NYC Care has 120,766 members and a $100 million budget. Health officials told the Council a Medicaid 'crisis' is coming

NYC Care, the city's program that gives uninsured New Yorkers low-cost care at public hospitals regardless of immigration status, faces a test starting in January. At a City Council hearing Wednesday, health officials said they expect many more people to need it.

Why it matters to residents: new federal Medicaid rules take effect Jan. 1, 2027. Enrollees will have to recertify every six months and meet work requirements. Council Member Mercedes Narcisse, who led the Hospitals Committee hearing, said city officials estimate as many as 900,000 New Yorkers could be affected (transcript). She said about 197,000 have already lost coverage in earlier federal eligibility changes (transcript). NYC Care is the place the city says people can turn if they lose insurance. It is not insurance itself. Members pay on a sliding scale at Health + Hospitals sites, the program says.

What the city told the Council

Membership is 120,766, as of Oct. 23, said Dr. Ted Long, who launched the program for Health + Hospitals in 2019 (transcript). He said it peaked around 150,000. Part of the drop, he said, came from older members moving onto state Medicaid after New York opened it to people 65 and older regardless of immigration status (transcript).

The budget hasn't grown. Asked about money, Long said NYC Care's budget is $100 million a year. It has been the same since a couple of years after the program began, though spending has grown with the program (transcript). He said that if every primary care panel were full, H+H could take in another 15,000 to 20,000 patients today (transcript).

Officials called it a crisis they can see coming. Long said recertification and work requirements will cause "coverage disruption," with people falling off insurance for a couple of months and then coming back (transcript). H+H has sent nearly 400,000 emails to patients about the changes, and its financial counselors will be the main point of contact, he said (transcript).

The Bronx may get an exemption. Long said the state has applied for a work-requirement exemption covering the Bronx, which he believes meets the criteria. It has not been approved yet (transcript).

Access numbers. Officials said more than 90% of members have been offered a new-patient appointment within two weeks (transcript). They also said three in four members complete a primary care visit within a year (transcript).

Members pressed on capacity. Council Member Selvena Brooks-Powers asked how H+H is preparing for the January changes and whether it will need more city money if enrollment climbs (transcript). Members also asked for neighborhood-level data on where NYC Care members live and where people losing coverage are likely to turn (transcript).

What else was said. A group representing community health centers testified that those centers provided more than 630,000 visits to uninsured patients in 2025. It said they could lose $224 million a year under the federal law (transcript).

What our records add

This was an oversight hearing, so no bill was attached. The matter record shows it was filed the same day. The Hospitals Committee has 10 items pending, all for more than 180 days, our committee page shows.

What's next

The federal changes start Jan. 1. The Council's next big chance to change NYC Care's funding is the preliminary budget hearings in the spring. Long told members that H+H is in "close communication" with City Hall about the program's costs.