Policymakers and healthcare experts discuss access to equitable care

With the new Medicaid work requirements starting on Jan. 1, nearly a million New Yorkers may lose their healthcare when the One Big Beautiful Bill Act goes into effect.

Local policymakers like New York City Department of Health and Mental Hygiene First Deputy Commissioner Nellie Afshar and state Sen. Erik Bottcher came together with healthcare experts on Wednesday at Healthix and City & State’s event “Excelling in a Time of Change.”

Afshar said more than 3.5 million New Yorkers are on Medicaid and an estimated 62% of New Yorkers cannot afford the true cost of living in one of the wealthiest cities in the world.

“H.R.1 (OBBA) was written with the intent to impose a massive red tape around Medicaid and put the burden on the individual to prove they qualify. It intentionally stacks the deck against working people,” Afshar said. “We cannot change federal legislation, but excellence in this moment means that we can change how it impacts our city.”

Now, the implementation of these new requirements is up to the state Department of Health while Afshar said she and her colleagues on the city level focus on providing direct support, outreach and education to mitigate harm. The city health department has contacted over 35,000 healthcare providers and 60,000 faith-based and community care partners.

However, the community care outreach cannot start and end with access to medical care after a diagnosis, when preventing these health outcomes is just as key. Bottcher has been working on legislation to target these social determinants of health, from affordable housing to gun control to mental health.

Bottcher, a former New York City Council member, said that treatment of people with mental health disorders was a necessary initiative when discussing healthcare outcomes.

“So here we are, the richest city in the richest country on the planet, with people dying on the street from untreated mental illness,” Bottcher said in his speech at the event. “We are so much better than that as a society.”

As a City Council member, Bottcher said he and his colleagues worked to expand funding for mental health facilities and to require the city to put mental health services in every family homeless shelter as a way to prevent mental illness from going undiagnosed and untreated.

In an interview with City & State after his speech, Bottcher said he’s speaking with his colleagues in Albany on prioritizing housing next year, as New York City faces a historically low 1.4% vacancy rate.

Bottcher said policy initiatives like his Build More, Get More Act, which proposes having the state pay municipalities $10,000 for every new unit of housing they create, is the first step. 

“When we talk about issues like healthcare, childcare, economic security or education, they really all come back to housing, and we have big, big headwinds with respect to housing,” he said.

The full-day event at the Museum of Jewish Heritage featured numerous panels, and speakers. The event was kicked off by emcee Larry Scott Blackmon of The Blackmon Organization, who provided the welcoming remarks, and then Healthix President and CEO Todd Rogow gave the opening remarks. The day’s panels focused on responding to national healthcare priorities at the local level, designing patient care, closing gaps in healthcare and overcoming barriers to maternal care. In the afternoon, New York City Council Majority Whip Kamillah Hanks also provided valuable legislative insights.