Millions of Americans Are Losing Health Insurance in 2026—Here’s What It Means for You

The Impact of Losing Health Coverage

Nearly 450,000 New Yorkers are set to lose their health coverage starting July 1. This is part of a broader trend where millions of Americans are expected to become uninsured over the next year due to federal changes in Medicaid funding and the expiration of subsidies that made Affordable Care Act (ACA) marketplace plans more affordable.

The New Yorkers affected were enrolled in what is known as the Essential Plan, a New York-specific, taxpayer-subsidized healthcare plan established in 2015 under the ACA. This plan was designed for individuals who earned too much to qualify for Medicaid but not enough to afford private health insurance. The Essential Plan used ACA tax credits to provide extremely low-cost health insurance to over a million New Yorkers. However, those earning between 200% and 250% of the federal poverty level will now lose their coverage. Some may try to find new plans on the ACA marketplace, but these can cost hundreds of dollars per month.

Changes Due to HR 1

These changes are a result of HR 1, also known as the “Big Beautiful Bill,” which was passed a year ago and signed into law on July 4, 2025. As part of HR 1, the federal government withdrew funding that had allowed New York state to receive tax credits for the health plans of certain legally present immigrants. To address this funding gap, the state of New York adjusted the eligibility criteria for the Essential Plan.

Bill Hammond, a senior fellow at the Empire Center, a nonprofit think tank focused on New York public policy, explains that the affected individuals are low-income people who will now have to find significant amounts of money to pay for insurance. “It goes on the list of things they have to spend money on, like rent, utilities, and food,” he says.

Other changes stemming from HR 1 are expected to reduce the number of people receiving Medicaid across the country. For example, 41 states (including D.C.) expanded Medicaid since 2014 under the ACA, allowing adults with incomes up to 138% of the federal poverty level to gain coverage. However, HR 1 requires that as of January 1, 2027, adults enrolled in Medicaid in states that have expanded the program must meet an 80-hour-per-month work requirement. Additionally, states must verify program recipients’ eligibility every six months instead of every year.

Rising Uninsured Numbers

The Congressional Budget Office, a federal agency, has estimated that the Medicaid program changes would result in 7.8 million more people in the U.S. without health insurance by 2034. The Urban Institute, a nonprofit think tank, projected that the number would be higher, sooner: up to 10.1 million fewer people enrolled in Medicaid by 2028.

Congress also allowed federal subsidies for ACA plans to expire this year, meaning that households earning more than 400% of the federal poverty level no longer qualify for premium subsidies. These Americans saw a significant increase in premiums starting in 2026, leading many families to drop coverage rather than pay hundreds or thousands of dollars a month for health insurance. Federal data released on June 26, 2026, showed that 19.2 million people enrolled in ACA Exchange plans in 2026—down about three million from the 22.1 million who enrolled in 2025.

Effects on Hospitals and Health Centers

The impacts of losing health coverage extend beyond families to hospitals and health centers. A federal law requires that hospitals participating in Medicare screen and stabilize anyone arriving in their emergency rooms, regardless of their ability to pay. When patients cannot pay, hospitals absorb the costs and pass them onto insured patients by increasing prices, according to studies.

Amanda Pears Kelly, CEO of Advocates for Community Health, a national membership organization for federally qualified health centers, says, “I would not be surprised if just the overarching cost of health care goes up, because if you have massive amounts of uncompensated care, they have to make up the dollar somewhere.”

Federally qualified health centers—essentially primary care hubs that treat both insured and uninsured patients—and public hospitals are concerned that their numbers of uninsured patients will rise to unsustainable levels, especially when their budgets are already stretched thin.

“It’s very likely that we are going to see a pretty significant influx in the number of uninsured patients,” Pears Kelly says. “There are no additional dollars to help with that.”

The National Association of Community Health Centers estimates that HR 1 will lead to 1,800 community health center closures across the country and will cost community health centers around $7 billion a year in uncompensated care.

Struggles of Federally Qualified Health Centers

Federally qualified health centers are already struggling because many of their patients are on Medicaid, and Medicaid often compensates them at a lower rate than it costs to provide care, Pears Kelly says. Now, as more people get kicked off of Medicaid, these centers won’t even get that compensation.

“There are zero resources coming in to support health centers to make sure that people can continue to access care,” she says.