however,  that  for the fiscal year commencing on April first, two thou-
    16  sand twenty-four, the commissioner shall only collect twenty per  centum
    17  of any assessments collected pursuant to this section in the fiscal year
    18  commencing  on  April  first, two thousand twenty, and provided further,
    19  however, that for the fiscal year commencing on April first,  two  thou-
    20  sand  twenty-five,  no  such  assessment  under  this  section  shall be
    21  collected.
    22    § 4. Section 1502-a of the tax law, as amended by section  2  of  part
    23  B-1  of chapter 57 of the laws of 2009 and as further amended by section
    24  104 of part A of chapter 62 of the laws of 2011, is amended to  read  as
    25  follows:
    26    § 1502-a.  Tax  on non-life insurance corporations. (a) In lieu of the
    27  tax imposed by section fifteen hundred one of this article, every domes-
    28  tic insurance corporation, every foreign insurance corporation and every
    29  alien insurance corporation, other than  such  corporations  transacting
    30  the  business  of life insurance, (1) authorized to transact business in
    31  this state under a certificate of authority from the  superintendent  of
    32  financial  services[,]  or (2) that is a risk retention group as defined
    33  in subsection (n) of section five  thousand  nine  hundred  two  of  the
    34  insurance  law,  [or  (3)  that  is  a  health  maintenance organization
    35  required to obtain a certificate of authority under  article  forty-four
    36  of the public health law,] shall, for the privilege of exercising corpo-
    37  rate  franchises or for carrying on business in a corporate or organized
    38  capacity within this state, and in addition to any other  taxes  imposed
    39  for  such privilege, pay a tax on all gross direct premiums, less return
    40  premiums thereon, written on risks located or resident  in  this  state.
    41  The  tax  imposed  by  this  section shall be computed in the manner set
    42  forth in subdivision (a) of section fifteen hundred ten of this  article
    43  as  such  subdivision  applied to taxable years beginning before January
    44  first, two thousand three, except that the rate of tax imposed  by  this
    45  section  shall  be [one and seventy-five hundredths percent on all gross
    46  direct premiums, less return premiums thereon, for accident  and  health
    47  insurance  contracts, including contracts with health maintenance organ-
    48  izations for health services, and]  two  percent  on  all  [other]  such
    49  premiums  except  accident  and  health  insurance  contracts, including
    50  contracts with health maintenance organizations for health services.
    51    (b) In lieu of the tax imposed by section fifteen hundred one of  this
    52  article,  every  domestic insurance corporation, every foreign insurance
    53  corporation and every  alien  insurance  corporation,  other  than  such
    54  corporations transacting the business of life insurance that is a health
    55  maintenance  organization  required to obtain a certificate of authority
    56  under article forty-four of the public health law, shall, for the privi-
        A. 9029                             3

     1  lege of exercising corporate franchises or for carrying on business in a
     2  corporate or organized capacity within this state, and  in  addition  to
     3  any  other  taxes  imposed  for  such  privilege, pay a tax on all gross
     4  direct  premiums, less return premiums thereon, written on risks located
     5  or resident in this state. The tax imposed  by  this  section  shall  be
     6  computed  in  the manner set forth in subdivision (a) of section fifteen
     7  hundred ten of this article as such subdivision applied to taxable years
     8  beginning before January first, two thousand three, except that the rate
     9  of tax imposed by this section shall be one and seventy-five  hundredths
    10  percent  on all gross direct premiums, less return premiums thereon, for
    11  accident and health insurance contracts, including contracts with health
    12  maintenance organizations for health services, provided,  however,  that
    13  for  the  taxable year beginning January first, two thousand twenty-one,
    14  the percentage shall be  one  and  four  tenths  percent,  and  provided
    15  further, however, that for the taxable year beginning January first, two
    16  thousand  twenty-two,  the  percentage  shall be one and five hundredths
    17  percent, and provided further, however, that for the taxable year begin-
    18  ning January first, two thousand twenty-three, the percentage  shall  be
    19  seven tenths of one percent, and provided further, however, that for the
    20  taxable  year  beginning  January  first,  two thousand twenty-four, the
    21  percentage shall be thirty-five hundredths of one percent, and  provided
    22  further,  however,  that  for  the  taxable years beginning on and after
    23  January first, two thousand twenty-five, no such tax shall be imposed.
    24    (c) All the other provisions in section fifteen hundred  ten  of  this
    25  article as amended from time to time, other than subdivision (b) of such
    26  section,  shall  apply  to  the tax imposed by this section. In no event
    27  shall the tax imposed under this section be less than two hundred  fifty
    28  dollars.
