As 2026 gets underway, so does some New Yorkers’ search for affordable health insurance. Affordable Care Act subsidies expired on Dec. 31, causing plan premiums to increase an average of 38%, or $877 annually, statewide. And this comes as cuts from the federal budget megabill are expected to leave 1.5 million New Yorkers without Medicaid coverage later this year.
Diane Spicer, supervising attorney for Community Health Advocates, Community Service Society of New York, said people must keep in mind individual costs when looking for new health-care plans.
“HR1 changed structure of cost-sharing for ACA plans in a way that affects cost-sharing for consumers,” she explained. “So, just be sure you understand, if you go to a specific specialist, what is the cost of your specialist? What’s your co-pay for that particular visit?”
Some are considering ‘catastrophic coverage’ plans, which don’t offer much for everyday health needs but would work for a major medical issue. Spicer said aside from cost, people need to consider what’s important to cover, in terms of medications and chronic conditions. The higher ACA plan premiums could mean New York medical providers lose about $213 million in funding.
Many New Yorkers are trying to be proactive about health-care access changes. Spicer noted that people are asking the Community Service Society of New York’s Community Health Advocates about how to navigate these changes and whether they can afford coverage anymore. She said officials also are advising people on other ways to get help with health-care costs.
“Our Hospital Financial Assistance Law in New York State had big reforms, a year ago, implemented, that makes getting hospital financial assistance, applying for it, and benefiting from it with higher income thresholds and easier application processes,” Spicer continued.
Several laws passed in 2025 are also now in effect to reduce some health-care costs. These include requiring health insurers to cover medically necessary EpiPens, with out-of-pocket costs capped at $100 per year, and expanding insurance coverage of breast cancer procedures to include screening and imaging.
Edwin is a reporter and producer in North Tonawanda, New York. He’s previously reported for the Niagara Gazette and the Ithaca Times. Edwin got an early start in radio interning for WBFO-88.7FM, NPR’s Buffalo affiliate. In 2018, he graduated from SUNY Buffalo State College with a B.A. in Journalism, and in 2022, graduated from Syracuse University with an M.S. in Communications.