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Troubling trends in New York’s small group market

July 15th, 2025|

Read Full Report By Bailey Hu, Health Policy Analyst, & Michael Kinnucan, Director of Health Policy Prior to the passage of the Affordable Care Act (ACA) in 2010, small business employers in New York and other states often had difficulty buying affordable health insurance, especially if their employees were in poor health. The ACA helped provide better options for workers and their families by regulating offerings in the "small group" health insurance market, which serves businesses with up to 100 employees. However, recent administrative data shows alarming trends: not only is New York's small group [...]

FPI Briefing on the Federal Budget Reconciliation Bill

July 10th, 2025|

The OBBBA spending cuts are concentrated in Medicaid and food stamps (SNAP), with devastating effects for New Yorkers. The bill will cut federal funding to the  New York State budget by approximately $10 billion annually and kick 1.5 million New Yorkers off their health insurance, more than doubling the statewide uninsured population. On top of the direct fiscal costs to New York State, the OBBBA will cut an additional $13 billion in funding to New York’s healthcare system.

One Big Beautiful Fiscal Crisis

July 2nd, 2025|

Yesterday, in a 51-49 vote, Senate Republicans passed the “One Big Beautiful Bill Act” (OBBBA), which, if passed by the House this week, will increase the national debt by approximately $4 trillion while leaving 11 million more Americans uninsured by 2035. The bill is significantly more draconian in its Medicaid cuts than the version passed by the House in May, cutting the program by $1 trillion over 10 years, rather than the $800 billion proposed in the House bill.

The House Medicaid Proposal Would be a Disaster for New York

May 15th, 2025|

In February, Congressional Republicans – including all seven New York representatives – voted for a budget reconciliation package requiring $880 billion in cuts to Medicaid over the next ten years. The reconciliation package set an overall target for spending reductions, but didn’t announce what specifically would be cut from the program. This week, House leadership finally revealed which program areas will be targeted.

Does New York State Have Universal Pre-K?

January 10th, 2025|

By the State’s account, it currently provides enough UPK funding to provide a UPK seat to every four-year-old in the State. Nevertheless, the program remains far short of universal, with incomplete coverage of four-year-olds outside of the state’s major cities and limited provision for three-year-olds across the state.

The Federal Housing Policy Landscape

December 9th, 2024|

State housing policy relies heavily on two federal programs that support housing affordability: the Low-Income Housing Tax Credit and Housing Choice Vouchers (also known as “Section 8” vouchers). These two programs underpin most affordable housing construction in the US and play an important role in the provision of affordable housing in New York State.

Making Sense of New York’s Medicaid Long-Term Care Spending

December 4th, 2024|

New York spends more on Medicaid long-term care than most states, but this higher spending is driven primarily by higher enrollment, particularly among seniors, rather than by higher per-enrollee spending. This high enrollment reflects policymakers’ decision to make long-term care, particularly home care, relatively accessible for working- and middle-class seniors.

Understanding Childcare Policy in New York

November 1st, 2024|

Childcare in New York State is unaffordable for many families, yet inadequately supports its workers. The State’s childcare costs are the third highest in the U.S., putting a strain on family budgets across the income distribution. The Bronx and Brooklyn have the costliest childcare as a share of family income of any county in the U.S.

The Medicaid MCO Tax Strategy

March 19th, 2024|

The legislative one-house budgets come out firmly for higher Medicaid spending, restoring most of the governor’s cuts and offering significant rate increases. But how will they pay for it? The Senate and Assembly budget memos propose to raise $4 billion a year through an obscure mechanism: A tax on Medicaid managed care plans, the private insurance companies which administer most of the state’s Medicaid program.

Consensus Economic and Revenue Forecast: Finding Quarters in the Couch Cushions

March 4th, 2024|

Over the past five budget cycles, the upward revisions to revenue established at the Economic and Revenue Consensus meeting has ranged from 0.6 percent to 1.9 percent of annual state operating funds. While these numbers may seem small in magnitude, the dollar amounts are significant when compared to current cost saving measures proposed in the fiscal year 2025 executive budget. Annualized revenue adjustments average $972 million over the past 6 budget cycles (excluding 2020) compared to a proposed $454 million in school aid cuts and $600 million in cuts to the homecare program CDPAP in this year’s executive budget.

New York State’s Reserves: A User’s Guide

September 21st, 2023|

New York State has generated significant budget surpluses in recent years as its economy recovered more quickly than expected from the Covid pandemic. Like most other U.S. states, New York saved a considerable portion of these surpluses in its fiscal reserve funds, building a buffer against fiscal stress during future economic downturns. With the Division of the Budget projecting an economic slowdown and depressed revenue in the years ahead, the appropriate use of the State’s fiscal reserves is now a subject of debate. This post will provide an overview on why fiscal reserves exist, and how they can be used to smooth out fluctuations in the economic cycle and maintain stable public services.  

Mind the Gap: When are State Budget Gaps a Concern?

September 5th, 2023|

New York’s fiscal year 2024 Enacted Budget Financial Plan, released June 2023, projected budget shortfalls for fiscal years 2025 through 2027. While future budget gaps are a perennial feature of New York’s budget forecasts, the most recent projected gaps exceed those generally projected in times of greater economic stability, aligning instead with gaps projected during economic downturns. These projections must be interpreted, however, in light of an improving economic outlook as well as the inherent uncertainty of fiscal forecasting.

Low Expectations: Understanding the NYC Budget Gap

May 23rd, 2023|

The Fiscal Policy Institute today released a new report, "Low Expectations: Understanding the NYC Budget Gap." Through an analysis of the past ten years of New York City outyear budget gaps, the report illustrates how the City uses conservative budget forecasting to protect against economic downturns, and outlines why lawmakers should not misinterpret outyear budget gaps as large impending deficits.

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