President Trump’s One Big Beautiful Bill, which includes over $1 trillion in Medicaid cuts over the next ten years, was signed into law by Congress. According to estimates, this will cost 20 million Americans their health care and cause 51,000 deaths nationwide. People with disabilities are excluded from losing individual coverage under the bill, but many Americans would be impacted due to the size of the cuts.
As the CEO of CP Unlimited, a group that provides advocacy and care for New Yorkers with disabilities, and as the city’s doctor, we are keeping a careful eye on these possible outcomes.
The act is predicted to result in over 30,000 employment losses for New Yorkers, more than $7 billion in economic losses for New York City, and $13 billion in lost funds for New York State. This will unavoidably affect our capacity to provide disabled New Yorkers with life-saving assistance.
The claim that vulnerable groups will be exempt is based on a skewed perspective on health care. It makes the assumption that, within our larger health care system, individual health insurance is a single variable. That argument, even if taken at face value, is flawed because not all individuals with disabilities would continue to be covered by Medicaid under a system that is so rife with red tape.
The effects are more nuanced for individuals who do keep their coverage.
The American health care system has flaws and is vulnerable. More than 70 million Americans and four million of our fellow New Yorkers are covered by Medicaid, the country’s largest health insurance program. Every element of the health care system will be impacted if Medicaid funding is cut by hundreds of billions of dollars.
More than a million people with disabilities in New York State and hundreds of thousands in New York City are dependent on Medicaid. Every day, we provide for them.
The New York City Department of Health and Mental Hygiene and CP Unlimited are dedicated to maintaining and growing community-based health services. By preventing ER visits, our approach lowers public expenses and enhances personal health outcomes. Our goal is to provide people with the means to live a satisfying life, stable housing, meaningful work, and connections to their community.
Medicaid is essential for such work.
Social service providers such as CP Unlimited are able to get Medicaid reimbursement for their services in New York State. Like the municipal Health Department, we also depend on federal funds that passes through state agencies.
For instance, CP Unlimited provides annual services to over 1,000 households. Additionally, we already have a limited budget, just like a lot of the groups that collaborate with us. Nurses and direct support providers are vital employees in the disability industry who need to be safeguarded.
More patients will inevitably turn to our hospitals for crisis care if social services and public health start to fail. The growing number of uninsured patients will result in severe deficits for hospitals. Medicaid will no longer be able to be billed by providers for people who are in urgent need of care. People with disabilities in New York will experience the burden of an underfunded system in their communities and at the hospital, even if they continue to have coverage.
More than a million people in New York State are expected to lose their Medicaid coverage as a result of this new law, with an estimated 600,000 of those individuals residing in New York City. New York’s Essential Plan, which provides publicly supported healthcare coverage to anyone earning less than 250% of the federal poverty level (in 2025, that’s just under $40,000 annually for an individual), would likewise be significantly impacted financially.
Over 700,000 subscribers in New York State’s Essential Plan would no longer be eligible for federal assistance, which would result in their loss of coverage or increased premiums.
One thing is certain: Medicaid is essential to preserving the infrastructure for basic care, particularly for New Yorkers with disabilities. The entire impact of these cuts on our health care system is impossible to predict. We must make sure that New Yorkers, especially our most vulnerable, are safeguarded at all times, even if the infrastructure is already under a lot of strain.
Morse is the New York City Health Department’s acting commissioner. Pancari is CP Unlimited’s CEO and president.
