More than 2 million New Yorkers could lose their health coverage under proposed insurance changes advanced by Republicans in Congress, according to new preliminary estimates from policy groups and Gov. Kathy Hochul's office.
The tally includes New Yorkers enrolled in Medicaid, a public insurance program that covers individuals earning up to about $20,000 per year, and the Essential Plan, which provides similar coverage for individuals earning up to about $39,000 per year. Together, these plans currently cover more than 8 million people statewide.
The proposed changes are part of Republicans’ effort to achieve President Donald Trump’s vision for a “big, beautiful bill” that both reduces federal spending and cuts taxes. The GOP has majorities in both the House and Senate, though far-right House members stalled the bill on Friday, arguing that it didn't cut enough.
“It's impossible for any individual state to backfill the massive cuts being proposed in Congress, but Gov. [Kathy] Hochul is committed to using litigation and other tools to protect New Yorkers," said Nicolette Simmonds, a spokesperson for the governor.
New Medicaid work requirements are a centerpiece of the proposed health care reforms.
The House Energy and Commerce Committee passed a bill Wednesday that would require childless adults on Medicaid who are not disabled to prove they’re working at least 80 hours per month, starting in 2029. They could also do community service, participate in a work training program, or show they’re enrolled in school.
The Energy and Commerce Committee has been tasked with saving about $880 billion over a decade, and this measure alone would save an estimated $301 billion during that time, Politico reported.
But similar work requirements in Arkansas led thousands of people to lose coverage without increasing employment, according to a study published in the New England Journal of Medicine. The study found that most of those who lost coverage were still eligible for Medicaid but were tripped up by the new reporting requirements and red tape associated with the work policy.
If New York lost coverage at the same rate as Arkansas, the federal work policy would end up kicking about 1 million people off Medicaid statewide, according to the Center on Budget and Policy Priorities. Nationally, the majority of Medicaid enrollees are already working, according to the health policy nonprofit KFF.
The Energy and Commerce bill would also eliminate a tax loophole New York is using to bring in more revenue for Medicaid and penalize states that use their own tax dollars to extend Medicaid coverage to undocumented immigrants. Currently, undocumented immigrants who are pregnant or over 65 are eligible for Medicaid in New York.
A separate bill approved by the House Ways and Means Committee would prevent green card holders and other immigrants who are in the United States legally but are not citizens from enrolling in the state’s Essential Plan or receiving federal subsidies for plans on the Affordable Care Act marketplace.
In addition to those affected by Medicaid work requirements, another 1.2 million New Yorkers are likely to lose coverage because of the latest proposals, according to an analysis Hochul’s office sent to congressional staffers, which was reviewed by Gothamist.
Where New York Republicans in Congress stand
“ We have an opportunity to stop this,” said Helen Schaub, interim political director for the health care union 1199 SEIU, which is organizing to pressure New York Republicans in Congress to reject the proposed changes.
But Schaub acknowledged that Medicaid may not be top of mind for some of those the union is targeting.
Congressional Republicans from Long Island and Westchester are among those who have been dubbed “SALT Republicans” for their laser focus on allowing Americans to claim bigger deductions on their state and local income taxes — another proposal under consideration in the Ways and Means bill.
Gothamist asked Ciro Riccardi, a spokesperson for Republican Rep. Mike Lawler, about 1199’s efforts to get him and other New York Republicans to reject Medicaid cuts. He responded, without elaborating, that the union has a history of “antisemitism” and shared a link to an article about the union criticizing Israel for its actions in Gaza.
Riccardi added that Lawler, who represents Westchester and other counties north of New York City, “has made it clear that he does not support cutting Medicaid for eligible recipients.”
Rep. Nicole Malliotakis, a Republican who represents Staten Island and parts of Brooklyn, maintains that the proposed Medicaid reforms are in line with a broader federal effort to eliminate “waste, fraud and abuse.”
“If we can implement some work requirements that are reasonable for able-bodied young people [who are] working age, if we can root out people who are here illegally benefiting from the program, that is all good,” she said on Good Day New York on Monday.
Malliotakis added that she and other “moderate” Republicans had successfully pushed back on more draconian cuts, including proposals to decrease the overall share the federal government pays for Medicaid and to cap per-person spending on the program, which she said “could have hurt New York and our hospitals.”
Outside of New York, some Republican lawmakers are calling for deeper Medicaid cuts, while others are raising concerns that any significant reduction in Medicaid spending will alienate the party’s base. The conservative lawmakers were able to stop the bill from reaching the House floor on Friday.
Sen. Josh Hawley, a Republican from Missouri, argued that “slashing health insurance for the working poor” was “morally wrong and politically suicidal” in a New York Times op-ed.
The spending bills passed out of committee will come to a full vote on the House floor before heading to the Senate.
