NY State Senate Bill 2025-S9589

Current Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 26, 2026	referred to health

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2025-S9589 (ACTIVE) - Details

See Assembly Version of this Bill:: A10926
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 2 Title 7 §268-i, Pub Health L; amd §369-gg, Soc Serv L

2025-S9589 (ACTIVE) - Summary

Provides for coverage for New Yorkers losing insurance due to the implementation of HR 1.

2025-S9589 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S9589

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law and the social services law, in
relation to coverage for New Yorkers losing insurance due to the imple-
mentation of HR 1

 
PURPOSE:

The purpose of this bill is to maintain access to health insurance for
New Yorkers who would otherwise lose eligibility for reduced cost health
insurance or publicly subsidized financial assistance to purchase health
insurance coverage due to the implementation of HR 1.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 of the bill creates a new section 268-i of the public health
law to amend the New York State of Marketplace implementation statute.
It authorizes the Marketplace to establish and administer a state-only
funded premium assistance program for lawfully present immigrants who

have been eligible between 2014 and 2026 for federal Advance Premium Tax
Credits and cost-sharing reductions to assist with the purchase of
health insurance coverage. Changes to federal law under HR 1 terminate
the eligibility for lawfully present immigrants for federally funded
financial assistance effective January 1, 2027. This section authorizes
the Marketplace to offer equivalent financial assistance to lawfully
present immigrants who will be rendered ineligible under HR 1. The
amount of State level assistance would be equivalent to the amount
offered by the federal level of assistance pursuant to the Affordable
Care Act's premium assistance and cost-sharing schedule.

Sections 2 and 2-a of the bill amend paragraph d of subdivision 3 of
369-gg of the Social Services Law, which establishes the Basic Health
Program (Essential Plan). The bill would eliminate obsolete language
related to the coverage of individuals at or below 250% of the federal
poverty level (FPL). It would also authorize New York State to provide
state-only funded Essential Plan coverage to lawfully present individ-
uals who are not eligible to participate in the program due to their
immigration status. Additionally, these sections authorize the state to
continue to provide Essential Plan coverage to individuals with incomes
between 200% and 250% of FPL.

Section 3 and 3-a of the bill modifies subdivision 5 of section 369-gg
of the social services law to clarify that New York state does not need
to seek federal permission related to cost-sharing requirements or
premiums for individuals covered under the Essential Plan when using
state-only dollars. It also makes some non-substantive technical
corrections.

Sections 4 and 4-a of the bill amends subdivision 7 of section 369-gg of
the social services law to make some non-substantive technical
corrections.

Section 5 of the bill is the effective date.

 
JUSTIFICATION:

New York State has historically maintained a high rate of health cover-
age while striving towards a holistic approach to healthcare, which
promotes access and affordability, and generates better outcomes for
everyone living in the state. Recent studies have shown that the rate of
uninsured people in New York State was less than 5%, as of 2023, one of
the lowest in the nation.

Due to H.R.1 and other federal inaction, billions in funding to support
New York's Essential Plan that is serving approximately 1.7 million New
Yorkers was intentionally eliminated. These cuts to this working class
health program were justified to help offset lost revenue from tax cuts
for the wealthiest of individuals in our society that were advanced by
the Trump Administration and Congressional Republicans, including all
seven of New York's Republican congressional representatives. In light
of these devastating cuts, which would have made the Essential Plan
insolvent, actions were recently undertaken by Governor Hochul's admin-
istration to unwind the expanded 1332 waiver version of the Essential
Plan to return it to the original program. This action, while providing
fiscal stability for the program's continued operation, had the unfortu-
nate consequence of causing the expanded populations being served under
the 1332 waiver to face a loss of coverage beginning July 1, 2026.

It is estimated that approximately 450,000 New Yorkers will lose cover-
age due to this forced federal unwind. To place this coverage loss into
perspective, a family of four with two children and a total household
income of $66,000-$82,500 will now be ineligible for healthcare coverage
under the Essential Plan because of H.R.1. A single individual making
$31,920 to $39,900 will also be ineligible.  A lawfully present immi-
grant family of four making $43,890 to $66,000 will also be ineligible,
as will single lawfully present immigrants making $21,227 to $31,920.

It is too bitter of a pill to swallow that healthcare for working class
families was cut by federal Republicans to give tax breaks to the
ultrawealthy in our country, but it is the reality. Levels of wealth
inequality in our country dwarf the Great Depression and rival levels
seen in the late 1700s in France. The $7.5 billion loss in funding to
the Essential Plan is roughly equivalent to the cost the federal govern-
ment spent bombing Iran for a week.

