When Mireille Satheu’s family lost their health insurance last month, she signed up her three children for a new plan. But she and her husband could not afford coverage for themselves.
Ms. Satheu, a personal care assistant who lives in Plattsburgh, N.Y., was among more than 400,000 people in the state who lost their low-cost health coverage, known as the Essential Plan, after federal funding cuts under President Trump.
“I was disappointed and also scared,” she said. “You never know. You could get sick any time.”
Ms. Satheu said that she and her husband, a machine operator in a warehouse, could not pay hundreds of dollars per month for insurance. Their previous plan had no monthly premium. She plans to work more hours and seek coverage through her employer.
New York’s Essential Plan, an unusual state program that is almost entirely federally subsidized, was a lifeline for people who earn too much to qualify for Medicaid but struggle to pay for private insurance. Established in 2015 under the Affordable Care Act, the plan also became popular with immigrants ineligible for Medicaid, and drove down the number of people in New York without health insurance to below 5 percent.
Now, health experts are worried that number will rise and that more people will lose access to care. And many New Yorkers are now paying more for insurance at a time when families are already struggling to afford housing and groceries.
The plan had become a spigot of billions of federal health care dollars, more than were routed to other states. When Mr. Trump’s domestic policy law was approved last year, it restricted which noncitizens were eligible, reducing the flow of funding. The state then limited eligibility. The earnings threshold for a family of four used to be $82,500; now it is $66,000.
Health officials and community groups are rushing to help people find new insurance. Nearly 450,000 people lost coverage on July 1, and about 242,000 have since joined new plans, state officials said. New Yorkers have until the end of August to sign up for coverage through the state’s marketplace.
Elisabeth Benjamin, a vice president at the Community Service Society, an antipoverty nonprofit that helps people access health care, said that many of those who lost coverage were freelancers and hourly workers.
“Our call volume has doubled,” she said. “People are confused and upset. They’re going without insurance.”
The deep cuts to the Essential Plan come as congressional Republicans have reduced federal subsidies for people on A.C.A. plans, and enrollment has dropped. More New Yorkers are expected to lose their insurance in January when new Medicaid rules, including work requirements, take effect. State officials have warned that more than one million people in New York could lose Medicaid coverage in the coming years.
Helen Arteaga, the deputy mayor of health and human services in New York City, said in an interview that she had met with health executives and community groups about how to support people who are losing coverage.
“This is not a one-time problem,” she said. “We’re going to need solutions to support New Yorkers for the next two to three years.”
Representative Alexandria Ocasio-Cortez of New York met with Ms. Arteaga at City Hall last week and posted a video on social media expressing concern about the health care cuts. Democrats have sought to highlight the issue ahead of the midterm elections in November.
Republicans like Representative Mike Lawler have defended the cuts, arguing that they reined in wasteful programs. A spokesman for Mr. Lawler, who is facing a competitive race in the Hudson Valley, said that Gov. Kathy Hochul “built a health care program no other state in the country runs, spent New York into a corner and now wants to blame Washington when the bill comes due.”
Bill Hammond, a health care policy analyst at the Empire Center for Public Policy, a fiscally conservative think tank, said the Essential Plan was unsustainable under the previous rules. Those losing coverage have incomes between 200 percent and 250 percent of the federal poverty level, or between $31,900 and $39,900 for a single adult.
“I think it’s reasonable to ask people in that range to pay more,” he said.
Ms. Hochul, a Democrat, has said that she fought to preserve the plan for more than one million people with lower incomes. Nicolette Simmonds, a spokeswoman for the governor, said that the state was helping people find new coverage.
“Make no mistake: The devastation families are experiencing is a direct result of Republicans’ callous vote,” Ms. Simmonds said, “and the governor will continue to do everything in her power to ensure New Yorkers are protected.”
Some state lawmakers had called on Ms. Hochul to provide state funding to prevent people from losing coverage, but it was not included in the state budget deal earlier this year. Keeping those 450,000 people on the plan could have cost more than $2 billion annually, experts said.
Mary Leming, a part-time teacher and editor who lives in Stony Brook on Long Island, lost her coverage last month and signed up for a plan on the state marketplace that costs more than $800 per month. She puts it on her credit card.
“That is not in my budget,” she said.
The new plan is worse than her old one, she said, and her dermatologist does not accept it. “I’ll have to pay out of pocket,” she said.
New York City’s public hospital system could be further strained by an influx of uninsured people.
Dr. Jonathan Jiménez is a family physician and executive director of NYC Care, a program overseen by the hospital system that provides low-cost and free services to those without insurance. He said he was worried about those who will delay preventive care and end up in hospitals.
“That’s where you see the impact of not having access,” he said. “People in their 40s or 50s showing up with a massive stroke and they had hypertension, but they weren’t connected to care. Those are all preventable deaths.”
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