Changes to Health Insurance for New Yorkers
Almost 500,000 middle-income residents of New York will lose their health insurance on July 1st, marking the beginning of significant coverage losses linked to HR1, a law enacted by Republicans about a year ago.
This legislation, titled the “One Big Beautiful Bill Act,” has cut government health spending by $911 billion. There’s also ongoing support for permanent tax reductions aimed at high-income households and enhanced border security.
“This feels like a state of emergency,” remarked Maia Dillane, the senior director of strategy and implementation at the Arab American Family Support Center in New York City. The center anticipates losing a significant portion of its premiums this summer.
The AAFSC collaborates with 20 community-based organizations through New York’s Community Service Association to assist residents in finding new health insurance. However, as the deadline approaches, individuals will have only 60 days to secure new coverage or wait until November’s open enrollment. Many are concerned about their ability to afford the new expenses.
“Families are in a tough spot, weighing their options between enrolling in qualifying health plans and dropping coverage altogether,” noted Rahem Bader, head of AAFSC’s Community Health and Human Services Program. “They face tough decisions about managing expenses like medical bills and food.”
The loss of coverage in July relates to the discontinuation of New York State’s “essential plan,” a provision from the Affordable Care Act. Recently, the federal government approved a pilot program for residents earning between 200 and 250 percent of the federal poverty line, which translates to a maximum of $39,900 for individuals and $66,625 for a family of three.
It’s worth mentioning that estimates suggest the living wage for a single person in New York is around $73,000. This pilot program was meant to run until 2028 but faced complications soon after HR1 was passed in 2025.
New York’s health agency announced that funding for the essential program had been halved, highlighting the changes introduced by HR1 that retract health insurance tax credits for legally admitted immigrants. Despite appeals for state support, the legislature couldn’t allocate funding for this crucial initiative, sealing its fate.
According to health policy analysts, the loss of this vital program is part of a complex scenario for New York State. In fact, HR1 could lead to up to 1.1 million people losing their health insurance over the next decade. “This is just the beginning. Starting in January, the other consequences of HR1 will start taking effect,” said Dr. Adam Aponte, CEO of the East Harlem Human Services Council.
New York City is anticipated to be particularly hit hard, with over 250,000 residents expected to become uninsured, including 200 of Aponte’s patients. On a national scale, this legislation could leave an additional 10 million people without health coverage in the next ten years.
“What options will these individuals have?” Aponte questioned. “Our federally qualified health centers will likely have to take on these people as uninsured patients.”
While HR1 imposes cuts on health care investments, it is projected to add $3.4 trillion to the federal budget deficit by 2034, primarily due to reduced tax revenues from the cuts.
“It’s doubtful that these individuals will be able to access marketplace insurance,” Aponte said, suggesting that a significant number will remain uninsured for an unknown duration. He predicts that many newly uninsured people will seek care in emergency rooms.
Those losing essential coverage must purchase health insurance through the Affordable Care Act marketplace, which means paying premiums and deductibles—leading to unprecedented premium increases. Additionally, HR1 allowed certain government subsidies for health insurers to lapse at the end of 2025, causing average deductibles to soar to record levels, currently estimated at $3,786 per person.
Experts anticipate that these rate hikes will persist into 2027, as private insurers have already requested increases. In New York, companies are seeking an average rate hike of 20.7%, with United Healthcare proposing a staggering 52.1% increase.
Most analysts suggest these premium hikes stem from sick individuals seeking coverage, while healthier people may be dropping their plans due to affordability concerns, which ultimately drives up costs for everyone. Bader, drawing from experience, noted that when his team assists families looking for insurance, “it’s not because they’re searching for preventive care; they are often in need of serious medical treatment.”
