New York currently underinvests in primary care compared to other states and countries with better health outcomes. We spend disproportionately on specialty and hospital-based care, often after conditions have worsened. The Primary Care Investment Act would begin to rebalance this system by requiring insurers to dedicate at least 12.5% of health care spending to primary care. That means more pediatricians, family physicians, nurse practitioners, and community-based care teams embedded in the neighborhoods where children and families live.
As a pediatrician, and as New York State Chair of the American Academy of Pediatrics, I see every day what happens when primary care for children is underfunded. When families cannot access timely pediatric care, essential foundations for health care are missed, including vaccinations, developmental delays, and emerging behavioral health needs.
Primary care is the gateway to a healthier New York
Debates about health often focus on adults with chronic disease and their high-cost care for serious illnesses, hospitalizations and emergency room use. These could be improved by investments in quality primary care. But the trajectory of lifelong health is set in childhood. When children lack access to consistent primary care, the consequences ripple across decades. When access to pediatric primary care services is inconsistent, we miss critical windows to identify delays, intervene early, and support families. Early childhood is a period of rapid brain development; missing those opportunities can have lifelong consequences for education, health, and economic stability. Investments made during these critical years determine the health and well-being of adults.
Consider this: in Rochester’s Lyell-Otis neighborhood, one in three emergency department visits (33%) are preventable — nearly three times the statewide rate of 13%. For children, this often means seeking care in emergency rooms for conditions that could have been managed — or prevented — through regular pediatric visits.
The result is predictable. Children who do not receive consistent preventive care are more likely to experience unmanaged chronic conditions such as asthma and obesity, untreated developmental delays and unmet mental health needs. These challenges do not resolve on their own—they become more difficult and more expensive to address over time.
We must also be clear about who is most affected. Communities like Lyell-Otis — where a majority of residents are people of color — face longstanding barriers to accessing care. When primary care is scarce, these inequities widen. Children who already face social and economic challenges are the same children least likely to receive the preventive services that could change their life trajectory.
For children, strong primary care means more than “check-ups.” It means ensuring every child is vaccinated and protected from preventable disease. It means screening for developmental delays and connecting families to early intervention services when concerns arise. It means addressing mental health needs early, before crises emerge. It means building trusted relationships with families and supporting them through every stage of a child’s growth.
Critics may argue that we cannot afford to shift resources into primary care. In reality, we cannot afford not to. This legislation does not increase overall spending—it simply requires insurers to prioritize primary care appropriately. The cost of preventable hospitalizations, emergency visits, and untreated conditions far exceeds the cost of routine pediatric care. Investing early saves money later—and more importantly, it changes lives.
The data from Lyell-Otis is not unique. It reflects what is happening in communities across New York. Too many children and families are missing out on the care they need to be healthy and thrive.
Why the Legislature must pass the Primary Care Investment Act
The New York State Legislature has an opportunity — and a responsibility — to act. Passing the Primary Care Investment Act would be a decisive step toward a more equitable, effective health care system that starts with children.
This is why the Primary Care Investment Act is not just sound policy — it is an investment in the future of New York. If we want a healthier New York tomorrow, and one that saves money, we must invest in children and primary care today.
Dr. Jeff Kaczorowski, MD, currently serves as the New York State Chair of the American Academy of Pediatrics and works as pediatrician in Rochester.
This article originally appeared on Rochester Democrat and Chronicle: Healthy kids make a stronger NY. Invest in primary care | Opinion
Reporting by Jeff Kaczorowski, Special to the USA TODAY Network / Rochester Democrat and Chronicle
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