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According to state officials, almost 200,000 New Yorkers have been impacted by federal cuts to the Essential Plan that made certain low-income working residents ineligible. Some only found out after going to the doctor or hospital.
Last month, Jorge had been working all day installing conduits for electrical cables until he could no longer lift his left arm, and had to go to the emergency room.
“When you arrive, they ask for your insurance card. I gave it to them,” Jorge, who asked that his last name be withheld for privacy reasons, said in Spanish.
He had an X-ray. His bones looked unbroken. His pain was muscular, so he got some medicine.
“And then, later, out of the blue, I got a bill saying I owe $500,” said Jorge, 56. “I went to the hospital and asked why they were charging me. ‘Your coverage has expired; you don’t have insurance,’ they told me.”
Starting on July 1, New Yorkers earning between 200 and 250 percent of the Federal Poverty Level—about $31,920 to $39,900 for a single person—began to lose coverage under the Essential Plan, which provided $0 monthly premiums and very low cost-sharing health insurance to low-income working residents.
As a result of federal cuts included in the omnibus “One, Big, Beautiful Bill,” people like Jorge are no longer eligible, and will have to find a new paid plan—or lose their health coverage entirely.
Before the cuts, 1.7 million New Yorkers depended on the Essential Plan, and the state estimated that 450,000 would lose it as a result of the federal changes.
According to the New York State Department of Health (NYSDOH), over half of those at risk (252,000 people, or around 56 percent of those impacted) have kept some form of insurance: 183,000 went to Medicaid or another Essential Plan, and 59,000 went to a private health plan sold through the NY State Marketplace, as of July 31.
As for the other 198,000 who haven’t found insurance and are at risk of losing it, the department didn’t say much. When asked, officials did not provide figures on the race or ethnicity of the people who have lost coverage. But a 2023 report from the state found that 28 percent of all Essential Plan enrollees at the time identified as Hispanic, and 22 percent said Spanish was their preferred written language.
“This is a challenging time for those impacted by the new laws,” Danielle R. De Souza, senior public information officer at the Department of Health, said in a statement. “We are committed to providing personalized guidance to these New Yorkers as they transition to new plan options through our enrollment assistors, ensuring advance notices and providing resources and information to make the path to new coverage as clear and as smooth as possible.”
In the meantime, many Latinos, like Jorge, are learning about the change just when they need coverage most.
“I have varicose veins, too. I had scheduled an appointment [for July],” said Jorge. “And I went, and they turned me down.”
Both advocates and public officials explained that people who lost their coverage have until Aug. 30 to enroll in a plan through NY State of Health, which could cost on average $200-$250 a month, or become uninsured.
Organizations that work with Latinos said they have seen a sharp increase in the number of people seeking help after losing their insurance.
“A tsunami of people we’ve received,” said President of the Latino Commission on AIDS Guillermo Chacón.
Bethsy Morales-Reid, Hispanic Federation’s vice president for program strategy, said they have noticed a 20 percent increase compared to last year, and that the main concern is a lack of alternative insurance options, which many find unaffordable.
“Some have also indicated that they may need to delay medical care while they determine what coverage they will obtain,” Morales-Reid said. “At a time when many people are already struggling to balance budgets, pay rent and the rising cost of food, healthcare is adding unexpected expenses that are difficult to include.”
Before the changes took effect, NYSDOH began sending notices to the 450,000 impacted Essential Plan enrollees. Jorge said he did not receive it, or any of the text messages or email alerts.
Then in May, the department sent renewal notices. But many people needed help understanding those materials, advocates and public health organizations said.
“The complexity is that these notices and letters include a lot of mandatory legal language that’s difficult to interpret and therefore, it’s difficult to understand if you are impacted, why you are impacted, and what actions you can take,” said Cassaundra Howell, president and CEO of Public Health Solutions, one of the largest public health nonprofit organizations in the city.
Advocates said that federal cuts are affecting a group known as the “working poor,” who earn just enough to make ends meet, but not enough to afford insurance on their own.
Moreover, the changes will mean new deductibles and copays that many lower-income Latino families cannot afford, while also disrupting care for a population that already has a high rate of uninsured individuals.
Among the affected groups are recipients of Deferred Action for Childhood Arrivals (DACA)—undocumented immigrants who came to the U.S. as children and were eligible for work authorization and certain deportation protections.
In 2023, New York State received federal government approval to fund Essential Plan coverage for DACA-eligible people with incomes below 250 percent of the federal poverty level.
With the new federal rules, DACA recipients who are not pregnant also lost coverage.
“It’s very upsetting that those folks don’t have access to anything,” said Elisabeth Benjamin, vice president of health initiatives at Community Service Society (a City Limits funder).
Advocates are beginning to sound the alarm, warning that a health crisis is looming due to budget cuts and the loss of coverage for thousands of people. At the same time, low-income Latinos are facing the fallout from other federal cuts and changes to the safety net, including new barriers to maintaining food stamps.
“This could lead to an even worse health crisis in this country,” said Lorena Kourousias, executive director of Mixteca Organization.
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