A last-ditch effort to prevent hundreds of thousands of New Yorkers from losing their publicly funded health insurance is facing an uphill battle in Albany.
A group of Democratic lawmakers is urging Gov. Kathy Hochul to put up state funds to preserve coverage for some 450,000 New Yorkers who are slated to get kicked off the insurance program known as the Essential Plan because of federal cuts.
Those New Yorkers, who have been notified they will lose coverage in July, will be able to shop for private coverage on the state insurance marketplace — but consumer advocates worry many won’t be able to afford it. More than 75 legislators signed onto a letter to the governor last week seeking her support for a plan to keep them insured.
State Assembly Speaker Carl Heastie, a Bronx Democrat, said legislative leaders and Hochul have discussed the issue as part of ongoing negotiations over the roughly $268 billion state budget, which is now nearly seven weeks late.
But while proponents of the plan to preserve coverage say there are ways to keep the cost to the state well under $1 billion per year, Heastie says the state would struggle to cover the price tag, which he placed in the “billions.”
Hochul’s office, meanwhile, said she’s reviewing the letter. But the governor continues to emphasize that the healthcare cuts — which political observers say could be a potent issue for Democrats in upcoming midterm elections — are the responsibility of President Donald Trump and the Congressional Republicans who approved them.
Trump and the Republicans in 2025 pushed through hundreds of billions of dollars in federal spending cuts, largely to help fund tax cuts primarily benefitting high-income earners.
"New York’s Republican members of Congress own these healthcare cuts after voting to rip healthcare away from millions of working families,” Hochul spokesperson Nicolette Simmonds said in a statement.
Simmonds noted that Hochul has already taken steps to maintain Essential Plan coverage for most of the 1.7 million people currently enrolled in the program statewide. “While no state can backfill these devastating cuts, the governor took decisive action to protect coverage for as many New Yorkers as possible,” Simmonds said.
But Assemblymember Amy Paulin and Sen. Gustavo Rivera, Democrats who chair the health committees in their respective chambers, said Hochul and the legislature can do more.
“While it is factual that we would not find ourselves in this position were it not for the actions of the federal government, the fact is that at this point right now, we have a way to solve it and we're not doing it,” Rivera said. “We're not engaging with it in a real way.”
Heastie told reporters last week that he struggles to see a path forward.
“We've kind of bounced around some ideas, but no matter which iteration you try to come up with, it still requires the state to come up with billions,” he said. “I'm not sure the money is there under our current tax structure.”
Other Democratic lawmakers and community healthcare advocates disagree. In their letter to Hochul, lawmakers pointed out that she already set aside $2.4 billion in contingency funding tied to the Essential Plan earlier this year that is no longer being used.
Advocates also say there are levers the state can pull to reduce the cost. One option discussed by Hochul and lawmakers is to charge a $50 monthly premium — a move that would generate revenue to defray the expense while also dissuading some people from enrolling, thereby reducing the cost further.
“If you are a healthy 28-year-old who feels like you're immortal, if the healthcare is free, then you'll definitely enroll in it,” said Michael Kinnucan, health policy director for the Fiscal Policy Institute, a left-leaning think tank. “If it costs $50 a month, especially if you're low income and you're squeezed in other ways, you might not.”
Another option is to lower the rates the plan pays healthcare providers.
The Community Service Society of New York, which advocates on behalf of healthcare consumers, has estimated that the plan to keep people insured could cost as little as $393 million this fiscal year, ramping up to about $675 million a year by fiscal year 2029.
Elizabeth Benjamin, the organization’s vice president for health initiatives, said Hochul has the opportunity to “show that she can be the hero and save health coverage for half a million people.” It would come as the governor is running for reelection on a campaign heavily focused on making the state more affordable.
The Trump administration’s cuts to the Essential Plan were tied to a decision to no longer provide federal funding for health coverage for certain legally present immigrants who are not U.S. citizens. But Hochul’s strategy for keeping the Essential Plan afloat has involved reducing the income limit for all members, regardless of immigration status — from about $40,000 a year for an individual to about $32,000 a year.
Those who now earn too much to qualify will still likely struggle to afford the thousands of dollars a year a private marketplace plan might cost, Benjamin said.
Some Albany Republicans, meanwhile, say the state already spends too much on healthcare and isn’t in a position to spend more.
Senate Minority Leader Rob Ortt, a Republican from the Buffalo area, said New York could have helped deter federal cuts by keeping healthcare costs down in the first place.
“You're running into unsustainable spending on some of these programs, and I worry about where that goes,” Ortt said. “Do I want people to lose health coverage? No. Was it entirely preventable, from my perspective? Yes.”
Paulin said the “good news” is that a final budget still isn’t forthcoming.
“The budget is not near done, unfortunately,” she said. “We still have some time.”