    29    §  5.  Subdivision  2  of  section 2807-j of the public health law, as
    30  amended by section 41 of part B of chapter 58 of the laws  of  2005  and
    31  paragraphs  (b), (c), (d), and (e) as amended by section 50 of part B of
    32  chapter 58 of the laws of 2009, is amended to read as follows:
    33    2. (a) The total percentage allowance for any period during the period
    34  January first, nineteen hundred ninety-seven  through  December  thirty-
    35  first,  nineteen hundred ninety-nine and on and after January first, two
    36  thousand, for a designated provider of services applicable  to  a  payor
    37  shall  be  determined in accordance with this subdivision and applied to
    38  net patient service revenues.
    39    (b) The total percentage allowance for each payor, other than  govern-
    40  mental  agencies,  or  health  maintenance  organizations  for  services
    41  provided to subscribers eligible  for  medical  assistance  pursuant  to
    42  title  eleven  of  article  five of the social services law, or approved
    43  organizations for services provided  to  subscribers  eligible  for  the
    44  family health plus program pursuant to title eleven-D of article five of
    45  the  social services law, and other than payments for a patient that has
    46  no third-party coverage in whole or in part for services provided  by  a
    47  designated provider of services, shall be:
    48    (i)  the  sum  of (A) eight and eighteen-hundredths percent, provided,
    49  however, that for services provided on and after July first,  two  thou-
    50  sand  three,  the  percentage  shall be eight and eighty-five hundredths
    51  percent, and further provided that for services provided  on  and  after
    52  January first, two thousand six, the percentage shall be eight and nine-
    53  ty-five  hundredths  percent,  and  further  provided  that for services
    54  provided on and after April first, two  thousand  nine,  the  percentage
    55  shall  be  nine and sixty-three hundredths percent, and further provided
    56  that for services provided on and after April first, two thousand  twen-
        A. 9029                             4

     1  ty, the percentage shall be twenty-two and sixty-one hundredths percent,
     2  and  further  provided  that  for  services  provided on and after April
     3  first, two thousand twenty-one, the  percentage  shall  be  sixteen  and
     4  ninety-six  hundredths  percent,  and further provided that for services
     5  provided on and after April first, two thousand twenty-two, the percent-
     6  age shall be eleven  and  thirty-one  hundredths  percent,  and  further
     7  provided  that for services provided on and after April first, two thou-
     8  sand  twenty-three,  the  percentage  shall  be  five   and   sixty-five
     9  hundredths  percent,  and further provided that for services provided on
    10  and after April first, two thousand twenty-four, the percentage shall be
    11  zero percent, plus (B) twenty-four percent, provided, however, that  for
    12  services  provided  on  and  after  July  first, two thousand three, the
    13  percentage shall be twenty-five and ninety-seven hundredths percent, and
    14  further provided that for services provided on and after January  first,
    15  two  thousand  six,  the  percentage  shall be twenty-six and twenty-six
    16  hundredths percent, and further provided that for services  provided  on
    17  and  after April first, two thousand nine, the percentage shall be twen-
    18  ty-eight and twenty-seven hundredths percent, and further provided  that
    19  for services provided on and after April first, two thousand twenty, the
    20  percentage  shall  be  twenty-two  and sixty-one hundredths percent, and
    21  further provided that for services provided on and  after  April  first,
    22  two  thousand twenty-one, the percentage shall be sixteen and ninety-six
    23  hundredths percent, and further provided that for services  provided  on
    24  and  after April first, two thousand twenty-two, the percentage shall be
    25  eleven and thirty-one hundredths percent, and further provided that  for
    26  services  provided  on and after April first, two thousand twenty-three,
    27  the percentage shall be five  and  sixty-five  hundredths  percent,  and
    28  further  provided  that  for services provided on and after April first,
    29  two thousand twenty-four, the percentage shall be zero percent, and plus
    30  (C) for a specified third-party payor as defined in subdivision one-a of
    31  section twenty-eight hundred seven-s  of  this  article  the  percentage
    32  allowance  applicable  for  a  general  hospital  for inpatient hospital
    33  services pursuant to subdivision two  of  section  twenty-eight  hundred
    34  seven-s of this article;
    35    (ii) unless (A) an election in accordance with paragraph (a) of subdi-
    36  vision five of this section to pay the allowance directly to the commis-
    37  sioner  or  the  commissioner's  designee is in effect for a third-party
    38  payor, and in addition (B) for a specified third-party payor an election
    39  to pay the assessment in accordance with  section  twenty-eight  hundred
    40  seven-t of this article is in effect.
