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.
FPI presented a briefing on the New York State budget for fiscal year 2026.
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.
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
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.
The statewide transition to PPL on April 1 risks being a catastrophe for home care workers – lowering wages while eliminating health insurance coverage for tens or even hundreds of thousands of workers. Neither PPL nor the state has offered any explanation of why this is happening or what PPL intends to do about it; many workers are currently seeking information about whether they will still have health insurance on April 1.
Healthcare didn’t take center stage in Governor Hochul’s State of the State address this week, but that doesn’t mean it won’t be central to New York politics this session. After all, rising healthcare costs are a key component of the affordability crisis squeezing New Yorkers, with premiums for individual and small-group health insurance set to increase by 12.7 percent this year.
FPI today released a report by Dr. Emily Eisner on the staffing crisis in Upstate New York's hospitals. The report finds that 90 percent of Upstate hospital shifts are current understaffed, and that an additional 5,000 Registered Nurses and 20,000 ancillary staff are needed to achieve safe staffing levels. As the report shows, chronic understaffing leads to a 14 percent rise in mortality risk for patients on the worst 10 percent of hospital units—about 280 additional patients death for every 100,000 hospitalizations.
Much recent reporting has focused on the growth of CDPAP in isolation, but this perspective exaggerates home care growth by ignoring the role of agency-model home care, which accounts for 44 percent of all Medicaid-funded home care in New York.
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.
The one-house budgets reflect a sharp disagreement between the Governor and the legislature on Medicaid spending. The executive budget proposes sharp cuts to several areas of Medicaid spending — most notably home care worker wages — and provides only limited support for financially distressed hospitals.
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.