Many New Yorkers were forced off of their state-sponsored health insurance as a result of cuts made under the One Big Beautiful Bill Act, which was signed by President Donald Trump last year
New York’s Essential Plan covers lower-income families and immigrants who do not qualify for Medicaid. Under federal rollbacks, 450,000 New Yorkers lost their expanded eligibility for Essential Plan coverage on July 1.
Earlier this month, WAMC's Lucas Willard spoke with Grace McIntyre, a contributing writer for the Adirondack Explorer, she reported on how health plan rollbacks are impacting northern New York.
INTERVIEW TRANSCRIPT
Editor's Note: This conversation has been lightly edited for clarity.
Grace McIntyre: Issues with healthcare access and affordability are not unique to the North Country. But that said, we do have our regional challenges. Obviously, in a rural area like the Adirondacks, we have lots of small business owners and people who work for them. We also have a lot of seasonal tourism jobs and people who may not work super consistent jobs throughout the year. Maybe they work one job in the spring, one job in the summer, and usually they're not going to be getting health insurance through their employer. So these are all people who are likely to need some sort of marketplace insurance to buy their own insurance. If they're low enough income, like many of them are, they may qualify for the Essential Plan. So that's part of why we were so affected by this particular cutback. But the more broad concerns with healthcare access are the downstream effects of both the Essential Plan, but also, looking ahead to Medicaid cuts and people potentially losing their Medicaid coverage.
Lucas Willard: In your piece that was recently published in the Adirondack Explorer, you focus on the Fitzgerald family. Can you tell me about the Fitzgeralds and some of the challenges that they're now trying to navigate.
McIntyre: The Fitzgeralds are a somewhat typical case of a working family up here. Sarah works for one of our local childcare providers, which is attached to one of our Catholic churches in Lake Placid. Her husband works at one of our long-term care facilities, and both of these jobs are not very high-paying jobs, but they are both extremely essential. We have a huge shortage of childcare and affordable childcare, especially, and we have a shortage of places where older people can go or people who are recovering can go to get long-term care. In this sense, they're essential workers. However, they've had kind of ups and downs with their insurance for a little while. They were on Medicaid, and when they no longer qualified for that, they were able to go onto the Essential Plan. That was great for them for a couple of years, but then they were in that sliver of people on the higher end of the income that qualified for the Essential Plan.
When the Essential Plan was rolled back this year, they no longer qualified for it, and so they were scrambling. They explored getting insurance through Sarah's husband's work, but that was just not affordable. It would have amounted to about half of his paycheck, so they went kind of back to the drawing table and were able to find other marketplace insurance. Because of the Affordable Care Act subsidies, they were able to still get some financial help with that but they went from paying no premium to paying around a $400 premium. That's a huge deal for a family with two kids who are both working essential but not super high paying jobs.
Willard: Can you tell me about any efforts ongoing in the North Country to try to change things. One of the organizations that you mentioned is Healthcare Coalition for the North Country. But with the challenges that are facing healthcare right now, and we are about to have a divided government in Washington, what are advocates trying to do?
McIntyre: The Healthcare Coalition for the North Country is a volunteer effort of former and current healthcare workers, as well as just other community advocates and people across the nonprofit space. They're really operating as kind of a coordinating place, they're hoping to continue being able to bridge the gap between different nonprofits and between providers, helping communicate across organizations and with the public about the challenges that we're facing. Obviously, healthcare affordability struggles do not begin in 2025, but the coalition did come together in 2025. It specifically was in response to some of the things we were seeing in federal legislation, cuts to Medicaid and the Big Beautiful Bill. For the last year or so, in the time that I've been speaking with them and watching them, it definitely seems like the coalition and other organizations across our region are, in some ways, bracing for what they see as kind of an inevitable change.
Certainly, there's advocacy and push for changes in legislation, but the big focus has been on communicating and educating people about exactly what's happening, who's going to be impacted, and really the big focus has been on the fact that Medicaid affects everyone. It's not just the people who are receiving those benefits. Especially in our area, our healthcare providers depend a lot on payments from the government because patients who are on Medicaid. Any cut to that income has the potential to cause our providers to lose revenue. We don't have that many providers, if a provider has to cut back services, has to cut back back staff, or has to close any of those changes that would affect affect everyone. And again, if heaven forbid the hospital down the street or the hospital in your immediate area were to close, you can't just drive down the street to the next hospital. You might have to go to the next county or even to the next state. I know a lot of people who go to Burlington for for healthcare, so it's really this focus that these changes do affect everyone.
That's been the main communication. Moving forward, I expect that their efforts will become a lot more concentrated on helping people specifically navigate the Medicaid work requirements. That's the next big hurdle and the big challenge. But I think we're still waiting to see exactly what that effort looks like. And obviously, our new situation in Congress and in the state house opens up new possibilities for avenues to address this. There's a lot of options.
