The Fiscal Policy Institute (FPI) last week released a report by Michael Kinnucan, Health Policy Director, with a plan to keep covered the one million New Yorkers at risk of losing health insurance under the OBBBA. This update looks at the impacts of coverage loss by region and by county.
This July, 470,000 of the 1.7 million New Yorkers currently enrolled in the Essential Plan (EP) will lose their current health insurance.
Hundreds of thousands will become uninsured. As we wrote last week, the State can and should step in to prevent this healthcare catastrophe—but Governor Hochul’s Executive Budget proposal fails to address this.
Unless the legislature takes action, New York will see the most rapid loss of healthcare coverage in its history.
In this post, we break down the potential impact by county and region. We find that, while New York City will see the largest coverage loss—with 233,000 residents impacted—every part of the state will see a dramatic loss of insurance. Long Island, for example, will see nearly 70,000 people lose coverage, including 38,000 in Suffolk County alone. Western New York will see 26,000 lose coverage.
Statewide, 2.4 percent of New Yorkers will lose their health insurance coverage—likely the largest and most rapid loss of insurance in the State’s history. Medicaid work requirements beginning in January 2027 will further decimate New York insurance rolls.
Figure 1: Impact of Medicaid work requirements and Essential Plan cuts on New York Uninsurance Rate
Table 1: Essential Plan Coverage Loss by Region
New York State can and must step in to offer alternative coverage. FPI has estimated that it would cost the state less than $1 billion in FY27 to prevent coverage loss for this population.