While most coverage of the Republican reconciliation proposals has focused on Medicaid, the largest financial impact on New York’s healthcare system comes from another program – the Essential Plan. The current House Republican budget proposal threatens to cut the program by $7.6 billion or 57 percent, while increasing state Medicaid costs by $2.7 billion.
A reduction of $10 billion in federal Medicaid funding would result in the direct loss of over 78,000 jobs in healthcare across the state and over 136,000 additional jobs lost through economic spillovers.
In this emergency briefing, FPI's health policy director, Michael Kinnucan, discusses the current budget reconciliation proposals to cut Medicaid and how these policies will impact New York State.
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.
The Enacted Budget, while it contains few significant new policy initiatives, allows state spending to recover some of the lost ground from a decade of austerity policies in the 2010s. The most important policy measure in the budget is a long overdue increase in unemployment insurance benefits that will better prepare the State economy for a possible recession (discussed in detail below). The bad news is that the Enacted Budget contains serious fiscal errors, including permanent tax cuts and one-time payments that will cost $3 billion in fiscal year 2026 alone.
FPI presented a briefing on the New York State budget for fiscal year 2026.
Stagflation is the deadly combination of low growth and high inflation. With the implementation of sweeping and high tariffs by the federal government, most economists and forecasters currently predict something resembling “stagflation” on the Unites States’ economic horizon. But New York may have already entered a period of stagflation: New York’s economy has recovered the jobs lost during the Covid-19 pandemic, but lags the economic growth seen in the rest of the country.
Budget agreement includes serious fiscal missteps that will undermine the State’s ability to weather federal funding cuts
Republicans have argued that they can cut Medicaid without cutting services to vulnerable populations by cutting “waste, fraud and abuse”; by targeting people who are not, or in their view should not be, eligible for the program; and by reforming complex state financing mechanisms like provider taxes.
Thursday Briefing, April 17 https://youtu.be/AOGhN5R9myw
The Trump Administration Just Cut Hundreds of Millions of Dollars a Year from New York’s 1115 waiver – and that could be just the beginning
The Adopted Budget should anticipate realistic revenue and spending on core services while maintaining a flexible reserve to prepare for fiscal uncertainty. The budget response put forward by the City Council takes important steps toward these goals.
Final budget must omit tax cuts, shore up funding for essential services – transit, childcare, housing – and fix unemployment insurance
New York State legislators have the opportunity to address private sector healthcare affordability by passing the Fair Pricing Act (S.705/A.2140). The act would address the root cause of rising healthcare costs by regulating hospital prices, which are the key driver of spiraling healthcare inflation.
New York State’s fiscal year 2025 ended on March 31 with good news for the State’s coffers: Total receipts for the year came in $6.0 billion higher than forecast as of January 2025, and a full $12.3 billion higher than forecast at the beginning of the fiscal year in May 2024. As we enter the final stage of budget negotiations, this additional revenue will allow the State to prepare for federal funding cuts by investing in the MTA, childcare, NYCHA, and other critical services and infrastructure.