HCFANY is thankful to have the opportunity to testify at the 2026 Joint Legislative Budget Hearing on Health. Find HCFANY’s detailed Executive FY27 Testimony here. The Executive Budget includes many proposals to help protect and enhance New Yorkers’ access to affordable health coverage. 

HCFANY’s budget testimony covers three topics:  

  1. Protect and improve health coverage 
  2. Regulate prices to create a more affordable health care system for New Yorkers 
  3. Robustly fund consumer assistance and enrollment programs and increase Article 6 funding to help New Yorkers navigate new complex hurdles 

(I) Protect and Improve Health Coverage

The enactment of HR 1 will drastically alter eligibility and funding for health insurance, leaving an estimated 1.5 million New Yorkers at risk of losing their coverage. Coverage losses for individuals on the Essential Plan may go into effect as soon as July 2026, so it is imperative that the State have a plan in place to mitigate these federal cuts.  

  • Support the transition from 1332 Waiver to 1331 Basic Health Plan (BHP) to allow 609,000 lawfully present immigrants to stay covered. 

If the federal government approves this change, 444,000 people enrolled in New York’s Essential Plan with incomes between 200-250 percent of the Federal Poverty Level (FPL) will become newly ineligible for the Essential Plan mid-year. The State should provide coverage options and financial support for this population: 6,000 individuals with Deferred Action for Childhood Arrival (DACA) immigration status or who are Permanently Residing Under Color of Law (PRUCOL), and 30,000 lawfully present immigrants with incomes over 200 percent FPL. These policy options are detailed in Community Service Society’s recently released report: Mitigating the Impact of HR 1 on New York’s Health Insurance Landscape: Four Policy Proposals to Preserve Coverage. 

  • Delay the repeal of continuous coverage of children up to age six. (Health and Mental Hygiene [HMH] Article VII, Part M) 

The federal government has made it clear that New York’s continuous coverage program for children up to age six will be discontinued. The Executive Budget includes a proposal to repeal this program on July 1, 2026. However, New York’s Medicaid 1115 waiver does not expire until March 2027. 

HCFANY recommends delaying the repeal until January 1, 2027, to ensure a smooth transition and keep these children covered for as long as possible. 

  • Support the reforms to prior authorization, with some recommendations. (Transportation, Economic Development, and Environmental Conservation [TED] Article VII, Part HH) 

The Budget requires additional information to be added to the Department of Financial Services (DFS) Consumer Guide, which helps consumers compare and select health plans offered in the New York Marketplace. HCFANY supports this addition but critically notes that the Consumer Guide currently does not report on plans that cover 80 percent of New Yorkers in the individual market. The Consumer Guide, and its additions, should be expanded to serve all consumers in the individual market.  

HCFANY supports language in the budget that expands the period insurers must cover out-of-network services for new enrollees, also known as continuity of care. In addition, HCFANY supports the budget proposal to improve consumer access to information on health plans’ formulary drug lists, helping patients understand which prescription drugs are covered under their plan.  

  • Enact the New York Health Act S3425|A1466, which would make many of the above changes unnecessary and better address the long-term health care needs of New Yorkers. 

(II) Regulate Prices to Create a More Affordable Health Care System for New Yorkers

Over the past few decades, New York’s health care spending has increased rapidly, and the State ranks second nationally in highest health care expenditures and premiums. Hospital prices are a primary contributor to these high health care costs.  

The FPA would cap payments at 150 percent of the Medicare rate for a defined list of low-complexity procedures. This would reduce cost disparities between hospital and non-hospital providers, such as doctors’ offices. Currently, a new patient office visit costs around $88 at a non-hospital site but can cost $436 (540 percent of the Medicare rate) in a hospital outpatient department. Adopting the Fair Pricing Act could save New York $1.14 billion annually, including $213 million in reduced out-of-pocket costs for consumers with commercial insurance. The Community Service Society recently released a brief, “How the Fair Pricing Act’s Site Neutral Policy Boosts Health Care Affordability by Ensuring Savings Will Be Passed Through to Patients and Payers“, exploring proposed solutions to curb this trend and make health care more affordable for New Yorkers. 

  • Invest in primary care by including provisions from the Primary Care Investment Act (PCIA) S1634|A1915A. 

