Lance's Corner

Governor Hochul Updates Health Care Effects of Proposed Federal Budget Legislation

Jun 9, 2025

Per the notice below, Governor Hochul has issued updated data on the health care effects of the proposed federal budget legislation.

Governor Hochul Unveils New Data Showing Massive Increases to New Yorkers’ Monthly Health Insurance Premiums if GOP’s ‘Big Ugly’ Reconciliation Bill Becomes Law

More Than 240,000 New Yorkers Would Experience Increased Premiums From Elimination of American Rescue Plan Enhanced Tax Credits and Additional Changes

Average Monthly Costs Could Rise by More Than $228 — an Increase of 38% for a Couple — Due to Elimination of Enhanced Tax Credits

Estimated 65,000 to 80,000 New Yorkers, Approximately One Third of Enrollees, Could Lose Individual Marketplace Coverage

Regional Breakdown of Cost Increases Available Here

Congressional District Breakdown Available Here

Governor Kathy Hochul today released new data showing the massive impact the GOP’s ‘Big Ugly’ Reconciliation Bill would have on New York families.  The latest bill threatens to severely disrupt health coverage for millions of New Yorkers.  In addition to increasing the number of uninsured by 1.5 million and stripping $13.5 billion in annual funding from New York’s healthcare system, the bill would trigger steep increases in private health insurance premiums for vulnerable New Yorkers and impose excessive burdens on consumers enrolling through NY State of Health, the State’s official health plan marketplace.

“The GOP’s Big Ugly bill would slash health care coverage for millions of New Yorkers and raise monthly costs by hundreds of dollars,” Governor Hochul said.  “If New York’s Republican delegation won’t stand up for their own constituents, I will.”

Health care providers, insurers and state leaders across the country are sounding the alarm over the proposed legislation, which would slash billions in federal health care support.  In addition to jeopardizing and in some cases entirely eliminating coverage for New York's 1.6 million Essential Plan enrollees, the bill would trigger steep increases in costs for many New Yorkers who purchase private health insurance.  The elimination of American Rescue Plan enhanced premium tax credits, alone, will increase net cost of coverage across the State by an average of 38 percent for 140,000 low-income individuals and families purchasing plans through the state’s marketplace.  This equates to an increase in cost of $114 per month for an individual and $228 per month for a couple.  See below for a summary of expected premium increases due to the elimination of American Rescue Plan enhanced premium tax credits across the State:

Region Average Monthly Cost Increase For a Couple ($) Average Monthly Cost Increase For a Couple (%)



New York City $211 38%
Mid-Hudson $206 31%
Long Island $219 32%
Capital Region $231 33%
Western New York $267 38%
Central New York $256 43%
Finger Lakes $248 42%
Mohawk Valley $270 49%
Southern Tier $265 48%
North Country $253 44%
Statewide $228 38%

The combined impact of the elimination of enhanced premium tax credits and additional provisions of the proposed U.S. House Republican reconciliation bill will push more healthy consumers out of the insurance market, leaving behind a less healthy population and driving further rate increases.  This cycle will result in spiraling insurance costs and lack of access to coverage for individuals and families.

New York State Health Commissioner Dr. James McDonald said, “The proposed cuts to federal health care support hurt everyone.  These cuts take health insurance away from working New Yorkers.  They undermine the progress we've made in providing affordable and accessible health insurance to New Yorkers.  When people lose health insurance, they risk going without needed health care or suffering financial hardship.”

In addition to increasing premiums for low-income individuals and families who qualify for tax credits, it is estimated that the elimination of those tax credits will increase insurance rates for the more than 100,000 New Yorkers who purchase coverage in the individual commercial market but do not qualify for tax credits.  Insurers have estimated that those consumers and families will face a 4.3 percent increase in their insurance rates next year solely due to the elimination of these credits.  Early estimates also indicate the proposed bill could result in 65,000 to 80,000 people — approximately one-third of enrollees in the individual market — losing their coverage.  Many more consumers will experience significant new red tape that will make it harder to enroll in and renew coverage.  The proposed bill would also strip New York of its flexibility and autonomy in running its own marketplace and serving the needs of its residents, imposing onerous and costly new administrative burdens on the State.  The State anticipates more than $10 million in new administrative costs to implement the changes required by the bill.

NY State of Health Executive Director Danielle Holahan said, “We have tremendous concerns about the compounding effects of this bill especially when combined with the expiration of the premium tax credits.  Reducing eligibility for the financial assistance that helps New Yorkers afford care means people end up paying more for doctor visits, medications, and mental health care.  Already struggling providers, especially in rural parts of the state, might not be able to sustain operations under this proposal, further restricting New Yorkers’ access to care.”

New York has had tremendous success over the past 12 years in operating its marketplace — with 6.7 million individuals currently enrolled in coverage — and has achieved a statewide uninsured rate of less than 5 percent, the lowest rate amongst large states across the country.  This bill would reverse decades of progress in expanding coverage and making health care more affordable and accessible in New York and jeopardize the health of consumers across the State.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc