The New York State Association of Counties (NYSAC) and the New York State County Executives Association (NYSCEA) are calling on New York’s Congressional Delegation to reject the “deeply harmful Medicaid and nutrition assistance cuts included in the House Budget Reconciliation” bill.
According to NYSAC, the proposed changes would strip vital healthcare coverage and food assistance from more than 2 million New Yorkers and siphon away billions in federal support from counties already under financial strain.
“This budget proposal is a direct threat to the health and well-being of our residents,” said Benjamin Boykin II, President of NYSAC and Westchester County Legislator. “Stripping coverage from over 2 million people and shifting billions in costs to counties will devastate public health infrastructure and leave local governments with impossible choices. Congress must reject this unconscionable plan.”
According to estimates, over 1.4 million New Yorkers would lose their Medicaid health insurance coverage, and more than 730,000 would be cut off from the Essential Plan—resulting in an annual loss of $13.5 billion in federal funds for New York and its counties.
At the same time, proposed changes to the Supplemental Nutrition Assistance Program (SNAP) would drastically reduce the federal contribution, costing the state an additional $2.1 billion annually. Counties, already financially strained, would face skyrocketing administrative costs.
“This proposal forces counties into an impossible position,” said Jason Garnar, President of NYSCEA and Broome County Executive. “We would either need to raise property taxes substantially or make deep cuts to critical services like mental health, child welfare, and public health. Our communities simply cannot absorb this kind of blow.”
The organizations claim the legislation not only jeopardizes the state’s healthcare and economic stability but also unfairly targets New York by shifting costs disproportionately compared to other states. The burden would fall heavily on local governments that are already grappling with limited resources and an overstretched workforce.
“The proposed federal cuts represent a triple threat—to county budgets, to the vulnerable people we serve, and to the stability of New York’s healthcare system,” said NYSAC Executive Director Stephen Acquario. “Counties simply cannot absorb the loss of billions in federal funding without massive service reductions or local tax increases. These changes will undermine public health, jeopardize hospitals and healthcare providers, and leave working families without the support they need. Congress must protect New York’s future by rejecting these devastating cuts.”
Safety-net hospitals and providers would be among the first casualties, facing over $1.3 billion in uncompensated care annually. Rural counties risk losing entire healthcare networks, resulting in healthcare deserts, economic instability, and diminished access to care.
Emergency departments will become the primary care providers for thousands of newly uninsured residents, leading to worse health outcomes, higher long-term costs, and lost jobs in an already fragile healthcare sector.
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