The PCIA would require New York to measure and report the current percentage of its health care expenditures that are spent on primary care. It would also require insurers to gradually increase spending by 1 percent each year until reaching a benchmark of spending at least 12.5 percent of their overall health spending on primary care. Nationally, only 4.6 percent of health care spending is spent on primary care, despite primary care accounting for nearly half of office visits each year. Adopting provisions from the PCIA will reduce health care costs, improve patient outcomes, and promote health equity.  

  • Create an independent New York Office of Health Care Affordability. 

California’s Office of Health Care Accountability is an independent entity that regulates the state’s health care spending growth, quality, and market consolidation. It also requires its members not to receive compensation from health care entities. Currently, New York’s Public Health and Health Planning Council (PHHPC) is comprised of political appointees affiliated with hospitals and other health care industry representatives. 

HCFANY recommends that the Legislature consider creating an independent office to address long-term structural issues to improve health care affordability in New York. 

  • Support strengthening the Department of Health’s oversight of health care transactions, with further recommendations for transparency. (HMH Article VII, Part H). 

HCFANY supports tracking the impact of material transactions on health care costs, quality, access, health equity, and competition. HCFANY urges the Legislature to go further and require an annual summary of this impact to be publicly posted for advocates and consumers to understand the impact of these transactions.  

HCFANY also supports the additional requirements for written notice of health care transactions and the utilization of cost and market impact review (CMIR) for material transactions. However, HCFANY urges the Legislature to expand the language to require public posting of documents related to the review process and results.  

(III) Robustly Fund Consumer Assistance and Enrollment Programs and Increase Article 6 Funding 

Given devastating cuts to federal health programs, consumer assistance advocates and navigators are more important than ever to help New Yorkers through coverage transitions and to reduce barriers in accessing affordable care.  

  • Increase funding for health insurance enrollment navigators. 

The Navigator program, predominantly run through trusted community-based organizations (CBOs), helps New Yorkers enroll, keep, and use their health insurance. Navigators provide unbiased, personal assistance year-round and speak over 40 languages.   

HCFANY is grateful that the Governor’s budget includes $28.3 million for Navigators and urges the Legislature to fund the Navigator program at $38 million to guarantee continued high-quality enrollment services. The State should also allocate $5 million in grants to CBOs to conduct outreach in underserved communities.  

  • Maintain funding for Community Health Advocates (CHA). 

CHA helps individuals with any type of health insurance access in-network care, resolve billing issues, avoid medical debt, appeal coverage denials, and address other barriers to obtaining affordable medical care. In FY 24-25, CHA saved consumers $25 million, yielding a 407% return on investment.  

HCFANY is grateful that the Governor’s budget includes $5.5 million for CHA and urges the Legislature to allocate an additional $1.7 million to maintain CHA’s funding at its current $7.2 million.  

  • Increase Article 6 funding in New York City. 

Under Article 6, New York City is reimbursed for essential public health services at a lower rate than all other localities in the State, receiving just 20 percent for spending above its base grant compared to 36 percent for all other local health departments.  

HCFANY strongly supports increasing Article 6 funding for NYC.  

Stay tuned, as HCFANY will review the Governor’s 30-day amendments, the One-House bills, and the finalized FY27 Executive Budget.  

The One-House Budgets are released! The Senate One-House Budget includes a significant portion of the HCFANY policy agenda, building on the Governor’s proposals in the Executive Budget. We’re still studying what is included in each bill, here’s what we know so far:

Good news: the Senate and Assembly One-House Budgets both:

  • Ban cost-sharing for insulin for enrollees in State-regulated health insurance plans
  • Improve affordability of Marketplace plans via premium assistance/ cost-sharing subsidies
  • Adopt Kids Coverage to ensure children up to age 6 remain continuously covered in Medicaid or Child Health Plus
  • Include Coverage4All, using federal funding to cover income-eligible immigrants in the Essential Plan

Even better, the Senate One-House Budget improves on the Governor’s budget by incorporating all of the HFAL improvements in the Ounce of Protection Act, including:

  • Expanding Hospital Financial Assistance eligibility to individuals making up to 600 percent FPL
  • Banning Hospitals from suing patients making under 600 percent FPL for medical debt
  • Incorporating time-limited debt repayment plans so patients who make an agreed upon number of payments don’t have to spend their lives in debt

Bad news: the Assembly Budget completely cuts the Governor’s proposed medical debt reforms.

