Glens Falls Chronicle Serving the Glens Falls/Lake George region; Warren, Washington and northern Saratoga counties since 1980
By Christopher D. Hoy, MD
The Healthcare Coalition for the North Country, of which I am a member, has just released a report on the impact on the North Country of the Medicaid cuts in the ”One Big Beautiful Bill” (HR 1).
The goal of this article is not to review all the findings in our report, but to focus on those findings most relevant to readers of the Chronicle.
Over the last several years Medicaid expansions have allowed New York State to decrease the number of uninsured people in the state to 5%, essentially achieving universal healthcare with premiums that are supplemented by subsidies where appropriate and with tax credits applied to the premium in advance.
Since the expansion of the NYS Essential Plan in 2023 hundreds of thousands of new enrollees have been able to get health care at affordable prices.
Because of the $1 trillion cuts in Medicaid in the OBBBA, The New York State Department of Health has already applied to end the Essential Plan by July 2026 and return to the Basic Plan that will not cover many of the new enrollees. 40% of the new enrollees have been small business owners, employees of small business owners, and independent contractors. If you are insured by the Essential Plan, the Marketplace, the Affordable Care Act, Obamacare, or Qualified health plans, you are insured by Medicaid.
You will be affected by these cuts as early as this January when your premiums will rise by 18-75%. The proposed Basic Plan is likely to cover for example single persons earning less than $33,000 a year, or a family of 4 earning less than $64,000 a year. In round numbers, commercial health insurance for a single person 19-64 costs $12,000, a married couple $18,000, a family of four $24,000. Many will be unable to afford these premiums and will gamble on continued good health. The uninsured rate in New York State is likely to rise back to 15%, affecting mostly working and middle class people.
The impact of these cuts extends far Into the entire healthcare system. We know from past experience that when people are uninsured, they delay seeking health care until they’re sicker and forced to go to the emergency room. They are more likely to require longer hospitalizations and to die. Care is more expensive and hospitals don’t get paid.
The biggest complaint of anyone who has gone to the emergency room has been the five hour wait. With these cuts the waits will only get longer for all people who go to the emergency room, not just people with Medicaid. Nine of the 15 hospitals in the North Country have fewer than 25 beds. Many may be forced to cut services or close. We will have to travel even further than we already do to get emergency care or see doctors.
The impact of these cuts will change the way we get healthcare in many other ways not outlined here. And that impact will come much sooner than we expected.
Dr. Hoy is a nephrologist in Queensbury.
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