Nearly 450,000 New Yorkers are set to lose health coverage on July 1 as changes to federal health funding take effect, part of a broader shift expected to increase the number of uninsured Americans over the next several years.
The affected New Yorkers were enrolled in the Essential Plan, a state program created under the Affordable Care Act for residents who earn too much to qualify for Medicaid but not enough to afford many private insurance plans. The program has provided low-cost coverage to more than one million people. Under the new rules, residents earning between 200% and 250% of the federal poverty level will no longer qualify.
The change stems from HR 1, known as the “Big Beautiful Bill,” which was signed into law in July 2025. The law ended certain federal funding arrangements that had helped New York use tax credits to cover some legally present immigrants and other low-income residents. In response, the state narrowed eligibility for the Essential Plan.
Some people losing coverage may seek insurance through Affordable Care Act marketplaces, though premiums can cost hundreds of dollars per month. Separately, the expiration of enhanced ACA subsidies has already reduced marketplace enrollment. Federal data show 19.2 million people enrolled in exchange plans in 2026, down from 22.1 million in 2025.
Other HR 1 provisions will affect Medicaid nationally. Beginning in 2027, adults in Medicaid expansion states must meet an 80-hour monthly work requirement, and states must check eligibility every six months instead of annually. The Congressional Budget Office estimates Medicaid changes could leave 7.8 million more people uninsured by 2034, while the Urban Institute projects up to 10.1 million fewer Medicaid enrollees by 2028.
Hospitals and community health centers are also expected to feel the effects. Providers that treat uninsured patients may face higher uncompensated care costs, potentially straining budgets and contributing to broader health care cost pressures.