BILL NUMBER: S9589
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the public health law and the social services law, in
relation to coverage for New Yorkers losing insurance due to the imple-
mentation of HR 1
 
PURPOSE:
The purpose of this bill is to maintain access to health insurance for
New Yorkers who would otherwise lose eligibility for reduced cost health
insurance or publicly subsidized financial assistance to purchase health
insurance coverage due to the implementation of HR 1.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 of the bill creates a new section 268-i of the public health
law to amend the New York State of Marketplace implementation statute.
It authorizes the Marketplace to establish and administer a state-only
funded premium assistance program for lawfully present immigrants who
have been eligible between 2014 and 2026 for federal Advance Premium Tax
Credits and cost-sharing reductions to assist with the purchase of
health insurance coverage. Changes to federal law under HR 1 terminate
the eligibility for lawfully present immigrants for federally funded
financial assistance effective January 1, 2027. This section authorizes
the Marketplace to offer equivalent financial assistance to lawfully
present immigrants who will be rendered ineligible under HR 1. The
amount of State level assistance would be equivalent to the amount
offered by the federal level of assistance pursuant to the Affordable
Care Act's premium assistance and cost-sharing schedule.
Sections 2 and 2-a of the bill amend paragraph d of subdivision 3 of
369-gg of the Social Services Law, which establishes the Basic Health
Program (Essential Plan). The bill would eliminate obsolete language
related to the coverage of individuals at or below 250% of the federal
poverty level (FPL). It would also authorize New York State to provide
state-only funded Essential Plan coverage to lawfully present individ-
uals who are not eligible to participate in the program due to their
immigration status. Additionally, these sections authorize the state to
continue to provide Essential Plan coverage to individuals with incomes
between 200% and 250% of FPL.
Section 3 and 3-a of the bill modifies subdivision 5 of section 369-gg
of the social services law to clarify that New York state does not need
to seek federal permission related to cost-sharing requirements or
premiums for individuals covered under the Essential Plan when using
state-only dollars. It also makes some non-substantive technical
corrections.
Sections 4 and 4-a of the bill amends subdivision 7 of section 369-gg of
the social services law to make some non-substantive technical
corrections.
Section 5 of the bill is the effective date.
 
JUSTIFICATION:
New York State has historically maintained a high rate of health cover-
age while striving towards a holistic approach to healthcare, which
promotes access and affordability, and generates better outcomes for
everyone living in the state. Recent studies have shown that the rate of
uninsured people in New York State was less than 5%, as of 2023, one of
the lowest in the nation.
Due to H.R.1 and other federal inaction, billions in funding to support
New York's Essential Plan that is serving approximately 1.7 million New
Yorkers was intentionally eliminated. These cuts to this working class
health program were justified to help offset lost revenue from tax cuts
for the wealthiest of individuals in our society that were advanced by
the Trump Administration and Congressional Republicans, including all
seven of New York's Republican congressional representatives. In light
of these devastating cuts, which would have made the Essential Plan
insolvent, actions were recently undertaken by Governor Hochul's admin-
istration to unwind the expanded 1332 waiver version of the Essential
Plan to return it to the original program. This action, while providing
fiscal stability for the program's continued operation, had the unfortu-
nate consequence of causing the expanded populations being served under
the 1332 waiver to face a loss of coverage beginning July 1, 2026.
It is estimated that approximately 450,000 New Yorkers will lose cover-
age due to this forced federal unwind. To place this coverage loss into
perspective, a family of four with two children and a total household
income of $66,000-$82,500 will now be ineligible for healthcare coverage
under the Essential Plan because of H.R.1. A single individual making
$31,920 to $39,900 will also be ineligible. A lawfully present immi-
grant family of four making $43,890 to $66,000 will also be ineligible,
as will single lawfully present immigrants making $21,227 to $31,920.
It is too bitter of a pill to swallow that healthcare for working class
families was cut by federal Republicans to give tax breaks to the
ultrawealthy in our country, but it is the reality. Levels of wealth
inequality in our country dwarf the Great Depression and rival levels
seen in the late 1700s in France. The $7.5 billion loss in funding to
the Essential Plan is roughly equivalent to the cost the federal govern-
ment spent bombing Iran for a week.
Healthcare costs are one of the single largest drivers of unaffordabili-
ty in our country. An analysis by the Kaiser Family Foundation found
that per capita healthcare spending in New York in 2020 was $14,007. It
is likely that costs have grown since then. Healthcare costs are one of
the single largest drivers of unaffordability in our country.
Additionally, a 30 year longitudinal study by the CATO Institute found
that, nationally, immigrants have created a total fiscal surplus of
$14.5 trillion, including $3.9 trillion in savings on interest on the
debt. This demonstrates that immigrant families give more than they
take. This bill would provide an affordable coverage option to immigrant
populations in New York to entice these families to remain here and
encourage new immigrants to seek out New York as a place to make their
home. The presence of immigrant populations continues to strengthen our
economy, increase tax revenue, and address significant workforce chal-
lenges that we are facing in this state.
This bill would combat uninsured rates, bolstering the healthcare system
as a whole in New York State and providing access to care for working
families in need. We have an opportunity to mitigate the harm on those
impacted by the dramatic effects of federal cuts on New Yorkers' health-
care. The cost of private health insurance is high and is only projected
to increase again this year, making it unattainable for many New York-
ers. Keeping New Yorkers insured helps patients and providers, in
support of the entire healthcare system. This bill is a crucial step
toward the consideration of healthcare as a right, not a commodity, and
it should be granted to everyone, regardless of their status or their
income.
 
LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
Undetermined
 
EFFECTIVE DATE:
This act takes effect July 1, 2026.

Statutes affected:
S9589: 369-gg social services law, 369-gg(5) social services law, 369-gg(7) social services law