Healthcare costs are one of the single largest drivers of unaffordabili-
ty in our country. An analysis by the Kaiser Family Foundation found
that per capita healthcare spending in New York in 2020 was $14,007. It
is likely that costs have grown since then.  Healthcare costs are one of
the single largest drivers of unaffordability in our country.

Additionally, a 30 year longitudinal study by the CATO Institute found
that, nationally, immigrants have created a total fiscal surplus of
$14.5 trillion, including $3.9 trillion in savings on interest on the
debt. This demonstrates that immigrant families give more than they
take. This bill would provide an affordable coverage option to immigrant
populations in New York to entice these families to remain here and
encourage new immigrants to seek out New York as a place to make their
home. The presence of immigrant populations continues to strengthen our
economy, increase tax revenue, and address significant workforce chal-
lenges that we are facing in this state.

This bill would combat uninsured rates, bolstering the healthcare system
as a whole in New York State and providing access to care for working
families in need. We have an opportunity to mitigate the harm on those
impacted by the dramatic effects of federal cuts on New Yorkers' health-
care. The cost of private health insurance is high and is only projected
to increase again this year, making it unattainable for many New York-
ers. Keeping New Yorkers insured helps patients and providers, in
support of the entire healthcare system. This bill is a crucial step
toward the consideration of healthcare as a right, not a commodity, and
it should be granted to everyone, regardless of their status or their
income.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

Undetermined

 
EFFECTIVE DATE:
This act takes effect July 1, 2026.

2025-S9589 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9589
 
                             I N  S E N A T E
 
                              March 26, 2026
                                ___________
 
 Introduced  by  Sen.  RIVERA -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the social  services  law,  in
   relation  to  coverage  for  New  Yorkers  losing insurance due to the
   implementation of HR 1
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Title 7 of article 2 of the public health law is amended by
 adding a new section 268-i to read as follows:
   §  268-I.  STATE  PREMIUM  ASSISTANCE  PROGRAM.  NO LATER THAN JANUARY
 FIRST, TWO THOUSAND TWENTY-SEVEN, THE MARKETPLACE  SHALL  ESTABLISH  AND
 ADMINISTER  A  STATE  PREMIUM  ASSISTANCE PROGRAM THAT OFFERS EQUIVALENT
 FINANCIAL ASSISTANCE TO INDIVIDUALS WHO  ARE  LAWFULLY  PRESENT  IN  THE
 UNITED  STATES  AND  WHO  ARE  INELIGIBLE  FOR THE BASIC HEALTH PROGRAM,
 PREMIUM TAX CREDITS, OR COST SHARING REDUCTIONS, BASED  ON  THEIR  IMMI-
 GRATION  STATUS. THE STATE PREMIUM ASSISTANCE PROGRAM SHALL OFFER EQUIV-
 ALENT LEVELS OF ASSISTANCE AS THE FEDERAL PREMIUM TAX CREDITS AND  COST-
 SHARING REDUCTIONS BASED ON THE ENROLLEES' INCOMES.
   §  2.  Paragraph  (d) of subdivision 3 of section 369-gg of the social
 services law, as separately amended by section 2 of part BBB of  chapter
 56 and section 86 of chapter 669 of the laws of 2022, is amended to read
 as follows:
   (d)  (i)  except as provided by [subparagraph (ii)] SUBPARAGRAPHS (IV)
 AND (V) of this paragraph, has household income at or below two  hundred
 percent  of the federal poverty line defined and annually revised by the
 United States department of health and human services for a household of
 the same size; and has household income that exceeds one  hundred  thir-
 ty-three  percent  of  the  federal  poverty  line  defined and annually
 revised by the United States department of health and human services for
 a household  of  the  same  size;  however,  MAGI  eligible  noncitizens
 lawfully present in the United States with household incomes at or below
 one  hundred  thirty-three  percent of the federal poverty line shall be
 eligible to receive coverage for health care services  pursuant  to  the
 provisions  of  this  title  if  such noncitizen would be ineligible for
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD15269-03-6
 S. 9589                             2
 
