Nearly 450,000 New Yorkers Are Losing Health Coverage July 1

The changes are coming because of HR 1, known as the “Big Beautiful Bill” passed a year ago and signed into law on July 4, 2025. As part of HR 1, the federal government withdrew the funding that had allowed New York state to receive tax credits that paid for the health plans of certain legally present immigrants, says Bill Hammond, a senior fellow at the Empire Center, a nonprofit think tank that studies New York public policy. To help make up for that funding gap, the state of New York changed who is eligible for the Essential Plan. 

“They’re low-income people, and they’ll have to find a lot of money to pay for insurance,” says Hammond. “It goes on the list of things they have to spend money on, like rent, utilities, and food.”

Other changes stemming from HR 1 are expected to limit the number of people receiving Medicaid across the country. 

For instance, 41 states (including D.C.) have expanded Medicaid since 2014 under the Affordable Care Act, allowing adults with incomes up to 138% of the federal poverty level to gain coverage. But HR 1 requires that as of Jan. 1, 2027, adults enrolled in Medicaid in states that have expanded the program must meet an 80 hours per month work requirement. The law also requires that states must verify program recipients’ eligibility every six months instead of every year.