A sweeping federal budget reconciliation bill, pushed by President Donald Trump and recently passed in the Senate, is poised to inflict serious harm on New York’s healthcare system. Dubbed the “One Big Beautiful Bill,” the legislation would slash Medicaid and Essential Plan funding, threatening coverage for 1.5 million residents and putting hospitals, health centers, and thousands of jobs at risk.
$8 billion in healthcare cuts and 65,000 jobs at stake
Joint analysis from the Greater New York Hospital Association (GNYHA) and the Healthcare Association of New York State (HANYS) projects $8 billion in funding losses to the state’s hospital systems alone. These cuts are expected to result in:
- 34,000 hospital jobs lost
- 29,000 additional job losses in related sectors
- $14.4 billion in lost hospital-driven economic activity
Hospitals, already facing financial strain, warn the bill could force downsizing, service reductions, or even closures—especially in rural areas.
Finger Lakes, NYC, and Long Island among hardest hit regions
The financial and employment fallout from the bill would ripple across all corners of the state. According to regional breakdowns:
- Finger Lakes: 4,532 jobs lost, $1.03 billion in economic activity gone
- New York City: 32,571 jobs lost, $7.4 billion lost
- Long Island: 6,521 jobs lost, $1.48 billion lost
- Mid-Hudson and Capital Region: Combined losses of nearly $2 billion
The impact spans all 26 congressional districts, including areas represented by both Democrats and Republicans.
“A top ten cause of death”: Yale/Penn researchers warn of 51K deaths
A public letter from scientists at Yale and the University of Pennsylvania predicts the bill’s healthcare rollbacks could lead to over 51,000 preventable deaths annually. These outcomes stem from reductions to Medicaid and ACA coverage, along with potential repeal of nursing home staffing regulations and expiration of ACA tax credits.
The researchers compared the potential death toll to chronic conditions like kidney and liver disease—placing the legislation among the top ten causes of death in the U.S.
Community Health Centers face layoffs, service cuts
The Community Health Care Association of New York State estimates a $300 million loss in funding, which would force nearly 2,000 layoffs at local Community Health Centers (CHCs). These centers provide care to one in eight New Yorkers—regardless of ability to pay—and are essential for preventive and behavioral healthcare access.
Without Medicaid funding, CHCs may be forced to:
- Cut hours and reduce staff
- Scale back or eliminate services
- Turn patients away due to funding gaps
GOP support drives legislation forward despite New York opposition
The bill’s advancement comes despite warnings from state leaders and healthcare advocates. Seven Republican representatives from New York voted in favor of the legislation, aligning with Trump’s vision to consolidate federal healthcare spending. Critics say the bill prioritizes federal budget savings at the expense of human lives and community health infrastructure.
What’s next for New York?
State officials and healthcare leaders are continuing efforts to oppose the bill and protect Medicaid and Essential Plan coverage. With the bill now heading to further negotiations and potential implementation, hospitals, providers, and patients are bracing for a possible overhaul of New York’s healthcare landscape.
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