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New Yorkers losing Essential Plan health coverage turn to market after budget fail
By
Caroline Lewis
Published Jun 2, 2026
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Will Waldron/Albany Times Union via Getty Images
By
Caroline Lewis
Published Jun 2, 2026
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Lauren Lavitt, who loses her premium-free public health insurance through New York’s Essential plan next month, is shopping in earnest for an alternative for her and her two children on the state’s Affordable Care Act marketplace.
Lavitt, who lives in Manhattan, said she hoped the state budget would provide a life raft for her and the 450,000 other New Yorkers who were told earlier this year they would no longer qualify for the coverage, starting July 1. She and the others were disappointed.
The $268 billion state budget passed last week without funding to preserve Essential Plan coverage, which many Democratic lawmakers were pushing for, leaving Lavitt and the others diving in headfirst to navigate the pricey private insurance marketplace.
“ The new plans are really expensive, even just for the Bronze plans,” Lavitt said, referring to the least expensive insurance tier. “But I need something.”
Those losing access to the Essential Plan earn between 200% and 250% of the federal poverty level — about $32,000 to $40,000 for an individual. Many will still qualify for financial assistance for private health insurance.
But that assistance got reduced when Congressional Republicans and President Donald Trump allowed enhanced federal subsidies to expire last year.
Enrollment in private marketplace plans has already declined this year as premiums have gone up, state data show. Consumer advocates worry the shift from the Essential Plan to private insurance will strain some New Yorkers financially, while leaving others uninsured.
Lavitt has an annual income of about $70,0000 from working part-time at a nonprofit. As such, she qualifies for government subsidies of more than $300 a month, according to estimates provided on the New York State of Health website.
But even with that help, the cheapest plan Lavitt can find would cost more than $700 a month and come with a $5,500 annual deductible — the amount she’d have to spend out of pocket before coverage kicks in.
Lavitt, who lives on the Upper East Side, said she has explored ways to access healthcare without enrolling in traditional insurance — such as using drug discount programs to make prescriptions more affordable. But she decided that at 53, going without insurance is not an option.
“One option is just to cut back on expenses, which is hard,” she said.
Lavitt said she would have been happy to pay more out of pocket to hold onto the Essential Plan and is disappointed that Gov. Kathy Hochul and state lawmakers didn’t provide that option.
“ Raise the copay. It's not a big deal,” Lavitt said. “But to go out in the marketplace and kind of just be thrown down a river without a paddle, I'm really annoyed by this.”
Nicolette Simmonds, a spokesperson for Hochul, emphasized that the governor took steps to preserve Essential Plan coverage for most of the 1.7 million enrollees in the face of federal cuts.
Hochul has placed the blame for any loss of coverage on Congressional Republicans, who passed billions of dollars in healthcare cuts in the federal spending bill H.R. 1 last year.
Still, some New Yorkers said they hold both federal and state lawmakers responsible for the current situation.
Statewide, private insurance premiums for New Yorkers who are eligible for marketplace subsidies increased by an average of $104 per month, or 20%, between last year and this year, according to a state report issued in April.
Compared with last year, about 50,000 fewer people enrolled in private marketplace plans this year are receiving any federal subsidies at all.
At the end of January, before accounting for Essential Plan changes, enrollment in any type of plan through the New York State of Health marketplace was down 2.4% from the previous year, amounting to about 160,000 fewer enrollees than in 2025, the report found. Private insurance enrollment was down about 5%.
Brooklynite Tatyana Walker said when she first learned she was losing Essential Plan coverage, she ”was freaking out, crying on the phone” to the state marketplace operators.
The 34-year-old, who has diabetes and epilepsy, makes about $52,000 a year working as a home health aide for her mother. She said she has never been on private insurance before and is worried she won’t be able to afford it, even with considerable subsidies.
Walker found through New York State of Health estimates that she could pay just over $300 a month for a Silver plan after federal assistance, but it would come with a $2,500 annual deductible.
“It seems like the less you pay, you're not getting the best coverage,” Walker said.
New Yorkers shopping for health insurance can get assistance navigating the marketplace by calling the New York State of Health at (855) 355-5777 or visiting the website. Organizations such as the Community Service Society of New York also assist.
Tagged
Health and Science
new york state
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].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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