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“For smaller, neighborhood-based practices—the backbone of primary care in immigrant communities—this level of disruption is an existential crisis: when community providers are destabilized, patient care suffers.”
A healthcare crisis is looming over New York’s Asian-American community—and it is already beginning to unfold.
As a primary care physician and endocrinologist practicing in New York City’s Chinatown and a member of the Coalition of Asian-American Independent Practice Associations (CAIPA), I see firsthand how recent federal changes to Medicaid and Medicare are destabilizing the safety net that hundreds of thousands of New Yorkers rely on.
The passage of H.R. 1 will result in sweeping losses of coverage, with an estimated 1 million New Yorkers projected to lose Medicaid eligibility. Immigrant communities and communities of color—including Asian-American and Pacific Islander (AAPI) New Yorkers—will be disproportionately harmed. Many of the patients from these communities are low-income immigrants with limited English proficiency, who face major barriers navigating complex social service and health care systems.
Washington created this crisis. Albany must now prevent it from becoming a catastrophe.
CAIPA is a physician-led network of 1,400-plus providers across more than 70 specialties, serving more than 500,000 patients across New York City. Nearly 90 percent of our patients depend on government programs such as Medicaid or Medicare. Many are seniors, working families, and recent immigrants. Many speak limited English or none at all. They rely on culturally competent, community-based care delivered in their language and grounded in an understanding of their communities’ unique health needs.
Under the new federal rules, an estimated 20 percent of CAIPA patients could lose their Medicaid or Essential Plan coverage. At the same time, total financial impacts on CAIPA’s independent physician practices are projected to reach approximately $135 million by 2027. For smaller, neighborhood-based practices—the backbone of primary care in immigrant communities—this level of disruption is an existential crisis: when community providers are destabilized, patient care suffers.
Those who remain eligible for coverage will face longer wait times, fewer accepting providers, and greater travel burdens. Preventive visits will decline. Chronic conditions will go unmanaged. Expensive emergency room visits will increase. Existing health disparities will deepen.
This is not only a moral concern—it is a fiscal one. Community-based, value-driven networks like CAIPA consistently deliver high-quality care at lower cost with emphasis on easy access to services, chronic disease management, and coordinated primary care. Through value-based care programs, CAIPA providers achieve over $200 million in annual savings for Medicaid by helping patients stay healthy and reducing avoidable hospitalizations. Weakening this infrastructure will ultimately drive costs higher for taxpayers.
We recognize that Medicaid represents a significant share of New York’s budget, and Gov. Kathy Hochul is right to focus on efficiency and responsible stewardship of public dollars. But efficiency cannot mean undermining access—especially at a moment when federal retrenchment is already stripping coverage from vulnerable New Yorkers.
Albany has tools to respond. First, the state must protect and strengthen Medicaid and Essential Plan coverage to prevent further erosion of access in immigrant and working-class communities.
Second, lawmakers must restore funding for the state’s Quality Incentive Program (QIP), which rewards providers who deliver high-quality outcomes for Medicaid patients. Over the past few years, funding for QIP has been cut from $300 million to $50 million. Now, this program is at risk of losing its funding entirely.
Thankfully, the state legislature has provided a critical first step in their independent budget offerings, with the Assembly and Senate each indicating a commitment to increased funding. These are concrete recognitions of the vital role community-based medical care plays in keeping New Yorkers healthy. Our ultimate goal is to see full funding restored, and we are hopeful that the final state budget will deliver it.
These dollars are not bonuses—they are resources that pass onto the frontline providers and allow practices to expand preventive care, improve chronic disease management, hire multilingual staff, and keep patients out of hospitals. Restoring and making this funding permanent would stabilize community providers at a time when federal policy is destabilizing them.
Thirdly, we urge the state to maintain and deepen its commitment to value-based care programs, which is one of the most effective ways to invest in local healthcare ecosystems, strengthen community infrastructure, and support long-term sustainability in historically underserved neighborhoods. Value-based care programs are mechanisms to align care and financial incentives, rewarding providers who successfully keep patients healthy and out of high-cost settings.
AAPI New Yorkers are the fastest-growing demographic group in our state. They deserve a healthcare system that protects their access to care, not one that pulls it away.
CAIPA and other community-based providers stand ready to partner with Albany to protect patients while continuing to deliver high-quality, cost-effective care. But the lethal impact of federal rollbacks and deep state funding cuts will lead to community outcomes that none of us can accept.
The crisis was created in Washington. With our allies in Albany, we believe a fiscally responsible solution can be found to ensure some of our most vulnerable neighbors continue to receive the care they need.
Dr. George C.K. Liu is president and CEO of Coalition of Asian-American Independent Practice Associations (CAIPA).