How the Next NYC Mayor Can Fight Trump’s War on Healthcare

In over four decades of public service, I have never witnessed such a deliberate and destructive assault on our nation’s healthcare system. The policies of the Trump administration, including Secretary of Health and Human Services Robert F. Kennedy Jr., and codified by Congressional Republicans, represent a dangerous unraveling of the public trust and institutional integrity that Americans rely on for their health and safety.

For the mayor of the nation’s largest city, where three out of five residents rely on public health insurance, the stakes could not be higher. The next city administration will have to confront policies aimed to gut Medicaid and the state’s Essential Health Program, and threats that undermine science-backed vaccine guidance and public health policy.

Here’s where the next mayor should focus to safeguard the health of our city.

Help New Yorkers Enroll in and Keep Their Coverage

Nearly one million NYC residents may lose coverage as the devastating impact of H.R.1 is realized in the coming years. This includes cuts to the Essential Plan, Medicaid work requirements, Medicaid biannual renewal requirements, the elimination of eligibility for LEGAL immigrants, and many, many other onerous rules designed to deter enrollment.

The next mayor must be prepared to meet this coverage crisis head-on. That means robustly funding community-based health consumer assistance programs like MCCAP and Access NYC, which help New Yorkers navigate the maze of enrollment, red tape, and renewal requirements. It also means ensuring strong, stable support for NYC Health + Hospitals and NYC Care, which is the city-funded health care program for residents who don’t qualify, or no longer qualify, for health coverage.

Fix the Tale of Two Cities in Our Hospitals

Healthcare access in New York is also shaped by stark inequities between the city’s hospitals. Wealthy hospitals in Manhattan’s Upper East Side post healthy profit margins by charging exorbitant rates, while safety-net hospitals in the outer boroughs struggle to keep their doors open. The next mayor should take steps to regulate the City’s hospitals to make sure any New Yorker that needs hospital care can access high quality hospital services in their own neighborhood.

To help achieve this goal, patients, workers and policymakers need basic information to allocate precious city resources responsibly. The Office of Health Care Accountability should be empowered to shine a light on hospital pricing, financial assistance practices, and the availability of hospital beds in underserved neighborhoods. With real data in hand, the next mayor can use tools like zoning, land use, and tax-exempt status to hold private non-profit hospitals accountable for providing financial assistance and equitable access for consumers with public insurance.

Combat Disinformation with a Shadow CDC

Finally, we cannot stand by as President Trump and his unhinged Health Secretary gut the CDC and spread dangerous misinformation about vaccines, medications, maternal care and public health. The NYC Department of Health and Mental Hygiene has a long, illustrious history as a public health leader. The next mayor should appoint a health commissioner with deep scientific credibility and charge them with creating a “mini–shadow CDC” that issues factual guidance around vaccinations, medications, and other health care matters to fill the truth void created by the Trump administration.

The federal government may be intent on tearing holes in our healthcare safety net, but New York City doesn’t have to let its residents fall through them. With bold leadership, the next mayor can safeguard access to care, ensure equity in hospitals, and ground public health in science, not misinformation.

This moment is a chance to defend and expand progress toward a fairer, more affordable healthcare system. If Washington retreats, New York City must lead.

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