Nearly 500,000 moderate-income New Yorkers will lose their health insurance plans on July 1 as a result of HR 1, a Republican-led law enacted nearly one year ago.
The legislation, officially titled the "One Big Beautiful Bill Act," reduced national government health spending by $911 billion to fund permanent tax breaks for high-income families and border security.
Local organizations are scrambling to transition affected individuals into alternative coverage options within a strict 60-day window before open enrollment begins in November.
"It's an all hands on deck situation," said Maia Dillane, senior director of strategy and implementation at the Arab-American Family Support Center (AAFSC).
The AAFSC is collaborating with 20 community-based organizations alongside the Community Service Society of New York to find alternative coverage for residents.
"We're seeing a lot of families still going back and forth on whether they can enroll in one of the qualified health plans – or whether they are just going to opt out of the coverage completely," said Rahem Bader, director of the community health and well-being program at AAFSC.
Advocates note that premium costs remain a primary obstacle for families navigating these sudden changes.
"Families are having to choose how they're going to split their costs when it comes to their healthcare, food, etc.
," Bader said.
Navigators report that struggling families choosing to maintain insurance are prioritizing immediate medical needs over preventive measures.
"It's because they are not looking for preventive care – they are looking for treatments for illnesses," Bader added.
The immediate terminations stem from the dissolution of New York's "essential plan," an Obamacare pilot program approved in 2023 for residents earning up to 250% of the federal poverty level.
According to the New York State of Health, federal funding for the program was halved following the passage of HR 1 in 2025, which also eliminated health insurance tax credits for lawfully present immigrants.
State lawmakers failed to secure alternative state funding in June, while the Kaiser Family Foundation projects up to 1.1 million state residents could become uninsured through 2034.
"This is just the tip of the iceberg, right – because come January all the other impacts of HR1 start to kick in," said Dr. Adam Aponte, chief executive at the East Harlem Council for Human Services.
The East Harlem Council for Human Services operates the Boriken Neighborhood Health Center, where approximately 200 of Dr. Aponte's patients face coverage losses.
"What do these folks turn to?" Aponte asked.
The Congressional Budget Office notes that HR 1 will add $3.4 trillion to the federal budget deficit by 2034 due to reduced tax revenue.
"It's very unlikely that these individuals will be able to afford a marketplace plan.
So many of them are going to be caught with no insurance, at least for a period of time – who knows how long," Aponte said.
Displaced individuals must now shop on Obamacare marketplaces, where average individual deductibles have hit a record high of $3,786 after Congress allowed special health insurer subsidies to lapse at the end of 2025.
Insurance companies in New York are currently requesting an average rate increase of 20.7% from regulators, with UnitedHealthcare of New York seeking a 52.1% increase.
