Nearly half a million people in New York State are poised to lose health insurance coverage as funding cuts from the Trump administration’s “One Big Beautiful Bill” begin to take effect.
On April 1, the state’s Department of Health began sending out notices to New Yorkers who receive coverage on the low-cost Essential Plan about how changes in eligibility requirements will take away their health care coverage.
The shift will affect hundreds of thousands of working, low-income New Yorkers who don’t qualify for Medicaid. Are you among them?
Here’s what we know about how the funding cuts will affect coverage, what people can do to stay insured, how to access care without insurance and the battle playing out in Albany to cover the costs:
Jump to …
- Why is this happening and who is affected?
- What should I do if I’m losing health care?
- What if I become uninsured, or cannot afford the insurance I am eligible for?
- What about accessing the medicine I need while uninsured, or struggling to afford medication?
- Can the state make up the Essential Plan funding that the federal government cut?
- Tell us your story.
Why is this happening and who is affected?
President Donald Trump signed a massive tax and spending bill in July 2025, including cuts to federal funding for New York’s Essential Plan. About 450,000 people will no longer be eligible for the program beginning July 1, even after New York State got approval from the federal government to keep about 1.3 million people enrolled.
The cuts primarily affect people with incomes from 200% to 250% of the federal poverty line, which this year equals yearly earnings of approximately $32,000 and $40,000 for an individual, or $54,000 to $68,000 for a family of three, according to Elisabeth Benjamin, vice president of health initiatives for the Community Service Society (CSS).
“These are not wealthy people,” Benjamin said. “It will be much more expensive. They’re going to lose their free, no-deductible coverage, and instead have to pay hundreds of dollars [per month], potentially, for a product with a deductible.”
With the state budget not yet finalized, advocates and officials are pushing Gov. Kathy Hochul to find the money to prevent so many people from losing health coverage. (More on that below.)
The cuts will also impact legal immigrants in New York on the Essential Plan by eliminating their premium tax credit eligibility entirely, Michael Kinnucan, health policy director at the Fiscal Policy Institute, said in an interview with Healthbeat.
What should I do if I’m losing health care?
If you are set to lose health care through the Essential Plan on July 1, use the next three months to seek care, Rebecca Wallach, director of New York Legal Assistance Group’s legal resources program, told THE CITY.
“Make an appointment to see a primary care doctor, get prescriptions in order, get whatever you need,” she said.
Pay attention to notices from the New York State of Health Marketplace, whether online or by mail, informing people of when they will lose health care and how they can purchase a new plan on the private market.
On May 16, you can begin shopping for Qualified Health Plans on the Marketplace, which can connect you with health care navigators trained to assist in the enrollment process. You have until August 30 to pick a new insurance plan, said Danielle Holahan, executive director of the New York State of Health. Remember, however, that you will lose insurance coverage on July 1 no matter what, so if you’re still choosing a plan after July 1 and before August 30, you’ll be uninsured during that time.
Call the Marketplace’s Customer Service Center at (855) 355-5777 with any questions. It is open weekdays 8:00 a.m. to 8:00 p.m., and Saturdays 9 a.m. to 1:00 p.m. For help in languages other than English and Spanish, call and request an interpreter.
“We will do what we can to smooth this transition,” said Holahan. “We will work with them to let them know what timeline this is all happening on, when they can come in and pick a plan that would take effect on July 1.”
The experts THE CITY spoke to all said it is critical to meet with health care navigators — trained individuals whose job it is to help people through the byzantine process of getting insured. Mid-May and June are the time to start reaching out, according to Wallach.
This is especially important if your life or home circumstances have changed since the last time you signed up for insurance, like if you are pregnant, have welcomed a new baby into your household or your income has gone down. These navigators will assist you according to your individual needs.
“It’s really important to have to redo your financial eligibility,” Benjamin said. “If your income this year isn’t as high as last year, you might still be able to get the free coverage.”
The Community Service Society partners with New York State to connect people with trained navigators. It has 17 community-based organizations who will assist you for free as part of its Navigator Network, which can be found here.