    41    (c) If an election in accordance with subdivision five of this section
    42  is  in effect for a third-party payor and in addition in accordance with
    43  section twenty-eight hundred seven-t of this  article  for  a  specified
    44  third-party  payor,  the  total  percentage  allowance  factor  shall be
    45  reduced to eight and  eighteen-hundredths  percent,  provided,  however,
    46  that  for  services provided on and after July first, two thousand three
    47  the total percentage allowance factor shall  be  reduced  to  eight  and
    48  eighty-five  hundredths  percent, and further provided that for services
    49  provided on and  after  January  first,  two  thousand  six,  the  total
    50  percentage  allowance  factor  shall be reduced to eight and ninety-five
    51  hundredths percent, and further provided that for services  provided  on
    52  and after April first, two thousand nine, the total percentage allowance
    53  factor  shall  be reduced to nine and sixty-three hundredths percent and
    54  further provided that for services provided on and  after  April  first,
    55  two  thousand  twenty,  the  percentage  shall  be seven and seventy-one
    56  hundredths percent, and further provided that for services  provided  on
        A. 9029                             5

     1  and  after April first, two thousand twenty-one, the percentage shall be
     2  five and seventy-nine hundredths percent, and further provided that  for
     3  services provided on and after April first, two thousand twenty-two, the
     4  percentage shall be three and eighty-six hundredths percent, and further
     5  provided  that for services provided on and after April first, two thou-
     6  sand  twenty-three,  the  percentage  shall  be  one  and   ninety-three
     7  hundredths  percent,  and further provided that for services provided on
     8  and after April first, two thousand twenty-four, the percentage shall be
     9  zero percent.
    10    (d) The total percentage allowance for payments by governmental  agen-
    11  cies,  as  determined  in  accordance  with  paragraphs (a) and (a-1) of
    12  subdivision one of section twenty-eight hundred seven-c of this  article
    13  as  in  effect on December thirty-first, nineteen hundred ninety-six, or
    14  health maintenance organizations for services  provided  to  subscribers
    15  eligible for medical assistance pursuant to title eleven of article five
    16  of  the  social  services  law,  or  approved organizations for services
    17  provided to subscribers eligible for  the  family  health  plus  program
    18  pursuant  to  title eleven-D of article five of the social services law,
    19  shall be five and ninety-eight-hundredths  percent,  provided,  however,
    20  that  for  services provided on and after July first, two thousand three
    21  the total percentage allowance shall be six and  forty-seven  hundredths
    22  percent,  and  further  provided that for services provided on and after
    23  January first, two thousand six, the total percentage allowance shall be
    24  six and fifty-four hundredths percent, and  further  provided  that  for
    25  services provided on and after April first, two thousand nine, the total
    26  percentage  allowance  shall  be  seven  and four hundredths percent and
    27  further provided that for services provided on and  after  April  first,
    28  two  thousand  twenty,  the  percentage  shall  be  five and sixty-three
    29  hundredths percent, and further provided that for services  provided  on
    30  and  after April first, two thousand twenty-one, the percentage shall be
    31  four and twenty-two hundredths percent, and further  provided  that  for
    32  services provided on and after April first, two thousand twenty-two, the
    33  percentage  shall  be two and eighty-two hundredths percent, and further
    34  provided that for services provided on and after April first, two  thou-
    35  sand  twenty-three, the percentage shall be one and forty-one hundredths
    36  percent, and further provided that for services provided  on  and  after
    37  April  first,  two  thousand  twenty-four,  the percentage shall be zero
    38  percent.
