CMS approved New York’s efforts to roll back Essential Plan coverage for New Yorkers with incomes between 200% and 250% of the federal poverty level, according to a March 23 news release from New York State of Health, the state’s exchange.
Starting July 1, under the termination of the state’s Section 1332 Innovation Waiver — which expanded Essential Plan coverage — roughly 450,000 state residents will lose Essential Plan access. However, 1.3 million enrollees will remain covered.
A September 2025 exchange news release said the program would lose $7.5 billion in annual federal funding.
New York will inform affected enrollees of changes April 1. Those affected can switch to a qualified health plan, but that coverage may include premiums and higher deductibles. These plans are now 40% more expensive due to the expiration of enhanced tax credits, the recent news release said. The One Big Beautiful Bill Act cut tax credit eligibility for some immigrants, as well.
New York is working with insurers to cut deductibles in half for those transitioning to a qualified health plan in the middle of the year. The state will also offer expanded enrollment assistance.
Essential Plan enrollees do not pay monthly premiums. This state-sponsored plan first became available in November 2015, offering low- or no-cost coverage to residents with incomes up to 200% of the federal poverty level.
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