Hundreds of Thousands Lost Essential Plan Coverage. How Can They Get Care Next Year?

1In a hurry? Start here

1. The people who lost Essential Plan (EP) coverage in July had incomes between 200% and 250% of the federal poverty level, or about $31,920 to $39,900 a year for one person. The change applied to citizens, green card holders and people with other statuses alike, with separate arrangements for pregnant people. People with lower incomes can keep EP and apply year-round.

2. Starting in January 2027, federal premium tax credits will be available only to citizens, green card holders, Cuban and Haitian entrants and people with a few specific statuses. Other lawfully present immigrants can still buy standard plans on the state marketplace, but most will pay full price. If your income is at or below 200% of the poverty level, refer to the notice the state sends you for what happens to your EP coverage next year.

3. Open enrollment runs from November 1 through January 31, 2027. Enroll by December 15 for coverage starting January 1. For people who end up without insurance, there are still options for children, pregnant people and emergency care, as well as NYC Care and hospital financial assistance.

Say Mrs. He is 55 and does housekeeping in Sunset Park. She has a green card, lives alone, files her own taxes and earns about $35,000 a year. She has been on EP for the past two years without paying a monthly premium.

(Mrs. He is fictional, and the situations below are hypothetical.)

This spring, a letter from the state told her that she would no longer qualify for EP after the change in July. She thought she had done something wrong. All that had changed were the rules.

2What people are asking in the comments

Over the past few weeks, Xiaohongshu has been full of posts about losing health insurance subsidies and paying higher premiums in 2027. One person said the change would leave them 「broke」 next year. In dozens of comments, people said they could not afford coverage and had stopped buying it, or shared monthly premiums of $600 or $700. A post about paying full price in 2027 without a green card drew plenty of saves. In the comments, people asked how to buy coverage when you're self-employed.

Some people also wonder whether EP and Obamacare are the same thing, or whether EP counts toward a 「public charge」 determination.

Those are readers' accounts and questions. Here is what the New York State Department of Health, the NY State of Health marketplace, the Department of Financial Services and New York City say about each issue.

3Who lost EP coverage in July?

First, two terms. EP is New York State's Essential Plan. The federal government provides much of its funding, and the monthly premium is currently $0. What people often call 「Obamacare」 means a Qualified Health Plan, or QHP, sold through the state marketplace in New York. Depending on your income, you may qualify for federal tax credits.

The state Department of Health's March 23 release says about 450,000 New Yorkers stopped qualifying for EP on July 1, while about 1.3 million kept it. The marketplace's Simplified Chinese guidance puts it plainly: people enrolled with incomes between 200% and 250% of the federal poverty level, or $31,920 to $39,900 a year, no longer qualify.

The change stems from H.R.1, a federal law passed in 2025. The marketplace says the law eliminated premium tax credit eligibility for most lawfully present immigrants, cutting EP's federal funding in half. The state could not make up the difference.

What happened to the people affected? The marketplace's August 30 data show that about 59% found new coverage through the marketplace. About 14% bought a Qualified Health Plan, about 35% stayed in EP, and about 11% moved to Medicaid. The report says that people in the latter two groups had an income change that let them stay in EP or made them eligible for Medicaid. Another 41% did not enroll through the marketplace, and the report does not say whether they have coverage now.

People who can stay on EP live in New York State, are 19 to 64, are lawfully present in the United States and have incomes at or below 200% of the federal poverty level. They do not qualify for Medicaid or Child Health Plus and do not have employer-sponsored or other coverage. The marketplace's EP page lists 2026 income limits of $31,920 for one person, $43,280 for two, $54,640 for three and $66,000 for four. People can apply at any time of year.

Back to Mrs. He. She is a household of one with a $35,000 annual income, squarely between 200% and 250%. With a green card, she can still receive federal premium tax credits in 2027 and buy a Qualified Health Plan during open enrollment. The IRS explains that receiving the credit requires filing a federal tax return each year, including when your wages are paid in cash. The Simplified Chinese guidance gives an average monthly premium of $220 after credits for a Silver plan as an example. That figure was for this year's transition. Use the official website and enter your own income to see what you would pay next year.

4Next year, most lawfully present immigrants without a green card lose the tax credit

Section 71301 of H.R.1 limits federal premium tax credits starting with the 2027 tax year to U.S. citizens and nationals, green card holders, Cuban and Haitian entrants, and people lawfully residing in the United States under a Compact of Free Association (COFA).

That means people with work or student visas or Temporary Protected Status (TPS), people applying for asylum, refugees and people granted asylum generally cannot get the credit when they buy a Qualified Health Plan in 2027. The health policy research organization KFF also says in its November analysis that refugees, asylees and other lawfully present immigrants can still buy plans on the marketplace, but without the credit.

The marketplace's November 2 guidance says the state will review accounts of people who receive tax credits this fall. Changes in what they pay begin in 2027.

Another change already happened on October 1. The same marketplace page says that from October 1, some immigrants could move from Medicaid to EP with the same benefits. It mainly affects refugees, asylees, people admitted on parole and survivors of domestic violence or human trafficking. The state sent notices by mail, text or WhatsApp in early September.