 medical assistance under title eleven of this article due to their immi-
 gration status;
   (ii)  [subject  to federal approval and the use of state funds, unless
 the commissioner may use funds under subdivision seven of this  section,
 has household income at or below two hundred fifty percent of the feder-
 al  poverty  line  defined  and  annually  revised  by the United States
 department of health and human services for  a  household  of  the  same
 size;  and  has  household  income that exceeds one hundred thirty-three
 percent of the federal poverty line defined and annually revised by  the
 United States department of health and human services for a household of
 the  same  size;  however,  MAGI eligible aliens lawfully present in the
 United States with household incomes at or  below  one  hundred  thirty-
 three  percent  of the federal poverty line shall be eligible to receive
 coverage for health care services pursuant to  the  provisions  of  this
 title  if  such  alien  would be ineligible for medical assistance under
 title eleven of this article due to their immigration status;
   (iii)] subject to federal approval if required and the  use  of  state
 funds,  unless the commissioner may use funds under subdivision seven of
 this section, a pregnant individual who is eligible  for  and  receiving
 coverage  for health care services pursuant to this title is eligible to
 continue to receive health care services pursuant to this  title  during
 the  pregnancy  and  for  a  period of one year following the end of the
 pregnancy without regard to any change in the income  of  the  household
 that  includes the pregnant individual, even if such change would render
 the pregnant individual  ineligible  to  receive  health  care  services
 pursuant to this title;
   [(iv)]  (III) subject to federal approval, a child born to an individ-
 ual eligible for and receiving coverage for health care services  pursu-
 ant to this title who would be eligible for coverage pursuant to subpar-
 agraphs  [(2)] TWO or [(4)] FOUR of paragraph (b) of subdivision [1] ONE
 of section three hundred [and] sixty-six of [the  social  services  law]
 THIS  ARTICLE shall be deemed to have applied for medical assistance and
 to have been found eligible for such assistance  on  the  date  of  such
 birth  and  to  remain  eligible for such assistance for a period of one
 year[.];
   (IV) SUBJECT TO THE USE OF STATE FUNDS, AN INDIVIDUAL  WHO  IS  PERMA-
 NENTLY  RESIDING  IN  NEW YORK STATE UNDER COLOR OF LAW WITH A HOUSEHOLD
 INCOME BETWEEN ONE HUNDRED THIRTY-THREE AND TWO HUNDRED PERCENT  OF  THE
 FEDERAL  POVERTY  LINE  SHALL BE ELIGIBLE TO RECEIVE COVERAGE FOR HEALTH
 CARE SERVICES PURSUANT TO THIS TITLE REGARDLESS OF THE  AVAILABILITY  OF
 FEDERAL FUNDING;
   (V) SUBJECT TO THE USE OF STATE FUNDS, AN INDIVIDUAL WHO IS A CITIZEN,
 OR  LAWFULLY PRESENT, OR IS PERMANENTLY RESIDING UNDER COLOR OF LAW WITH
 A HOUSEHOLD INCOME BETWEEN TWO HUNDRED AND TWO HUNDRED FIFTY PERCENT  OF
 THE  FEDERAL  POVERTY  LINE  SHALL  BE  ELIGIBLE TO RECEIVE COVERAGE FOR
 HEALTH CARE SERVICES PURSUANT TO THIS TITLE REGARDLESS OF THE AVAILABIL-
 ITY OF FEDERAL FUNDING.
   An applicant who fails to make an applicable premium payment, if  any,
 shall  lose  eligibility to receive coverage for health care services in
 accordance with time frames and procedures determined by the commission-
 er.
   § 2-a. Paragraph (d) of subdivision 3 of section 369-gg of the  social
 services  law, as separately amended by section 3 of part BBB of chapter
 56 and section 86-a of chapter 669 of the laws of 2022,  is  amended  to
 read as follows:
 S. 9589                             3
 
