Concerns Over Potential Medicaid Changes in New York
Local health officials in New York state are cautioning that planned federal changes to Medicaid, outlined in HR1, known as the “One Big Beautiful Bill,” might leave roughly 1.5 million residents without health insurance in the coming years. This shift could also add strain to clinics that already provide support to millions of low-income patients throughout the state.
These worries come as Governor Kathy Hochul and state legislators are working out the details of New York’s postponed budget, including key funding for community health centers. Health providers stress that this funding is crucial if coverage losses accelerate.
The proposed federal changes would mandate stricter eligibility checks and new work reporting rules for Medicaid, starting in 2027. Advocates for health policy have indicated that these new requirements might result in eligible individuals losing coverage—not because of income issues, but due to administrative hiccups, delays in reporting, or general confusion.
Reginal Picard, who has cared for his brother, who has paranoid schizophrenia, for over two decades, recently discovered that his brother lost Medicaid coverage while trying to get his medication. Picard recounted, “I was told my co-pay would be $690, while the actual out-of-pocket cost was only about $12 or $13.” He was informed that either paperwork was not completed, or something was reduced.
As a result, Picard has begun paying out of pocket to ensure his brother continues to get treatment. “No matter how much it costs, I have to do what’s necessary to keep him on his medication,” he mentioned.
The New York State Community Health Association estimates that around 1.5 million residents might lose health insurance due to the federal law changes. Furthermore, the Fiscal Policy Institute has reported that nearly 460,000 individuals enrolled in the Essential Plan—those earning between 200% and 250% of the federal poverty line—could start losing coverage by July 2026. Over time, about 800,000 Medicaid recipients may also face loss of coverage once the new work reporting requirements go into effect on January 1, 2027.
“We need $300 million to address not only our current needs but also the losses we anticipate,” stated Tricia Peter Clark, CEO and president of ConnextCare. Healthcare providers are pushing for Hochul to allocate this $300 million to community health centers, arguing that the current budget proposal falls short in preparing clinics for a possible rise in uninsured patients. Currently, these centers serve roughly 2.4 million clients, regardless of their payment abilities.
The New York State Senate’s latest proposal includes an additional $50 million for federally qualified health centers and non-FQHC clinics, raising the total proposed funding for these facilities to $80 million.
Clark expressed concern that patients losing coverage might postpone necessary treatment or further strain an already overwhelmed safety net system. “There will be delays for those we expect to arrive at our facilities just as we try to manage the current safety net,” Clark conveyed.
On May 7, Hochul presented a framework for a $268 billion national budget—over a month past the initial April 1 deadline. Yet, legislative leaders have stated that finalizing the budget remains a work in progress, with ongoing negotiations on multiple points.
