Trump’s Impact on Health Benefits on Southampton and Beyond

For many of us on the East End, the Trump Administrations impacts on potential changes to our health benefits will be a return to a market where "short-term" plans can deny you for pre-existing conditions. For you, your family, friends, and neighbors - this means healthcare is becoming a luxury instead of a right! And necessary care is no longer guaranteed.

LOCAL HEALTHCARE ALERT 

Suffolk County and Southampton families, prepare for a major hit to your wallet. Under the new Health Benefits laws, health insurance premiums are projected to spike by 20-30%:

• Your Cost: Hundreds of dollars in extra monthly expenses for Long Islanders

• Your Loss: Federal subsidies that made private insurance affordable are being rolled back

How this matters to health benefits for New York State, CD-1 and our Southampton community

Last July’s Republican “Big Beautiful Bill” is estimated to leave 16 million people across the United States without health coverage:

• 8 million will lose Medicaid coverage

• 4.2 million will lose enhanced Affordable Care Act marketplace insurance tax credits

• 3.1 million from eligibility changes

• .8 million from administrative changes

Specifically, New York State Congressional District 1**

• 148,000 Eligible or presumptively eligible Medicaid recipients could be denied Medicaid coverage.

• 27% of children in Cong District 1 could lose coverage because of Medicaid and Child Health Care Plus cuts.

• 31,000 Seniors could lose or partially lose coverage

• 38,000 individuals could lose coverage through federal cuts to NYS Essential Health Plan

New York State’s Response – essentially finding ways to ameliorate Federal cuts:

• New York State will offset cuts to Medicaid spending by increasing their share by 16%

• NYS is currently working on corrective measures to reverse some of the cuts to the Essential Health Plan

• NYS is endeavoring to protect Chil Health Plus beneficiaries from Federal Cuts.NY State’s position

NY State’s position

NYS legislature is trying to reverse at least the Essential Health Plan. Adding hope based on actions taken by NYS legislative Democrats*, the NYS Assembly has made funding for healthcare one of its top priorities. In progress for its FY2027 budget, A10926 is the NYS Assembly’s version to restore some of the healthcare cuts due to the Big Beautiful Bill. The NYS Senate has their own version, too.

Our US Representative’s position

Last summer, our U.S. Representative Nick LaLota (NY-01 voted in favor of the “Big Beautiful Bill”, supporting the proposed "Great Healthcare Plan", which includes NYS Essential Plan cutbacks and corresponding surging monthly premiums. He also featured ads in the Southampton Press in 2024 that promoted aspects of the Great Republican Health Plan. Their healthcare coverage ideas have been kicking around for years. LaLota peddles features that he thinks would be popular but seem likely not to stand up to scrutiny.

To contact LaLota, call his Washington, D.C. office at (202) 225-3826 or his Hauppauge district office at (631) 289-1097.

What is the Essential Plan?

The Essential Plan is a low-cost health insurance option for low-income residents who do not qualify for Medicaid. No premiums, no deductibles and low-cost sharing are key features for those who qualify.

Effective July 1, 2026, NY State of Health is rolling back the expanded Essential Plan (EP) due to federal funding cuts, removing eligibility for approximately 450,000 enrollees with incomes between 200% and 250% of the Federal Poverty Level (FPL). While the core program for incomes below 200% FPL remains with $0 premiums, those in the 200–250% bracket will lose coverage and must transition to Qualified Health Plans.

Impact on NY CD1: According to 2025–2026 data, approximately 25,000 individuals in New York's 1st Congressional District are expected to lose coverage through the Essential Plan due to federal funding cuts.

What is Child Health Plus?

Child Health Plus (CHP) is a New York State-sponsored health insurance program for children under 19, offering free or low-cost comprehensive coverage to those who do not qualify for Medicaid, regardless of income or immigration status. It covers essential services like check-ups, dental, vision, and prescriptions with no deductibles and low or no premiums.

Impact on NY CD1: There is no specific breakdown for NY CD1 but 8,594 Suffolk County children are expected to lose coverage through the Child Health plus program starting on July 1, 2026.

What is Medicaid?

Medicaid is a joint federal and state program in the United States that provides free or low-cost health coverage to millions of Americans with limited income and resources. It covers various groups, including low-income adults, children, pregnant women, seniors, and people with disabilities, serving as the largest source of long-term care coverage.

Impacts on NY CD1: According to Senator Chuck Schumer’s office hospitals in NY CD 1 will lose funding to the tune of $26,066,244 and 47,515 individuals will lose their eligibility for Medicaid.

Infrastructure Collapse: Hospitals, rural clinics, and nursing homes—particularly those with thin margins—may be forced to shutter, reduce services, or implement mass layoffs of healthcare workers.

Medicare Reductions

The bill is projected to trigger roughly $500 billion in mandatory Medicare spending cuts nationally between 2026 and 2034, including a 4% reduction in hospital payments.

*all outside other current sticking point between the NY Governor and the legislature (https://info.nystateofhealth.ny.gov/stay-connected)

** FamiliesUSA and the Fiscal Policy Institute