NEW YORK (BLOOMBERG) -- Nearly 1 million New Yorkers are expected to lose health coverage as a result of President Donald Trump’s federal budget, a shift that will strain the city’s struggling public hospital system.
Under eligibility changes enacted as part of Trump’s One Big Beautiful Bill Act, an estimated 800,000 New York City residents are expected to lose Medicaid coverage, state Comptroller Thomas DiNapoli said in a report Wednesday. An additional 150,000 residents will likely lose coverage from the state’s Essential Plan, which provides health care to low-income New Yorkers.
The growth in the number of uninsured New Yorkers will have a disproportionate impact on Health and Hospitals, the city’s system of 11 publicly run hospitals, DiNapoli said in the report.
Federal cuts and changes to Medicaid eligibility “will hurt the agency’s bottom line, even as a growing uninsured population is likely to push more patients into its facilities,” DiNapoli said. Any increase to the uninsured rate “will create a financial burden for H+H since its primary mission is to provide care regardless of a patient’s ability to pay,” he said.
H+H, the largest public hospital system in the US, already serves a significant population of the city’s Medicaid and uninsured patients, including many undocumented immigrants. Last year, Medicare and Medicaid patients made up 84% of patient discharges at H+H hospitals, and 72% of the system’s revenue came from Medicaid or the Essential Plan.
The H+H system has long struggled to stabilize its finances. Since 2016, it’s been operating on a savings plan that depends heavily on the city’s ability to obtain supplemental federal Medicaid payments. Those payments are volatile because they have to be approved by the state and federal government, and can be “inconsistent and often delayed,” DiNapoli said.
“H+H will likely need to revisit its cost-cutting plans that could lead to some difficult choices by consolidating and/or eliminating services,” DiNapoli said.
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