Nearly 450,000 New Yorkers are losing access to health coverage as of July 1, marking a significant impact of federal legislative changes on vulnerable populations. The shifts are a direct consequence of HR 1, legislation enacted a year ago and signed into law on July 4, 2025, referred to as the “Big Beautiful Bill.”
This federal law led to the withdrawal of funding that previously enabled New York state to receive tax credits for the health plans of certain legally present immigrants. Bill Hammond, a senior fellow at the Empire Center, a nonprofit think tank focused on New York public policy, explained that to address this funding gap, the state of New York has revised its eligibility criteria for the Essential Plan.
"They’re low-income people, and they’ll have to find a lot of money to pay for insurance,” Hammond stated. “It goes on the list of things they have to spend money on, like rent, utilities, and food.”
The changes stemming from HR 1 are anticipated to reduce the number of individuals receiving Medicaid nationwide. For instance, in the 41 states, including Washington D.C., that have expanded Medicaid under the Affordable Care Act since 2014, new federal requirements are set to take effect. Beginning January 1, 2027, adults enrolled in Medicaid in these expanded states must meet a work requirement of 80 hours per month. Additionally, the law mandates that states must now verify program recipients’ eligibility every six months, a shift from the previous annual verification process.
These federal actions underscore a broader trend of tightening eligibility and reducing support for health coverage initiatives, with low-income residents in New York being among the first to experience these consequences.