This bill establishes the New York State Public Health Care Option Program, a comprehensive and affordable health insurance program designed to provide coverage for all state residents. The program will be administered by the Commissioner of Health, who will create a board of trustees comprising 13 members appointed by various state officials. The program aims to offer competitive, affordable health insurance with access to quality providers, and will be available through the state’s health insurance Marketplace. Key provisions include setting premiums based on household income, establishing criteria for healthcare providers, developing payment methodologies, and creating an enrollment process for small employers. The bill also creates a dedicated fund to support the program, which will be financed through member premiums, potential federal payments, and other state funds. The commissioner is required to submit an implementation plan within 12 months and seek necessary federal waivers. The program will ensure that members can access premium tax credits and will have annual limitations on cost-sharing expenses. The board of trustees will help develop recommendations for program implementation and will evaluate whether additional revenue sources are needed to sustain the program. The act will take effect 180 days after becoming law.