Thanks to Trump and HR1, 500,000 New Yorkers Are Losing Health Coverage
David R. Jones, The Urban Agenda
On July 1, nearly 500,000 New Yorkers enrolled in the Essential Plan will begin losing their health coverage because of changes enacted through President Trump’s HR1 legislation. These are working New Yorkers, families, and individuals who earn too much to qualify for Medicaid but too little to afford commercial insurance through the state’s health insurance marketplace. Around 90 percent are U.S. Citizens.
HR1, driven by Republicans in Washington, is totally responsible for the gutting of public health programs.
State lawmakers almost saved the day by identifying state funding to fill the federal void through the now over state budget process. More than 100 legislators signed a letter, led by the Chairs of the Assembly and Senate Health Committees urging Governor Hochul to include legislation based on S9589/A10926 in the final state budget.
Allowing half a million New Yorkers to lose coverage is penny-wise and pound-foolish. For many of these residents, losing coverage does not mean losing the need for health care. People will still get sick. They will still need medications, treatment, and preventive services. The difference is that more of them will delay care until conditions worsen or turn to already overcrowded hospital emergency departments and community health centers when their health problems become crises, all of which will be ultimately more costly than the cost of preserving coverage through S9589/A10926.
The message from lawmakers was simple: New York should not stand by while nearly half a million residents lose health coverage through no fault of their own. Unfortunately, that message was not reflected in the final budget this year. That said, CSS will continue to fight for its inclusion in the coming budget year when lawmakers return to Albany in early 2027, when even more New Yorkers will begin to lose insurance under additional HR1 imposed hurdles to keeping Medicaid coverage that start then.
My organization, the Community Service Society of New York (CSS), estimates that Essential Plan coverage losses will generate between $794 million and $940 million annually in new uncompensated care costs borne by hospitals, taxpayers, and the health care system. Community health centers, already operating on thin margins, stand to lose roughly $100 million in revenue attributable to these coverage losses. At the same time, increased reliance on emergency rooms could add another $218 million in costs, while delayed treatment and preventable hospitalizations could result in nearly $1 billion in additional inpatient charges. The total cost will be an estimated $2–$2.2 billion annually — over three times as expensive as providing coverage as proposed in S9589/A10926.
The consequences will be felt across the state, but nowhere more harshly than in New York City, where nearly 230,000 of the affected enrollees live. As more residents become uninsured, the city’s public hospitals and community providers will be asked to care for a growing number of uninsured patients without a reliable source of reimbursement. The result will be greater strain on a safety-net system that is already facing significant challenges.
At the same time, programs that help consumers navigate the health care system will become more important than ever. The Managed Care Consumer Assistance Program (MCCAP), operated by CSS, is on the front lines of this unfolding crisis. CSS’s helpline is listed as a resource in the disenrollment notices being sent to affected Essential Plan members, and we are already seeing the impact.
Calls from Essential Plan enrollees have increased by approximately 50 percent as people seek answers about their options, eligibility for other forms of coverage, and access to affordable care. We expect those numbers to rise substantially after July 1 as coverage losses take effect. New Yorkers who have questions about their coverage options or need help navigating the transition should contact MCCAP’s helpline at 888-614-5400 for free, unbiased assistance.
New York has long prided itself on being a national leader in expanding access to health care coverage. This year, it missed an opportunity to demonstrate that leadership. The state can still correct course next year and create a new pathway to coverage for those being left behind. These New Yorkers are not going away. And even more will be joining their ranks. New Yorkers’ health care needs are not going away, and neither are the economic consequences of leaving them uninsured.
At CSS, we will continue helping affected New Yorkers navigate the challenges ahead, and we will continue advocating alongside legislative champions, providers, and community organizations until the state fulfills its responsibility to protect low-income residents from losing health coverage.
The coverage may be ending for hundreds of thousands of New Yorkers on July 1. Our commitment to them is not.
David R. Jones, Esq., is President and CEO of the Community Service Society of New York (CSS), the leading voice on behalf of low-income New Yorkers for more than 175 years. The views expressed in this column are solely those of the writer. The Urban Agenda is available on CSS’s website: www.cssny.org.