    39    (e) The total percentage allowance for payments for services  provided
    40  by  designated  providers  of services for which there is no third-party
    41  coverage in whole or in part  shall  be  eight  and  eighteen-hundredths
    42  percent, provided, however, that for services provided on and after July
    43  first,  two thousand three the total percentage allowance shall be eight
    44  and eighty-five  hundredths  percent,  and  further  provided  that  for
    45  services  provided  on  and  after  January first, two thousand six, the
    46  total percentage allowance shall be  eight  and  ninety-five  hundredths
    47  percent,  and  further  provided that for services provided on and after
    48  April first, two thousand nine, the total percentage allowance shall  be
    49  nine  and  sixty-three  hundredths percent and further provided that for
    50  services provided on and after April first,  two  thousand  twenty,  the
    51  percentage  shall  be  seven  and  seventy-one  hundredths  percent, and
    52  further provided that for services provided on and  after  April  first,
    53  two  thousand  twenty-one, the percentage shall be five and seventy-nine
    54  hundredths percent, and further provided that for services  provided  on
    55  and  after April first, two thousand twenty-two, the percentage shall be
    56  three and eighty-six hundredths percent, and further provided  that  for
        A. 9029                             6

     1  services  provided  on and after April first, two thousand twenty-three,
     2  the percentage shall be one and  ninety-three  hundredths  percent,  and
     3  further  provided  that  for services provided on and after April first,
     4  two  thousand  twenty-four,  the percentage shall be zero percent.  This
     5  paragraph  shall  not  apply  to  patient  deductibles  and  coinsurance
     6  amounts.
     7    (f) The total percentage allowance for patient deductibles and coinsu-
     8  rance  amounts  shall  be  the  same  percentage allowance applicable to
     9  payments by the primary third-party payor covering the patient  in  each
    10  case  determined  in accordance with paragraphs (a), (b) and (c) of this
    11  subdivision.
    12    (g) The total percentage allowance for  secondary  third-party  payors
    13  under  coordination  of benefits principles shall be the same percentage
    14  allowance applicable to payments by the primary third-party payor in the
    15  case determined in accordance with paragraphs (a), (b) and (c)  of  this
    16  subdivision.
    17    §  6.  Subdivision  2  of  section 2807-s of the public health law, as
    18  added by chapter 639 of the laws of 1996, subparagraph (ii) of paragraph
    19  (b) of subdivision 2 as amended by chapter 1 of the laws of 1999,  para-
    20  graph (c) as amended by section 15 of part A-3 of chapter 62 of the laws
    21  of  2003,  subparagraphs  (ii)  of paragraph (c) as amended and (iii) of
    22  paragraph (c) as added by section 31 of part B of chapter 58 of the laws
    23  of 2005, and subparagraph (iv) of paragraph (c) as added by  section  21
    24  of  part  A  of  chapter  58  of the laws of 2007, is amended to read as
    25  follows:
    26    2. (a) The regional percentage allowance for  any  period  during  the
    27  period  January  first,  nineteen  hundred ninety-seven through December
    28  thirty-first, nineteen hundred ninety-nine for all general hospitals  in
    29  the  region  applicable to a specified third-party payor, and applicable
    30  to related patient coinsurance and deductible amounts and  to  secondary
    31  third-party  payors  under coordination of benefits principles, shall be
    32  the following, and shall be applied to inpatient  hospital  net  patient
    33  service revenues:
    34    (b) the result expressed as a percentage of:
    35    (i)  for each region, the amount allocated to the region in accordance
    36  with subdivision six of this section, divided by
    37    (ii) the total estimated nineteen hundred ninety-six general  hospital
    38  inpatient  revenue of all general hospitals in the region, excluding (A)
    39  an estimate of revenue from services provided to beneficiaries of  title
    40  XVIII  of the federal social security act (medicare), (B) an estimate of
    41  revenue from services provided to  patients  eligible  for  payments  by
    42  governmental  agencies,  patients  eligible for payments pursuant to the
    43  comprehensive motor vehicle  insurance  reparations  act,  the  workers'
    44  compensation  law,  the  volunteer  firefighters'  benefit  law, and the
    45  volunteer ambulance workers' benefit law,  and  self-pay  patients,  (C)
    46  from  general  hospitals  providing  graduate  medical  education in the
    47  aggregate an amount equal to the amount specified in subparagraph (i) of
    48  this subdivision, other than the components of such amount allocable  to
    49  payors specified in clause (B) of this subparagraph, and (D) an estimate
    50  of  revenue  reductions  related to negotiated reimbursement in nineteen
    51  hundred ninety-seven with specified third-party payors which shall be  a
    52  uniform statewide percentage estimated reduction.
    53    (c)  (i)  The  regional  percentage  allowance for the periods January
    54  first, two thousand through June thirtieth, two thousand three, for  all
    55  general  hospitals  in  the  region  applicable to specified third-party
    56  payors, and applicable to related  patient  coinsurance  and  deductible
        A. 9029                             7

     1  amounts,  shall  be  the  same  regional percentage allowance calculated
     2  pursuant to paragraph (b) of this subdivision  for  the  period  January
     3  first, nineteen hundred ninety-nine through December thirty-first, nine-
     4  teen hundred ninety-nine.
