Per the notices below, Governor Hochul and the New York State Department of Health (NYSDOH) have each issued statements on the termination of the Essential Plan as health insurance coverage in New York State.

Following Devastating Federal Funding Cuts, New York State Takes New Action to Preserve Health Care for As Many New Yorkers As Possible

Washington Republicans Cut $7.5 Billion in Annual Funding, Threatening Coverage for 1.7 Million New Yorkers

Cuts Will Force New York to Make Major Changes to its Successful Essential Plan to Preserve Coverage for 1.3 Million New Yorkers

Despite This Action, 450,000 New Yorkers Will Lose Essential Plan Eligibility Due to the Newly-Enacted Federal Law

A 30-Day Public Comment Period Opens Today on State's Plan to Return to a Basic Health Program

The New York State Department of Health today announced that the State is taking proactive action to preserve access to health care for as many New Yorkers as possible following devastating cuts in federal funding from the Republican-passed budget bill H.R.1.  A 30-day public comment period opens today on the State's proposed plan to end the State Innovation Waiver and return to a Basic Health Program.  The federal law eliminates $7.5 billion in annual funding for New York State's Essential Plan, jeopardizing health care coverage for the nearly 1.7 million low- and middle-income New Yorkers who are currently enrolled in the program.  Due to this funding cut from H.R.1, the State has no choice but to terminate its groundbreaking Section 1332 State Innovation Waiver and Essential Plan expansion.  To preserve coverage for as many New Yorkers as possible, Governor Hochul is proposing to revert to the Basic Health Program.  This action would allow an estimated 1.3 million New Yorkers to remain enrolled in the program and mitigate revenue losses to the health care delivery system despite the federal Government's targeted disinvestments.

"I have been very direct and clear with New Yorkers about the disastrous impact of H.R.1 on our health care system, and the devastating choices it would force states to make," State Health Commissioner Dr. James McDonald said.  "By reverting to a Basic Health Program, Governor Hochul is making sure that 1.3 million working people will be able to keep their affordable health insurance.  Even with these steps, too many New Yorkers – nearly half a million– will lose affordable health coverage and be forced to choose between keeping food on the table and paying their medical bills.  I am grateful to Governor Hochul for standing up and doing what's right while Washington Republicans rip health care away from their constituents."

As a result of the drastic budget cuts in the newly enacted federal Law, an estimated 450,000 middle class New Yorkers will lose access to zero-premium comprehensive health insurance despite the State's efforts.  The reduction of federal funding will lead to coverage losses and increases in uncompensated care for New York State providers, who will be left to cover the costs of uninsured New Yorkers.  This will affect the delivery of health care services for all New Yorkers and could force facilities to close.  Communities across the state will also incur job losses and economic loss as healthcare dollars disappear from communities.  Congressional inaction to repeal or delay H.R.1 changes to premium tax credit eligibility for lawfully-present individuals will force New York State to terminate its waiver and leave hundreds of thousands of New Yorkers uninsured.  The 1332 Waiver proved that innovative healthcare policy can work.  Last year, NYS officials celebrated New York's Section 1332 waiver as a groundbreaking achievement.  The program expanded the Essential Plan to New Yorkers who are not eligible for Medicaid with incomes up to 250% of the federal poverty level, or about $39,125 annually for an individual, providing comprehensive health insurance with zero monthly premiums, no deductibles, and minimal cost-sharing.  The expansion saved participants an average of over $6,000 per year compared to Qualified Health Plan coverage.

NY State of Health Executive Director Danielle Holahan said, "The Essential Plan has been the linchpin to driving down New York's uninsured rate among those who do not qualify for Medicaid but still struggle with health care costs.  Many enrollees are essential workers, small business employees, and families working multiple jobs to make ends meet.  Our decision to terminate the waiver allows us to preserve coverage for as many New Yorkers as possible and protect more than a decade of progress in expanding healthcare."

As the full impact of these federal changes comes into effect, New York State is committed to an orderly transition, as well as collaborating with the Centers for Medicare & Medicaid Services (CMS) to design and provide affordable coverage options for impacted enrollees.  In addition to providing consumers with 90-days notice prior to their eligibility change, New York State will provide a special enrollment period for CMS-approved coverage options and enhanced customer service assistance to affected consumers to ease the transition.  The New York State Department of Health is opening a public comment period today, September 10, 2025 through October 10, 2025, on the plan to transition from the 1332 waiver to a Basic Health Program.  Instructions for submitting public comments are posted at: https://info.nystateofhealth.ny.gov/1332.  The transition to a Basic Health Program is anticipated to take effect by July 1, 2026, pending approval by CMS, giving the State time to implement these protective measures while following federal requirements for waiver termination.

STATEMENT FROM GOVERNOR KATHY HOCHUL

“For months, I’ve warned that Washington Republicans’ devastating cuts would rip health care away from New Yorkers.  Today, we have no choice but to confront that reality.  Nearly 1.7 million New Yorkers rely on the Essential Plan for health care – working moms and dads, families living paycheck to paycheck, people doing everything right and still struggling to get by.  The Big Ugly Bill forced through by Donald Trump and Republicans puts every single one of them at risk of losing their care.  I refuse to stand by while Washington punishes vulnerable New Yorkers.  That’s why today, I’m taking action to preserve health care for 1.3 million people by shifting their coverage to our state’s Basic Health Program, allowing us to access emergency funds that would otherwise not be available.  But even with these steps, 450,000 New Yorkers are at risk of losing their care.  That includes 127,000 people represented by New York’s seven Republican Members of Congress, who are abandoning their own constituents to hand out tax breaks for the wealthy.  It doesn’t have to be this way.  If Republicans give a damn about protecting health care for their constituents, they can act right now to pass a three-year delay of HR1's cuts to health care eligibility and keep every New Yorker on the Essential Plan covered.  And in the meantime, the Center for Medicare and Medicaid Services needs to work with us to identify more low-cost health insurance options for New Yorkers.  There is still work to do here in New York.  Many of the 1.7 million people on the Essential Plan are working part time, including at big retailers and other companies that deliberately limit hours to avoid covering health care.  It’s time for these employers to stop passing the cost on to taxpayers and start providing coverage for their workers.  The message from across our state is clear: we can act together and stop these devastating impacts before it’s too late.”