New Yorkers enrolled in the Essential Plan who earn more than 200 percent of the federal poverty level will lose eligibility for that coverage beginning July 1, Attorney General Letitia James said in new guidance issued Monday.
James said the change is expected to affect about 450,000 New Yorkers and urged residents to use official state resources when shopping for replacement coverage.
The Essential Plan is a low-cost Affordable Care Act marketplace plan for some low- and middle-income New Yorkers who do not qualify for employer-sponsored insurance or Medicaid. It offers no monthly premiums, no deductibles and low copays.
New York State of Health has announced plans to eliminate Essential Plan eligibility for people earning between 200 and 250 percent of the federal poverty level. That range includes single New Yorkers making $31,920 to $39,900, two-person households making $43,280 to $54,100, three-person households making $54,640 to $68,300 and four-person households making $66,000 to $82,500.
The loss of Essential Plan coverage is considered a qualifying life event, meaning affected New Yorkers can enroll in a new health insurance plan through the New York State of Health marketplace before Sept. 1, 2026.
James’ office warned that ACA plans are expected to be more expensive than the Essential Plan and are increasing in price because of the expiration of federal subsidies.
“Losing health insurance can be stressful and confusing, and New Yorkers deserve clear, reliable information as they make decisions about their care,” James said.
The attorney general’s guidance tells consumers to check whether their doctors are in network, confirm prescriptions are covered, compare full plan costs and be cautious of scams. James’ office warned residents to avoid anyone who pressures them to enroll immediately, asks for payment to renew coverage or promises a plan that sounds too good to be true.
New Yorkers can get free enrollment help through New York State of Health at nystateofhealth.ny.gov or by calling 1-855-355-5777.
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