   (d)  (i)  except as provided by [subparagraph (ii)] SUBPARAGRAPHS (IV)
 AND (V) of this paragraph, has household income at or below two  hundred
 percent  of the federal poverty line defined and annually revised by the
 United States department of health and human services for a household of
 the  same  size; and has household income that exceeds one hundred thir-
 ty-three percent of  the  federal  poverty  line  defined  and  annually
 revised by the United States department of health and human services for
 a  household  of  the  same  size;  however,  MAGI  eligible noncitizens
 lawfully present in the United States with household incomes at or below
 one hundred thirty-three percent of the federal poverty  line  shall  be
 eligible  to  receive  coverage for health care services pursuant to the
 provisions of this title if such  noncitizen  would  be  ineligible  for
 medical assistance under title eleven of this article due to their immi-
 gration status;
   (ii)  [subject  to federal approval and the use of state funds, unless
 the commissioner may use funds under subdivision seven of this  section,
 has household income at or below two hundred fifty percent of the feder-
 al  poverty  line  defined  and  annually  revised  by the United States
 department of health and human services for  a  household  of  the  same
 size;  and  has  household  income that exceeds one hundred thirty-three
 percent of the federal poverty line defined and annually revised by  the
 United States department of health and human services for a household of
 the  same  size;  however,  MAGI eligible aliens lawfully present in the
 United States with household incomes at or  below  one  hundred  thirty-
 three  percent  of the federal poverty line shall be eligible to receive
 coverage for health care services pursuant to  the  provisions  of  this
 title  if  such  alien  would be ineligible for medical assistance under
 title eleven of this article due to their immigration status;
   (iii)] subject to federal approval if required and the  use  of  state
 funds,  unless the commissioner may use funds under subdivision seven of
 this section, a pregnant individual who is eligible  for  and  receiving
 coverage  for health care services pursuant to this title is eligible to
 continue to receive health care services pursuant to this  title  during
 the  pregnancy  and  for  a  period of one year following the end of the
 pregnancy without regard to any change in the income  of  the  household
 that  includes the pregnant individual, even if such change would render
 the pregnant individual  ineligible  to  receive  health  care  services
 pursuant to this title;
   [(iv)]  (III) subject to federal approval, a child born to an individ-
 ual eligible for and receiving coverage for health care services  pursu-
 ant to this title who would be eligible for coverage pursuant to subpar-
 agraphs  [(2)] TWO or [(4)] FOUR of paragraph (b) of subdivision [1] ONE
 of section three hundred [and] sixty-six of [the  social  services  law]
 THIS  ARTICLE shall be deemed to have applied for medical assistance and
 to have been found eligible for such assistance  on  the  date  of  such
 birth  and  to  remain  eligible for such assistance for a period of one
 year[.];
   (IV) SUBJECT TO THE USE OF STATE FUNDS, AN INDIVIDUAL  WHO  IS  PERMA-
 NENTLY  RESIDING  IN  NEW YORK STATE UNDER COLOR OF LAW WITH A HOUSEHOLD
 INCOME BETWEEN ONE HUNDRED THIRTY-THREE AND TWO HUNDRED PERCENT  OF  THE
 FEDERAL  POVERTY  LINE  SHALL BE ELIGIBLE TO RECEIVE COVERAGE FOR HEALTH
 CARE SERVICES PURSUANT TO THIS TITLE REGARDLESS OF THE  AVAILABILITY  OF
 FEDERAL FUNDING;
   (V) SUBJECT TO THE USE OF STATE FUNDS, AN INDIVIDUAL WHO IS A CITIZEN,
 OR  LAWFULLY PRESENT, OR IS PERMANENTLY RESIDING UNDER COLOR OF LAW WITH
 A HOUSEHOLD INCOME BETWEEN TWO HUNDRED AND TWO HUNDRED FIFTY PERCENT  OF
 S. 9589                             4
 
