ALBANY – Gov. Andrew Cuomo signaled support of single-payer health care at both the federal and state levels on Monday as Democrats nationwide rally around the issue.

"I think that would be a good idea," Cuomo said on WNYC's "The Brian Lehrer Show" when asked about a federal "Medicare for All" system.

But single-payer may face a roadblock from Republicans who are weighing another effort to repeal the Obama-era Affordable Healthcare Act.

"I'm afraid (the Republicans) come back with health care reform," the governor added. "I think we're in the eye of the storm, where it's apparently quiet right now on health care. I think the back half of the storm is going to come around."

Single-payer — the concept that everyone chips in to cover "free" health care coverage when someone needs it — recently gained the support of U.S. Sen. Kirsten Gillibrand of New York and is a point on which Democrats seeking office next year are touting.

Yet while federal legislation is going nowhere in a Republican-controlled Congress, New York Democrats have pushed for a single-payer system on the state level. The Assembly, which is controlled by Democrats, has passed single-payer legislation repeatedly in recent years. The GOP-held state Senate has not taken up the issue.

Cuomo seemed open to single-payer on the state level, assuming that federal health care funding funneled to the state is maintained. He has bemoaned a proposal that would force the state to pick up the county share of Medicaid costs, lest it risk losing federal funding of an equal amount.

"If they were to pass it and it was not incongruous with what the federal government would do to us, I think it's a very exciting possibility," Cuomo said. "But I think it's going to be a federal play. Our funding system basically relies on Medicaid from the feds. If they turn off that valve or slow that valve, there is no way we're going to be able to make that up in this state no matter what."

It's worth noting that the state would have to raise an estimated $91 billion in revenues to fund a state-level single-payer system, according to Assembly sponsor Dick Gottfried, D-New York. According to Gottfried's bill, any revenue proposal would need to account for ending of local payments for Medicaid.

Cuomo has been mentioned as a potential Democratic candidate for president in 2020, a year when single-payer may be a key issue for a White House run. On the heels of his trip to the U.S. Virgin Islands on Friday to survey hurricane damage, Cuomo was asked on Lehrer's program if he is taking actions with an eye toward 2020.

"Once you start with this presidential question, whatever you do, you can interpret as 'he's doing that because he wants to run for president,'" Cuomo said. "Whatever I do they could say that."

He added: "The Virgin Islands, I don't even believe they vote for president. So if you're running for president, there are a lot of other places to go besides the Virgin Islands — like Florida would probably be where you would have gone."

mhamilton@timesunion.com • 518-454-5449 • @matt_hamilton10