Rehan Mehmood is the director for health services and a health care navigator at the South Asian Council for Social Services, one of the organizations in the Navigator Network with an office in Flushing, Queens. He said appointments are not necessary — just walk in, and they will help you.
“Our people will make sure you have access to health care,” Mehmood said. “We speak over 20 different languages. We can assist individuals going through plans, seeing what services are covered and helping them get the care they need.”
Holahan recommends that people not put off choosing a new plan.
“They can always make a change later, but I would encourage people to take action so there’s no gap in coverage,” she said.
If you speak to a navigator and are not eligible for insurance through the New York State of Health, the state’s health marketplace, but have a medical condition that affects your daily activities, Wallach advises reaching out to the Facilitated Enrollment for the Aged, Blind and Disabled (FE-ABD) — an application assistance program for public health insurance.
Those who could consider FE-ABD include New Yorkers with active cancer treatment, who receive dialysis or have multiple sclerosis, Wallach said.
“For an individual who is not able to get insurance through those systems in New York State of Health, FE-ABD can evaluate and screen a person for the possibility of Medicaid,” she said.
The Community Service Society’s network list of community-based organizations in the FE-ABD Program can be found here. The Department of Health also has a list of facilitated enrollers for FE-ABD, which can be found here.
What if I become uninsured, or cannot afford the insurance I am eligible for?
If you have exhausted your options to access an insurance plan you can afford, the city has a safety net program administered through NYC Health + Hospitals for getting the care you need: NYC Care.
“It is one of the major avenues where we can make sure clients are connected to comprehensive health care,” Mehmood said.
Anyone within the five boroughs who is uninsured or cannot afford the insurance for which they are eligible can access NYC Care.
NYC Health + Hospitals administers the program and provides free or low-cost services at the facilities listed here. The enrollment process is outlined here, or you can call (646) 692-2273 for information on how to become a NYC Care member.
These services are available regardless of immigration status, and health care professionals will not record your immigration status, according to the NYC Health + Hospitals website.
There are also free health clinics funded through grants from the U.S. Department of Health and Human Services, where people can seek ongoing care. Enter your location here to find one.
And if you have a medical emergency, do not put off care. “Go to the emergency room,” Wallach said. “That is still true.”
What about accessing the medicine I need while uninsured, or struggling to afford medication?
You can access medication as a NYC Care member, but Wallach said there are other ways to afford many of the medications you need on an ongoing basis.
Seek prescription drug discount programs, like GoodRx that compare prescription drug prices and tell you what pharmacies take specific insurance. NPR also has a good guide on how to get the best price for your prescription when navigating drug discount options.
Can the state make up the Essential Plan funding that the federal government cut?
Gov. Kathy Hochul maintains that the state cannot take on the costs of the cuts to provide coverage for people who will lose their health insurance.
“From the beginning, I sounded the alarm about the devastating impact H.R. 1 would have on our hospitals and health care system, and made clear that no state can fully backfill cuts this severe,” she said in an April 1 statement.
But Benjamin from the Community Service Society said with the state budget yet to be finalized this spring, “it’s not over yet.”
“It can be done for just under a billion dollars. The money’s there,” she said; the entire state budget is about $260 billion. “Get ahold of your state elected officials and the governor to say we don’t have to lose our coverage.”
State Sen. Gustavo Rivera and Assemblymember Amy Paulin introduced legislation last week that would protect half a million people from losing coverage through state funding. The bill currently has 10 co-sponsors in the Senate.
“We can absolutely cover folks,” Rivera told THE CITY. “You would have 450,000 New Yorkers who without any action would lose their coverage come July.”
“That’s going to happen regardless,” he said. “Since it’s happening during this budget year that we’re negotiating right now, we have to do something.”
Holahan from the Department of Health echoed the governor’s sentiment. “The governor has been pretty clear, states cannot backfill cuts of this magnitude,” she said. “It’s not something that we wanted to do, but the federal government had different ideas.”
Wallach noted that “We do not know where the budget is going to fall, so the advice could change.”
But Mehmood said that currently, Essential Plan enrollees who make up to 250% of the federal poverty line will lose coverage.
“Legislators are still pushing,” he said. “But as of now, what we know is that July 1 is the last day.”