 THE  FEDERAL  POVERTY  LINE  SHALL  BE  ELIGIBLE TO RECEIVE COVERAGE FOR
 HEALTH CARE SERVICES PURSUANT TO THIS TITLE REGARDLESS OF THE AVAILABIL-
 ITY OF FEDERAL FUNDING.
   An  applicant  who  fails  to make an applicable premium payment shall
 lose eligibility to receive coverage for health care services in accord-
 ance with time frames and procedures determined by the commissioner.
   § 3. Paragraph (b) of subdivision 5 of section 369-gg  of  the  social
 services law, as amended by section 7-a of part BBB of chapter 56 of the
 laws of 2022, is amended to read as follows:
   (b) The commissioner shall establish [cost sharing] COST-SHARING obli-
 gations  for  enrollees,  subject  to federal approval; PROVIDED FEDERAL
 APPROVAL SHALL NOT BE REQUIRED FOR INDIVIDUALS  RECEIVING  STATE  FUNDED
 COVERAGE FOR HEALTH SERVICES. There shall be no cost-sharing obligations
 for  enrollees for dental and vision services as defined in subparagraph
 (ii) of paragraph (c) of subdivision one of this section;  services  and
 supports  as  defined in subparagraph (iii) of paragraph (c) of subdivi-
 sion one of this section; and  health  care  services  authorized  under
 subparagraphs  (II) AND (iii) [and (iv)] of paragraph (d) of subdivision
 three of this section.
   § 3-a. The opening paragraph of paragraph (a)  and  paragraph  (b)  of
 subdivision  5 of section 369-gg of the social services law, the opening
 paragraph of paragraph (a) as amended by section 51 of part C of chapter
 60 of the laws of 2014, and paragraph (b) as amended by section  7-b  of
 part  BBB  of  chapter  56  of  the laws of 2022, are amended to read as
 follows:
   Subject to federal approval, the commissioner shall establish  premium
 payments  enrollees  shall pay to approved organizations for coverage of
 health care services pursuant to this title; PROVIDED  FEDERAL  APPROVAL
 SHALL  NOT  BE  REQUIRED FOR INDIVIDUALS RECEIVING STATE FUNDED COVERAGE
 FOR HEALTH SERVICES. Such premium payments shall be established  in  the
 following manner:
   (b) The commissioner shall establish [cost sharing] COST-SHARING obli-
 gations  for  enrollees,  subject  to federal approval; PROVIDED FEDERAL
 APPROVAL SHALL NOT BE REQUIRED FOR INDIVIDUALS  RECEIVING  STATE  FUNDED
 COVERAGE FOR HEALTH SERVICES. There shall be no cost-sharing obligations
 for  services and supports as defined in subparagraph (iii) of paragraph
 (c) of subdivision one of this section; and health care services author-
 ized under subparagraphs (II) AND (iii) [and (iv)] of paragraph  (d)  of
 subdivision three of this section.
   §  4.  Subdivision  7 of section 369-gg of the social services law, as
 amended by section 2 of part H of chapter 57 of the  laws  of  2021,  is
 amended to read as follows:
   7. Any funds transferred by the secretary of health and human services
 to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
 Funds from the trust shall be used for providing health benefits through
 an  approved  organization, which, at a minimum, shall include essential
 health benefits as defined in 42 U.S.C. 18022(b); to reduce  the  premi-
 ums,  if  any,  and  [cost  sharing] COST-SHARING of participants in the
 basic health program[; or for such other purposes as may be  allowed  by
 the  secretary  of health and human services]. Health benefits available
 through the basic health program  shall  be  provided  by  one  or  more
 approved  organizations  pursuant to an agreement with the department of
 health and shall meet the requirements of applicable federal  and  state
 laws and regulations.
   §  4-a. Subdivision 7 of section 369-gg of the social services law, as
 amended by section 51 of part C of chapter 60 of the laws of  2014,  and
 S. 9589                             5
 
 as renumbered by section 28 of part B of chapter 57 of the laws of 2015,
 is amended to read as follows:
   7. Any funds transferred by the secretary of health and human services
 to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
 Funds from the trust shall be used for providing health benefits through
 an  approved  organization, which, at a minimum, shall include essential
 health benefits as defined in 42 U.S.C. 18022(b); to reduce the premiums
 and [cost sharing] COST-SHARING of  participants  in  the  basic  health
 program;  or  for such other purposes as may be allowed by the secretary
 of health and human services.  Health  benefits  available  through  the
 basic health program shall be provided by one or more approved organiza-
 tions  pursuant  to an agreement with the department of health and shall
 meet the requirements of applicable federal and  state  laws  and  regu-
 lations.
   §  5.  This  act shall take effect July 1, 2026; provided however that
 the amendments to paragraph (d) of subdivision three of  section  369-gg
 of  the  social  services  law  made by section two of this act shall be
 subject to the expiration and reversion of such  paragraph  pursuant  to
 section  3 of part H of chapter 57 of the laws of 2021, as amended, when
 upon such date the provisions of section two-a of this  act  shall  take
 effect;  provided further that the amendments to paragraph (b) of subdi-
 vision five of section 369-gg of the social services law made by section
 three of this act shall be subject to the expiration  and  reversion  of
 such paragraph pursuant to section 3 of part H of chapter 57 of the laws
 of  2021,  as  amended,  when  upon  such date the provisions of section
 three-a of this act shall take effect; provided further that the  amend-
 ments  to subdivision seven of section 369-gg of the social services law
 made by section four of this act shall be subject to the expiration  and
 reversion  of  such paragraph pursuant to section 3 of part H of chapter
 57 of the laws of 2021, as amended, when upon such date  the  provisions
 of section four-a of this act shall take effect.

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Senate Bill S9589

Sponsored By

Current Bill Status - In Senate Committee Health Committee

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co-Sponsors

2025-S9589 (ACTIVE) - Details

2025-S9589 (ACTIVE) - Summary

2025-S9589 (ACTIVE) - Sponsor Memo

2025-S9589 (ACTIVE) - Bill Text download pdf

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Sponsored By

Current Bill Status - In Senate Committee Health Committee

Actions

co-Sponsors

2025-S9589 (ACTIVE) - Details

2025-S9589 (ACTIVE) - Summary

2025-S9589 (ACTIVE) - Sponsor Memo

2025-S9589 (ACTIVE) - Bill Text download pdf

Comments