The marketplace's public pages do not clearly say whether lawfully present immigrants without green cards who earn at or below 200% of the poverty level can stay in EP in 2027 or will have to pay. The state comptroller's July budget report says that federal funding for EP coverage of certain lawfully present immigrants will end in January 2027. After EP returns to its original Basic Health Program structure, the state can use its accumulated trust funds to continue covering 「certain immigrants」 through EP. The Division of the Budget estimates that existing funds can keep the whole plan operating through December 31, 2028. The report also says its finances after that are uncertain. Check the notice the state sends you to see what happens in your case.

5Open enrollment: mark December 15 and January 31

The state Department of Health's October 28 release says open enrollment for 2027 Qualified Health Plans runs from November 1, 2026, to January 31, 2027. Enroll by December 15 for coverage starting January 1. The release says this is another opportunity for people who lost EP this year to return to the marketplace. Applications for EP, Medicaid and Child Health Plus are open all year.

A few numbers put next year's premiums in context.

• The state Department of Financial Services' September 4 release says individual-market insurers asked for a 20.6% increase. The state approved 6.0%.

• The enhanced federal premium tax credits expired on December 31, 2025, according to the governor's office. At the time of checking, we found no extension passed by Congress.

• The marketplace says the additional state cost-sharing reductions on Silver plans this year, Silver Supreme and Silver Enhanced, will end after 2026 because of the new federal law.

Look up next year's prices on the marketplace and estimate what you would pay based on your household's income and status before making a decision.

Hi, I'd like a Mandarin interpreter, please. I lost my Essential Plan coverage this year. Can you help me compare plans for 2027 and see if I qualify for a premium tax credit?

Hello, I need a Mandarin interpreter. I lost my EP coverage this year. Can you help me compare 2027 plans and check whether I can get a premium tax credit?

6If you are still uninsured, here are other options

• Children: New York City says children under 19 in New York can get Child Health Plus regardless of immigration status and income. The state Department of Health says there is no premium when household income is below 2.2 times the federal poverty level.

• Pregnancy: The city says the income limits are higher during pregnancy, and pregnant people can apply for Medicaid regardless of immigration status. The marketplace also says coverage is unchanged for children, pregnant people and people who recently gave birth.

• Emergency care: The marketplace's H.R.1 toolkit says people without lawful status and short-term visa holders who are not New York State residents can still apply for Emergency Medicaid.

• NYC Care: Its website describes a program for getting care through NYC Health + Hospitals (H+H) without insurance. You must live in one of the city's five boroughs and either be ineligible for any New York State insurance plan or unable to afford one under government guidelines. It does not record immigration status or charge a monthly fee. Fees for care depend on income and start at $0. Call 646-692-2273.

• Discounts at public hospitals: H+H says it does not turn people away because they cannot pay and does not share application information with immigration officials. Call 1-844-692-4692 and press 3 for a financial counselor.

• Other hospitals: The state attorney general says people with incomes at or below 400% of the federal poverty level can apply for hospital financial assistance. Hospitals cannot consider immigration status. For non-emergency care, you generally have to live in the hospital's service area.

7Where to ask for help in Chinese

• Marketplace customer service: 1-855-355-5777 (TTY 1-800-662-1220), Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 9 a.m. to 1 p.m. Its language support page is available in Chinese and says help is free.

• Free enrollment assistors: The marketplace's 「Find Local Help」 directory lets you search by ZIP code and 「Preferred Language」. Chinese-language options include Mandarin, Cantonese, Chinese, Fujianese, Taishanese and Shanghainese. Under 「Type of Helper」, select 「Assistor」 for free help. The directory also lists licensed insurance brokers, who the marketplace says do not charge for enrollment help. Brokers sell insurance, so start with an assistor if you want a more neutral view.

• Free NYC Health Department counselors: Call 866-INSURED (866-467-8733) or text CoveredNYC to 55676. The department's Chinese page says help is available in multiple languages regardless of immigration status.

• Chinese materials: The marketplace's guide to EP changes is available in Simplified and Traditional Chinese.

8Two 「but what if」 questions

「But I'm in decent health. What if I just skip insurance next year?」

Run the numbers first. You can apply for EP, Medicaid and Child Health Plus at any time, but you generally can buy a Qualified Health Plan only during open enrollment. After January 31, 2027, you would have to wait until the next open enrollment in November 2027 for coverage starting in January 2028, unless you have a qualifying life event such as loss of coverage, a move, marriage, having a baby or pregnancy. You generally need to report that to the marketplace within 60 days. 「I need to see a doctor now」 is not on that list. Start by estimating your price on the marketplace, then ask a free enrollment assistor.

「But I've heard EP doesn't count as public charge?」

Some people say that on Xiaohongshu, but be careful. Under the new public charge rule that took effect September 18, any means-tested government benefit received after the effective date may be considered. The rule does not expressly exclude EP. Whether it affects you depends on what type of immigration application you are filing. This series' article on public charge goes into more detail. For help with your situation, call the free immigration legal hotline at 800-354-0365.

9One last thing

Mrs. He lost EP because federal funding fell. She didn't do anything wrong.

She needs to sit down and compare a few plans for next year by December 15. If she is unsure, she can call for free help.

The options are narrower for people without a green card, but options for children, pregnant people and emergency care are still there, along with NYC Care and hospital financial assistance.

Did someone in your household lose EP this year? How did you handle it? Tell us in the comments, and leave out personal information.