New York Scrambles to Save Essential Health Plan Covering 1.7M

Federal cuts threaten coverage for lawfully present immigrants in the state's affordable insurance program.

Published on Feb. 19, 2026

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New York Governor Kathy Hochul is working to preserve the Essential Plan, a publicly funded health insurance program that provides affordable coverage to 1.7 million residents who don't qualify for traditional Medicaid. Recent federal cuts have put the program at risk, with lawfully present immigrants comprising 43% of enrollees. Hochul has proposed changes to the plan, but they require federal approval, and the state is preparing a contingency plan in case the proposal is rejected.

Why it matters

The Essential Plan is a crucial safety net for New Yorkers who struggle with high healthcare costs but don't qualify for Medicaid. Its potential loss would leave an estimated 1.2 million people uninsured and cost the state over $2 billion. Community health centers that serve Essential Plan members are also bracing for increased demand and financial strain.

The details

The federal cuts amount to $7.5 billion annually, roughly half of the Essential Plan's funding. These reductions are largely due to the Trump administration's decision to eliminate federal funding for legally present immigrants who are not citizens. New York faces a unique challenge, as a long-standing court decision mandates the state provide equal insurance coverage to lawfully present immigrants as it does to citizens.

  • Recent federal cuts stemming from a domestic policy bill pushed through Congress last year have thrown the Essential Plan into jeopardy.
  • Hochul has proposed reverting to a previous version of the Essential Plan, limiting eligibility to New Yorkers earning up to 200% of the federal poverty level.
  • If Hochul's proposal is rejected, the state is preparing for a 'worst-case scenario': shutting down the Essential Plan entirely by July.

The players

Kathy Hochul

The Governor of New York who has proposed changes to the Essential Plan to preserve coverage.

Edward Roller

A Long Island printing company employee and one of the 1.7 million New Yorkers who rely on the Essential Plan for affordable healthcare.

Carolina Fortin-Garcia

A spokesperson for the U.S. Centers for Medicare and Medicaid Services, who stated the agency will ensure federal taxpayer dollars are only used for lawfully eligible individuals.

Gustavo Rivera

A New York State Senator who highlighted a potential source of budget relief through an obscure tax loophole.

Community Health Care Association of New York State

An organization representing community health centers that serve Essential Plan members and are bracing for increased demand and financial strain.

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What they’re saying

“I'm in my early 60s... If I got thrown off my health insurance, it would be a freaking nightmare. It would be a total catastrophe.”

— Edward Roller, Printing company employee (newsy-today.com)

“We must ensure federal taxpayer dollars are only used only for individuals who are lawfully eligible for coverage.”

— Carolina Fortin-Garcia, Spokesperson, U.S. Centers for Medicare and Medicaid Services (newsy-today.com)

What’s next

The judge in the case will decide on Tuesday whether or not to allow the state's proposed changes to the Essential Plan.

The takeaway

The potential loss of the Essential Plan would have far-reaching consequences, leaving an estimated 1.2 million New Yorkers uninsured and straining the state's healthcare system. This case highlights the complex interplay between federal policies, state obligations, and the need to ensure affordable healthcare access for all.