     5    (ii) The regional percentage allowance for the periods July first, two
     6  thousand three through December thirty-first, two thousand five, for all
     7  general  hospitals  in  the  region  applicable to specified third-party
     8  payors, and applicable to related  patient  coinsurance  and  deductible
     9  amounts,  shall  be  the  same  regional percentage allowance calculated
    10  pursuant to paragraph (b) of this subdivision  for  the  period  January
    11  first, nineteen hundred ninety-nine through December thirty-first, nine-
    12  teen  hundred  ninety-nine  multiplied by one hundred eight and nineteen
    13  hundredths percent.
    14    (iii) The regional percentage allowance for the periods January first,
    15  two thousand six through June thirtieth, two  thousand  seven,  for  all
    16  general  hospitals  in  the  region  applicable to specified third-party
    17  payors, and applicable to related  patient  coinsurance  and  deductible
    18  amounts,  shall  be  the  same  regional percentage allowance calculated
    19  pursuant to subparagraph (ii) of this paragraph for the  period  January
    20  first,  two  thousand  five  through December thirty-first, two thousand
    21  five multiplied by one hundred one and thirteen hundredths percent.
    22    (iv) The regional percentage allowance for periods [on and after] July
    23  first, two thousand seven through March thirtieth, two thousand  twenty,
    24  for  all  general hospitals in the region applicable to specified third-
    25  party payors, and applicable to related patient coinsurance and  deduct-
    26  ible amounts, shall be the same regional percentage allowance calculated
    27  pursuant  to subparagraph (iii) of this paragraph for the period January
    28  first, two thousand six through June thirtieth, two thousand seven.
    29    (v) The regional percentage allowance for  periods  April  first,  two
    30  thousand  twenty  through  March thirtieth, two thousand twenty-one, for
    31  all general hospitals in the region applicable to specified  third-party
    32  payors,  and  applicable  to  related patient coinsurance and deductible
    33  amounts, shall be the  same  regional  percentage  allowance  calculated
    34  pursuant  to  paragraph  (b)  of this subdivision for the period January
    35  first, nineteen hundred ninety-nine through December thirty-first, nine-
    36  teen hundred ninety-nine  multiplied  by  ninety-seven  and  seventy-one
    37  hundredths percent.
    38    (vi)  The  regional  percentage allowance for periods April first, two
    39  thousand twenty-one through March thirtieth,  two  thousand  twenty-two,
    40  for  all  general hospitals in the region applicable to specified third-
    41  party payors, and applicable to related patient coinsurance and  deduct-
    42  ible amounts, shall be the same regional percentage allowance calculated
    43  pursuant  to  paragraph  (b)  of this subdivision for the period January
    44  first, nineteen hundred ninety-nine through December thirty-first, nine-
    45  teen hundred ninety-nine multiplied  by  seventy-three  and  twenty-nine
    46  hundredths percent.
    47    (vii)  The  regional percentage allowance for periods April first, two
    48  thousand twenty-two through March thirtieth, two thousand  twenty-three,
    49  for  all  general hospitals in the region applicable to specified third-
    50  party payors, and applicable to related patient coinsurance and  deduct-
    51  ible amounts, shall be the same regional percentage allowance calculated
    52  pursuant  to  paragraph  (b)  of this subdivision for the period January
    53  first, nineteen hundred ninety-nine through December thirty-first, nine-
    54  teen  hundred  ninety-nine  multiplied  by  forty-eight  and  eighty-six
    55  hundredths percent.
        A. 9029                             8

     1    (viii)  The regional percentage allowance for periods April first, two
     2  thousand twenty-three through March thirtieth, two thousand twenty-four,
     3  for all general hospitals in the region applicable to  specified  third-
     4  party  payors, and applicable to related patient coinsurance and deduct-
     5  ible amounts, shall be the same regional percentage allowance calculated
     6  pursuant  to  paragraph  (b)  of this subdivision for the period January
     7  first, nineteen hundred ninety-nine through December thirty-first, nine-
     8  teen hundred  ninety-nine  multiplied  by  twenty-four  and  forty-three
     9  hundredths percent.
    10    §  7.  This act shall take effect immediately; provided, however, that
    11  the amendments to section 2807-j  of  the  public  health  law  made  by
    12  section five of this act shall not affect the expiration of such section
    13  and  shall  expire therewith; provided further, however, that the amend-
    14  ments to section 2807-s of the public health law made by section six  of
    15  this  act  shall  not  affect  the  expiration of such section and shall
    16  expire therewith.