Assemblywoman Sarahana Shrestha in 2024 leading a rally at the state Capitol in support of “coverage for all” legislation, which would have expanded access to the state’s Essential Plan health coverage to undocumented immigrants. Eligibility for the taxpayer-subsidized program is ending for hundreds of thousands of New Yorkers in July due to federal changes enacted last year.
Lori Van Buren/Times Union
ALBANY — Hundreds of thousands of New Yorkers will lose their health insurance coverage this week after cuts set in motion by President Donald J. Trump’s “Big, Beautiful Bill” last year.
The cuts affect just under 450,000 people enrolled in the Essential Plan, a taxpayer-subsidized healthcare plan established under the federal Affordable Care Act for low-income New Yorkers who earn too much to qualify for Medicaid but not enough to afford private insurance. The group is divided between citizens and lawful immigrants who no longer qualify for federal financial assistance to help pay for their coverage.
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Among those expecting to lose the free healthcare coverage are about 6,000 recipients of Deferred Action for Childhood Arrivals, or DACA, an Obama-era program that protected from deportation immigrants brought to the U.S. as children, according to an analysis by the nonprofit policy group Community Service Society. Also affected are tens of thousands of low-income immigrants — refugees, asylum-seekers and people with temporary protected status — who were dropped from federal tax credit programs that helped cover the cost of their health insurance.
“It is heartbreaking,” said Elisabeth Benjamin, Community Service Society’s vice president of health initiatives.
Earlier this year, the state began sending letters and text messages to affected residents warning them that their government-subsidized health coverage through the state’s online marketplace would end in July. Until now, the group had received $0-premium, low-cost-sharing coverage that was primarily funded by the federal government based on enrollment.
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Benjamin said her nonprofit’s “navigator network” has been trying to reach as many of those residents as possible to help them find alternative health insurance. Under the new rules, a person making 200% to 250% of the federal poverty level — or about $32,000 to $39,000 annually — may now have to pay an additional $200 to $400 per month for health insurance, she said.
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For most, Benjamin said, “it’s basically not doable. We are going to see a huge spike in the number of uninsured people.”
It remains unclear how many of those being dropped from the Essential Plan would be able to access coverage through their employer. A spokesperson for the state Department of Health said officials did not yet have a clear picture of how many affected people had signed up for new coverage through a Qualified Health Plan ahead of the deadline.
State health officials began bracing for the cuts last year, as Trump’s “Big, Beautiful Bill” headed toward approval in the U.S. Senate. The massive spending bill included significant funding cuts and policy changes to Medicaid and insurance marketplaces that healthcare advocates warned would worsen patient access to care.
The bill stripped the state of an estimated $7.5 billion in federal tax credits that had been used to fund the Essential Plan. The federal cuts disproportionately affected New York because the state has one of the highest per-capita Medicaid enrollment rates in the nation, as well as a large number of lawful immigrants targeted by the changes.
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At the time, U.S. Rep. Elise Stefanik defended the bill, telling reporters at the state Capitol that it was “getting rid of Medicaid benefits for illegals specifically to improve (benefits) for New Yorkers who qualify.”
As a result of the cuts, the state moved to terminate a federal waiver that had allowed it to expand the Essential Plan to half a million New Yorkers who qualified with incomes between 200% and 250% of the federal poverty level. The 1.3 million New Yorkers enrolled in the Essential Plan with incomes below 200% of the federal poverty level — or about $31,000 annually — will keep their coverage as the state adjusts to the new federal funding landscape, health officials said.
But that leaves many people who had previously benefited from heavily subsidized, low-cost coverage scrambling to buy a new health plan in the individual marketplace, where they are likely to find much higher premiums, deductibles and out-of-pocket costs.
“If you’ve been getting free insurance and now your only option is to pay hundreds or even thousands of dollars a year, that’s a big deal,” said Bill Hammond, a senior fellow with the Empire Center for Public Policy. “It will be a big added expense for those people.”
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Hammond believes lawmakers could have done more to maintain health coverage for those low-income residents, including tapping into an $8.9 billion surplus accumulated in the state’s Basic Health Program Trust Fund. He called officials’ inability to assist the hundreds of thousands of affected residents “a failing of our political system.”
In April, as affected residents began receiving letters from the state notifying them of the coming coverage cuts, Democrats in the state Legislature proposed a state-funded fix. Assemblywoman Amy Paulin, a Democrat from Westchester County who chairs the Health Committee, and state Senate Health Committee Chair Gustavo Rivera introduced a bill that would have required the state to pay for a new subsidized health care plan for the 400,000-plus people set to lose coverage on July 1.
Both Rivera and Paulin said at the time that they expected that their proposal would make its way into negotiations around the state budget. But when budget negotiations wrapped up earlier this month, the health chairs’ proposal was not in it.
Gov. Kathy Hochul’s office did not immediately comment for this story.
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Last month, Hochul issued a statement saying she had taken steps to mitigate the impacts of the federal cuts, including directing the state Department of Health to return the Essential Plan to a Basic Health Program, which the Centers for Medicare and Medicaid Services approved in March. Hochul said it would preserve coverage for roughly 1.3 million New Yorkers who had been enrolled in the Essential Plan.
She said the state agency would also assist consumers during the transition to ensure they are aware of available options and to provide support and assistance in signing up for new coverage.