Gothamist
A non-profit newsroom, powered by WNYC.
Gothamist
Listen Live
News
Hochul scrambles to save health program insuring 1.7M people in NY
By
Caroline Lewis
Published Feb 16, 2026
Modified Feb 16, 2026
Share
FacebookTwitterRedditEmail
Never miss a story
Email address
By submitting your information, you're agreeing to receive communications from New York Public Radio in accordance with our Terms .
BRENDAN SMIALOWSKI/POOL/AFP via Getty Images
By
Caroline Lewis
Published Feb 16, 2026
Modified Feb 16, 2026
Share
FacebookTwitterRedditEmail
We rely on your support to make local news available to all
Make your contribution now and help Gothamist thrive in 2026. Donate today
Gothamist is funded by sponsors and member donations
Edward Roller, a 62-year-old from Long Island, has worked for the same small printing company for years and says he loves his job. But he says the health insurance his employer is able to offer comes with high costs that would be a strain on his $50,000 annual salary.
Roller and his family instead rely on New York’s publicly funded Essential Plan to cover their health care needs. “We don't have any premiums,” Roller said on a recent call. “We just have copays on the doctors’ visits. The dental is free, too. And so is the vision.”
More than 1.7 million people statewide similarly rely on the popular insurance option, which has a higher income threshold than traditional Medicaid. But recent federal cuts under President Donald Trump have made the program’s future uncertain.
Gov. Kathy Hochul and state health officials are now scrambling to overhaul the Essential Plan in a way that will minimize the loss of coverage without blowing a hole in the state budget. Nonetheless, it’s likely a large swath of those covered by the Essential Plan will lose their insurance as early as July.
“Probably some folks will get coverage in other places,” said Rose Duhan, president and CEO of the Community Health Care Association of New York State. But, she said, “There’s going to be a good chunk of those folks who are uninsured.”
The best-case scenario
The massive domestic policy bill Trump pushed through Congress last year slashes $7.5 billion in federal support for the Essential Plan annually — about half its funding, according to a state analysis.
The cuts stem from the Trump administration’s decision not to provide federal funding for certain legally present immigrants who aren’t citizens — a cohort that makes up about 43% of Essential Plan enrollees, according to an analysis by the Empire Center.
But New York can’t just cut off Essential Plan eligibility for those immigrants. Under a long-standing court decision, New York is legally obligated to provide the same insurance coverage for lawfully present immigrants as it does for citizens.
Hochul’s preferred solution, which she first announced in September, involves reverting back to a previous version of the Essential Plan that covers New Yorkers earning up to 200% of the federal poverty level, rather than the current 250%.
For a family of three, that would mean lowering the annual income limit from $68,300 to $54,640 — meaning Roller’s family would likely still qualify.
But that would still kick 450,000 people off the Essential Plan by July, according to Hochul's administration.
This scenario would allow the state to use a trust fund linked to the original version of the insurance program to cover its costs, at least in the short term.
Advocates for health care consumers, clinics and hospitals in New York say they support Hochul’s proposal. But it has yet to receive the approval it needs from the Trump administration to move forward. That’s left the Essential Plan in limbo as the state budget process has gotten underway — and has state officials now preparing for a “worst-case scenario.”
The worst-case scenario
State Health Commissioner James McDonald said at the state health budget hearing in Albany last week that while he’s still hopeful New York will get the green light to move forward with Hochul’s plan, it’s not a sure thing.
“I believe our argument is strong,” James told state lawmakers at the hearing. “Having said that, I think you’ll all agree with me this government is a little more than unpredictable.”
The U.S. Centers for Medicare and Medicaid Services is still reviewing Hochul’s request, according to Carolina Fortin-Garcia, a spokesperson for the agency. She added that the agency will “ensure federal taxpayer dollars are only used only for individuals who are lawfully eligible for coverage.”
In the meantime, the executive budget Hochul released last month includes a contingency plan, which McDonald referred to as the “worst-case scenario” at the budget hearing.
Under that scenario, the state would shut the Essential Plan down entirely and transfer any lawfully present immigrants on the plan who have low enough incomes to qualify to a version of Medicaid funded only by the state.
The proposal would preserve coverage for only 500,000 or so of the Essential Plan’s 1.7 million members, leaving the other 1.2 million in the lurch — and it would come at a cost of more than $2 billion in state funding.
Dealing with the fallout in the budget
New Yorkers affected by the Essential Plan changes could seek alternative coverage through an employer, a family member, or the state’s Affordable Care Act marketplace, though plans on the exchange often cost hundreds of dollars a month, even with federal subsidies.
Roller said he remains optimistic that he will be able to keep his insurance, but doesn’t want to imagine the alternative.
“ I'm in my early 60s,” he said. “If I got thrown off my health insurance, it would be a freaking nightmare. It would be a total catastrophe.”
State Sen. Gustavo Rivera, a Bronx Democrat who chairs the state Senate's health committee, said he and other lawmakers are thinking about ways to use the budget to assist those who end up losing coverage through the Essential Plan.
Rivera said he was encouraged by the fact that the state will have more revenue than initially anticipated in the budget from an obscure but lucrative tax loophole, which the Trump administration is allowing the state to exploit for longer than expected.
“We might have a little bit more money to move around and therefore might be able to figure out how to secure [coverage] for more people,” Rivera said.
But various health care groups are also jockeying for that money, including those representing hospitals and other health care providers.
Duhan said she expects many of the New Yorkers who become uninsured, either because of cuts to the Essential Plan or additional federal changes to Medicaid that are coming in 2027, to end up at the community health centers she represents.
Her organization is projecting those clinics will lose some $300 million as a result of treating more uninsured patients in the coming fiscal year, which her group is asking Hochul and lawmakers to cover in the budget.
This story has been updated with comment from the U.S. Centers for Medicare and Medicaid Services.
Tagged
Health and Science
health
health insurance
new york state
public health
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
Read more
Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
MORE news
Central Park birders, others remember 63-year-old woman killed in park
People who said they knew her described her as an artist and a familiar presence in the Ramble.
By
Charles Lane
Published Sep 28, 2026 at 7:04 p.m. ET
Dump truck driver hits and kills cyclist on 34th Street in Midtown, NYPD says
It's the latest in a string of hit-and-run deaths in the city in recent months.
By
Liam Quigley
News
Dump truck driver hits and kills cyclist on 34th Street in Midtown, NYPD says
It's the latest in a string of hit-and-run deaths in the city in recent months.
By
Liam Quigley
New ingredient mandated for Latin American kitchen, restaurant plates in NJ
By
Arya Sundaram
A Brooklyn jail cell filled with smoke. The emergency button failed, a lawyer said.
By
Samantha Max
Crews launch tunnel machines to dig first new Hudson River rail tunnels since 1910
By
Michael Sol Warren
Never miss a story
Catch up on the most important headlines with a roundup of essential NYC stories, delivered to your inbox daily.
Sign upEmail address
By submitting your information, you're agreeing to receive communications from New York Public Radio in accordance with our Terms .