Losing Health Coverage Due to Trump Cuts? Your Guide on 'Essential Plan' Changes
Nearly half a million people in
On
The shift will affect hundreds of thousands of working, low-income New Yorkers who don't qualify for Medicaid. Are you among them?
Here's what we know about how the funding cuts will affect coverage, what people can do to stay insured, how to access care without insurance and the battle playing out in
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Why is this happening and who is affected?
President
The cuts primarily affect people with incomes from 200% to 250% of the federal poverty line, which this year equals yearly earnings of approximately
"These are not wealthy people," Benjamin said. "It will be much more expensive. They're going to lose their free, no-deductible coverage, and instead have to pay hundreds of dollars [per month], potentially, for a product with a deductible."
With the state budget not yet finalized, advocates and officials are pushing Gov.
The cuts will also impact legal immigrants in
What should I do if I'm losing health care?
If you are set to lose health care through the Essential Plan on
"Make an appointment to see a primary care doctor, get prescriptions in order, get whatever you need," she said.
Pay attention to notices from the
On
Call the Marketplace's
"We will do what we can to smooth this transition," said Holahan. "We will work with them to let them know what timeline this is all happening on, when they can come in and pick a plan that would take effect on
The experts THE CITY spoke to all said it is critical to meet with health care navigators — trained individuals whose job it is to help people through the byzantine process of getting insured. Mid-May and June are the time to start reaching out, according to Wallach.
This is especially important if your life or home circumstances have changed since the last time you signed up for insurance, like if you are pregnant, have welcomed a new baby into your household or your income has gone down. These navigators will assist you according to your individual needs.
"It's really important to have to redo your financial eligibility," Benjamin said. "If your income this year isn't as high as last year, you might still be able to get the free coverage."
"Our people will make sure you have access to health care," Mehmood said. "We speak over 20 different languages. We can assist individuals going through plans, seeing what services are covered and helping them get the care they need."
Holahan recommends that people not put off choosing a new plan.
"They can always make a change later, but I would encourage people to take action so there's no gap in coverage," she said.
If you speak to a navigator and are not eligible for insurance through the
Those who could consider FE-ABD include New Yorkers with active cancer treatment, who receive dialysis or have multiple sclerosis, Wallach said.
"For an individual who is not able to get insurance through those systems in
What if I become uninsured, or cannot afford the insurance I am eligible for?
If you have exhausted your options to access an insurance plan you can afford, the city has a safety net program administered through
"It is one of the major avenues where we can make sure clients are connected to comprehensive health care," Mehmood said.
Anyone within the five boroughs who is uninsured or cannot afford the insurance for which they are eligible can access NYC Care.
These services are available regardless of immigration status, and health care professionals will not record your immigration status, according to the
There are also free health clinics funded through grants from the
And if you have a medical emergency, do not put off care. "Go to the emergency room," Wallach said. "That is still true."
What about accessing the medicine I need while uninsured, or struggling to afford medication?
You can access medication as a NYC Care member, but Wallach said there are other ways to afford many of the medications you need on an ongoing basis.
Seek prescription drug discount programs, like
Can the state make up the Essential Plan funding that the federal government cut?
Gov.
"From the beginning, I sounded the alarm about the devastating impact H.R. 1 would have on our hospitals and health care system, and made clear that no state can fully backfill cuts this severe," she said in an
But Benjamin from the
"It can be done for just under a billion dollars. The money's there," she said; the entire state budget is about
State Sen.
"We can absolutely cover folks," Rivera told THE CITY. "You would have 450,000 New Yorkers who without any action would lose their coverage come July."
"That's going to happen regardless," he said. "Since it's happening during this budget year that we're negotiating right now, we have to do something."
Holahan from the
Wallach noted that "We do not know where the budget is going to fall, so the advice could change."
But Mehmood said that currently, Essential Plan enrollees who make up to 250% of the federal poverty line will lose coverage.
"Legislators are still pushing," he said. "But as of now, what we know is that
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