Opinion: GOP’s ‘One Big Beautiful Bill’ will savage NY’s health care system, budget and economy

It’s quite astonishing to think that we have reached a point in this extremely charged and partisan political environment where members of Congress would decline to protect their own constituents in unashamed deference to party politics. 

Yet, that’s exactly where we are, and that’s exactly what happened in New York. 

On May 22, Republicans in the U.S. House of Representatives voted to gut Medicaid and the Affordable Care Act, leaving millions without health insurance and ravaging state budgets across the country. Any of the seven New York Republican members of Congress had the power to stop this bill, which passed by a one-vote margin, but none did. 

In effect, they all voted in favor of egregious cuts to public health coverage for seniors, people with disabilities and low-income children and families in their congressional districts. All except Rep. Andrew Garbarino, that is, who reportedly slept through the vote. 

Make no mistake, the GOP’s “One Big Beautiful Bill” that was voted out of the House and is now with the U.S. Senate is a poison pill for New York. Perhaps deliberately so, given the animus the GOP has shown for blue states with large urban centers and diverse populations. 

Consider this: New Yorkers would make up more than 10% (1.5 million) of the 16 million Americans at risk of becoming uninsured due to federal threats to Medicaid and the Affordable Care Act. The University of Pennsylvania estimates these cuts will lead to over 42,000 excess deaths annually.

The cuts in the bill will devastate New York’s health care system, budget, and economy. If the bill is passed as-is, 1.5 million New Yorkers will become uninsured, a $13.5 billion hole will be left in the state budget, hospital funding will be cut by $3 billion and marketplace premiums will rise by 38%, or $2,700 a year for a couple. 

The Essential Plan, New York’s basic health plan, includes comprehensive benefits with no monthly premium or deductible for 1.6 million New Yorkers with incomes below 250% of the federal poverty line. Lawfully present New York low-income residents are eligible for Essential Plan coverage. However, under the One Big Beautiful Bill, approximately 500,000 of the lowest-income lawful immigrants would have to move from Essential Plan coverage to Medicaid plans funded solely by the state, costing New York around $2.7 billion. Around 225,000 lawfully present New York residents with slightly higher incomes would lose coverage entirely and become uninsured. 

Congress has a bullseye on New York. In addition to eviscerating the state’s health care coverage landscape as we know it, the reconciliation bill would leave three million New Yorkers at risk of losing SNAP benefits, decimating the longstanding federal-state partnership and leaving New York with another $2.1 billion annual hole in its budget.

It’s possible New York GOP members either did not read or did not understand what they were voting for, as the bill was rushed to the floor for a vote. That would partially explain why earlier this month, after the House passed the bill, five Republican members representing New York issued a letter to a top member of the U.S. Senate finance committee detailing how the bill (which is formally known as H.R. 1) would disproportionately harm New York and gut New York’s Essential Plan.

Late last week, the Senate’s parliamentarian issued a ruling on several provisions within the Senate’s version of the Big Beautiful Bill Act. Essentially, the parliamentarian found that multiple health-related provisions included in the Senate Finance Committee’s text were in violation of the Senate’s reconciliation rules and would thereby subject the bill to a 60-vote point of order rather than a simple majority vote.

Over the weekend, Senate Republicans navigated around this obstacle by ignoring the parliamentarian and employing some questionable mathematics to conceal the full cost of the tax cuts in the Senate version of the bill, all so they could advance it to the full Senate, which they did, and avoid a filibuster from Senate Democrats. It’s worth noting that Senate Republicans have called for even deeper cuts to Medicaid than House Republicans.

At this point, it’s unclear when the bill will return to the House. When it does, New York’s seven Republican members of Congress will have a second chance to stand up for New York and protect the state and their constituents from these devastating cuts.