Take Action: Use the Phone2Action tool to call your legislators.

  • Thank your Senators and ask them to fight to keep the Senate One-House Budget consumer health and medical debt reforms in the final budget.
  • Ask your Assembly members to tell Assembly leadership to fight medical debt and fix our broken Hospital Financial Assistance Law.

There are lots of opportunities coming up over the next couple of weeks to learn more about health policy priorities and how to take action. Here’s a few of them!

TODAY: Statewide Day of Action for Guaranteed Healthcare (link)

The Campaign for New York Health is holding a day of action for the New York Health Act, which would provide comprehensive health coverage for everyone who lives or works full-time in New York. Look for #PassNYHealth to see what people are saying and join in!

  • Learn more about why we need the New York Health Act here.
  • If you missed the day of action you can always show your support for the New York Health Act by clicking this link and telling your State Assemblymember and Senator to support the bill. If they already do, the link will give you an opportunity to thank them!

Tomorrow: #Coverage4All Virtual Day of Action

There are 400,000 New Yorkers without insurance because of their immigration status. A1585/S2549 would guarantee that all New Yorkers can access life-saving health coverage if they have had COVID-19. Look for #Coverage4All and #PassA1585 all day tomorrow to help get the word out!

What else can you do?

  • Sign up for campaign updates here.
  • Become listed as a supporting organization here.
  • Contact your legislator any time using the instructions here.

Friday, 11:00-12:00: Budget Briefing for Health Justice Advocates

Join the Campaign for NY Health, the Consumer Directed Personal Assistance Association of New York State, Coverage4All, Health Care for All NY, and Medicaid Matters NY for an overview of the FY22 Executive Budget Proposal and its implications for healthcare in New York. Register here.

Friday, February 5 1:00-3:00: HCFANY Annual Meeting

What can we expect from legislative session this year? How do we push forward and ensure quality, affordable health care for everyone in New York State during a pandemic and a budget crisis? Join us to learn more about our legislative and budget priorities for 2021 and how you can take action yourself! Click here to register!

During this virtual meeting we will:

  • Award Senator Gustavo Rivera as this year’s Consumer Champion and present a posthumous Lifetime Achievement award to Kristin Sinclair, Director of the Senate Health Committee.
  • Share information about the state budget and our legislative priorities, including expanding health coverage to all New Yorkers, ending medical debt, and addressing systemic inequity in our health care system.
  • Talk about future workshops that will offer deep dives on different health policy issues and opportunities to take action.

Learn what’s in the HEROES Act from New York’s Congressional leaders and advocates, and find out what you can do get it enacted! The HEROES Act, which already passed the House, would provide much needed pandemic relief and protect the programs, like Medicaid, that are helping people get by during the crisis. Read more here, and register for the virtual rally here. 

Action step – Sign-ons needed by close of business tomorrow:

Sign your organization on to this letter (link) drafted by Citizen Action of New York, Medicaid Matters New York, Health Care For America Now, and HCFANY. The letter thanks Senators Schumer and Gillibrand for their work so far to protect New Yorkers during the pandemic – and describes what New Yorkers need included in an enacted version of the HEROES Act. Add your organization’s name here. 

Also Coming Up: 

100 Years On: Celebrating and Championing Our Civil Rights and Social Programs

So many of our most important civil rights laws and social programs were created in July and August – the National Labor Relations Act (1935), Social Security (1935), the Civil Rights Act (1964), Medicare and Medicaid (1965), the Americans with Disabilities Act (1990). Join fellow New York advocates to celebrate these achievements and fight for justice! 

  • Dessert Party for Democracy: A Multi-Generational Celebration. We will share pictures and videos of everyday people sharing stories and holding signs saying “I celebrate X because…” We will end with a toast and display of your dessert, holding up signs, including all members of your family or household. August 13, 7:00 – 8:00 PM, register here.
  • Renewing the American Promise: Defending and Expanding Our Social Contract. Learn more about the civil rights and social programs that everyday New Yorkers benefit from and learn how these programs and laws are at risk.  August 19, 12:00 – 1:00PM, register here.