Understanding the Impact of the Federal Reconciliation Bill on New York
The sweeping changes contained in the Congressional Budget Reconciliation Bill 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.
See how your premiums could change depending on where you live. Visit our NY Healthcare Impacts by Congressional District Map.
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 over 730,000 individuals losing their Essential Plan coverage starting in 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.
QUALIFIED HEALTH PLAN (QHP)
- An estimated 65,000 – 80,000 New Yorkers may lose their coverage.
- 140,000 enrollees who receive tax credits may see their costs increase by 38 percent.
- 100,000 enrollees could see their rates go up by at least 5 percent.
Deferred Action for Childhood Arrivals (DACA)
DACA individuals are no longer eligible to enroll in a Qualified Health Plan through NY State of Health. If a DACA individual was enrolled in a Qualified Health Plan through NY State of Health, coverage will be terminated as of August 31, 2025.
DACA individuals can enroll into a Qualified Health Plan directly with a health insurance company.
If a DACA individual chooses to enroll directly with the same health plan they enrolled with through NY State of Health, that plan will apply any cost-sharing payment already made to their new coverage. This means that any out-of-pocket costs paid, including copayments, coinsurance, and deductible will apply to the new Qualified Health Plan maximum out-of-pocket limit.
Customer Service Phone Numbers and Provider Network URLs for each Qualified Health Plan can be found here.
DACA individuals can contact an enrollment assistor who can help review options including enrolling in coverage directly with a Qualified Health Plan.
For those who have concerns about their immigration status or are worried about coverage through the NY State of Health Marketplace, speak with an immigration expert before making any decisions.
Free or low-cost, high-quality legal representation/counseling services may be available through the following agencies:
- For New York City Residents: Legal Aid Society at 212-577-3300 or New York State Office for New Americans at 1-800-566-7636
- For non-New York City Residents: New York State Office for New Americans at 1-800-566-7636
Learn More:
- Download our Fact Sheet
- Read the latest press releases
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