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Understanding the Impact of H.R.1 Legislation on New York
The sweeping changes contained in the federal H.R.1 legislation represent more than just policy adjustments — they present substantial challenges to the health care infrastructure that millions of New Yorkers rely on for their well-being. As the full scope of this legislation becomes clear, we want to keep you updated on the wide-ranging consequences that will affect every level of our health care system, from individual families to hospitals.
Watch for our messages to learn what this could mean for you.
We will continue to update this page as more information is made available to NY State of Health.
How could my health insurance change in 2026?
ESSENTIAL PLAN
The legislation will have devastating effects on New York’s Essential Plan, which currently serves 1.6 million New Yorkers who depend on this affordable coverage option:
- Significant changes to eligibility for lawfully present immigrants (EP 3 and EP 4)
- This will result in an estimated 450,000 individuals losing their Essential Plan coverage starting in July 2026. New York State is reviewing options for these individuals.
- There will be new limits on Marketplace ability to leverage trusted data sources needed to verify the consumer’s information.
MEDICAID
The impact of the bill extends to New York’s Medicaid program, which provides comprehensive health coverage to more than 7.5 million New Yorkers:
- Between 1 and 1.5 million Medicaid enrollees may lose insurance due to new paperwork and work requirements.
- Nearly 2 million enrollees will have to renew their coverage twice a year instead of annually and face additional cost-sharing requirements.
- Mandatory work requirements and other reforms will increase Medicaid administrative costs by at least 20 percent.
Learn More:
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