July 11, 2025
Attached please find a flyer from our friends at the Therapeutic Communities Association of New York and OASAS regarding TCA’s upcoming Residential Summit to be held on August 27-28. Note: The room block for this event to be held in downtown Albany expires on 8/1.
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Following is a letter sent to all NYS navigators (navigators assist New Yorkers with accessing health insurance through the NYS of Health Insurance Exchange and other public insurance programs) regarding changes as result of recent CMS adoption of a Final Rule governing the Marketplace:
Dear Assistor:
We are writing to provide you with important information regarding the recent Centers for Medicare & Medicaid Services (CMS) “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability Final Rule”.
The Department of Health is providing guidance to assistors on two (2) main changes that impact NY State of Health enrollees.
- The first change directly impacts the Deferred Action for Childhood Arrivals (DACA) population and their eligibility for coverage in a Qualified Health Plan (QHP) through NY State of Health.
- Under the final rule, consumers who are DACA, will no longer be eligible for Qualified Health Plans (QHPs) due to their immigration status. This change applies to all QHP eligibility with or without financial assistance.
- Consumers who are DACA and who are currently enrolled in a QHP through NY State of Health, will be disenrolled, but we are still determining the effective dates of these changes. This could happen as early as August 31, 2025. These consumers will receive notices in advance and may also receive emails and text reminders.
- This change does not apply to consumers who are DACA and enrolled in Medicaid or the Essential Plan through NY State of Health. At this time, DACA recipients enrolled in programs other than Qualified Health Plans are not impacted.
- Consumers who are DACA can still enroll in “Off-Marketplace” plans purchased directly through a health plan.
- The second change reinstates the reasonable opportunity period to document income discrepancies from 150 (90 + 60) days back to the original 90 days, required by law for Essential Plan (EP) and for QHP eligible consumers. NY State of Health will no longer be extending a consumer’s opportunity period to document their income the additional 60 days when they are temporarily eligible for EP or a QHP.
In addition to the Marketplace Integrity and Affordability Final Rule, as of July 3, 2025, the House voted to approve the Reconciliation Bill and the President signed the bill into law Friday, July 4, 2025. This law will also impact consumers’ coverage in different ways in the future.
Federal Bill Impact Consumer Fact Sheet.pdf (English)
Federal Bill Impact Consumer Fact Sheet – Spanish.pdf (Spanish)
We acknowledge that there is a lot of information out there on how the bills could impact consumers. NY State of Health is, as always, working hard to minimize the impact of these changes on New Yorkers. We will keep you updated on these policy changes as often and as quickly as possible.
Additionally, we will continue to provide timely information to help your consumers, including email communication, resources, and talking points.
In addition to direct communication from our office, NY State of Health will be posting pertinent updates to the following site: https://info.nystateofhealth.ny.gov/stay-connected.
If you have any questions about this information, please do not hesitate to reach out.
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New Analysis from the Rockefeller Foundation re: the Federal Budget Reconciliation Bill (that is now law) and its impact on Healthcare in NY
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An Analysis of the One Big Beautiful Bill Act (OBBBA’s) Impact on Healthcare for New YorkRecent actions taken by the Trump administration and the Reconciliation bill approved last week by Congress and signed by the president will significantly alter New York’s healthcare programs and funding. In this follow-up to our report, How Health Policy Changes in Washington Could Affect New York, we review which proposals in the One Big Beautiful Bill Act made their way into the final bill and what this will mean for New Yorkers and New York’s $300 billion healthcare economy. Continue Reading… ——————————- AG Press release: |
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(Politico, 7/11 regarding yesterday’s press availability with NYS Director of Budget Blake Washington)
$750 million.
That’s the hole that New York will be forced to fill as early as January thanks to the megabill signed into law July 4, according to Budget Director Blake Washington.
An estimated 500,000 legally authorized immigrants will be thrown off the state’s Essential Plan at the start of the year, requiring the state to use its own money to cover them through Medicaid.
The cost will amount to roughly $3 billion on an annual basis.
Not to mention, the state anticipates spending upwards of $500 million over several years to stand up a system for administering the megabill’s new Medicaid work requirements, Washington said.
“There’s no way the state of New York can finance what’s been foisted upon us,” Washington told reporters Thursday. “There’s no way any state can do that, frankly. There’s going to be hard decisions moving forward.”
Gov. Kathy Hochul opposes tax hikes, but will face pressure from left-flank state lawmakers as New York grapples with one of its toughest budget years since Covid.
New York’s budget gap was previously projected to be $7.5 billion after state officials approved a $254 billion spending plan in May.
Officials are still assessing how the federal tax-and-spend package will expand that hole; early estimates show the gap nearly doubling as a result.