On January 22nd the House voted to extend the Affordable Care Act (ACA, or Obamacare) subsidies.  Recognizing the need of our communities to have access to affordable health care, 17 Republicans sided with Democrats in voting for the extension.  But why was the extension necessary in the first place?  As is being uncovered on a daily basis, the provisions of the so-called “One Big Beautiful Bill Act” (OBBBA, or H.R.1) which the president signed into law on July 4, 2025, have such egregious cuts to health care that even those vehemently opposed to Obamacare recognize the need for subsidies until the current administration can come up with a better plan.  The Congressional Budget Office reported the OBBBA will make low-income people poorer and wealthier people richer.   Distributional Effects of H.R. 1, the One Big Beautiful Bill Act (Congressional Budget Office letter dated 6/12/25).

Recognizing the need for more information on this topic, the League of Women Voters Huntington, in cooperation with the Healthcare Education Project, sponsored a webinar centered on the effects on health care of H.R.1.  Panelists Mark Hannay of Metro NY Health Care for All, Vanessa Baird-Streeter of the Health & Welfare Council of Long Island, and Anna Barone of Grace Group Medicare Consultants – with an introduction by Cynthia Ngombe of the Healthcare Education Project who coordinated the event - led us through some alarming facts and statistics.  H.R.1 cuts over $1 trillion from Medicaid, Medicare and the Affordable Care Act, strips Medicaid and Essential Plan coverage from millions of New Yorkers, and slashes hospital and nursing home funding.  Effects of these cuts mean premium tax credits for buying coverage on ACA marketplaces will be discontinued, people will face large increases in private health care premiums, and copays and deductibles will rise.  An estimated 1.5 million New Yorkers will become uninsured, including 30,000 Long Islanders.  

One scenario might play out like this.  As people are forced to let their insurance lapse because they are either excluded from various public programs or because they can no longer afford private insurance premiums, they will forgo doctor visits and instead wait until they are sick enough to go to hospital ERs.  With cuts in Medicaid and Medicare reimbursement and potential staff shortages, hospitals facing staffing shortages and funding cuts may be forced to dramatically scale back services or close.  The Health Education Project (HEP) estimates New York hospitals will lose $8 billion in annual funding and 34,000 New Yorkers could lose their hospital jobs.  The closure of local hospitals or reduction in their ability to serve their communities will have negative effects on people of all income levels and all political affiliations.

It is important for all of us to understand these changes and cuts and how they may affect each individual and family.   Even those fortunate enough to be able to withstand premium increases may know people who are less able to do so.  HEP’s online calculator can help in understanding potential increases in out-of-pocket costs and eligibility impacts:  https://healthcareeducationproject.org/one-big-bill.

What do we do next?  Now that the extension for ACA subsidies has been approved by the House, the vote goes to the Senate.  Call US Senators Schumer and Gillibrand and tell them you want the subsidies extended.  On the State level, the New York Health Care Act (Assembly bill A.1466) proposes a comprehensive, single-payer health care system for all New Yorkers.  The legislation is currently in committee in the New York State Assembly.  Contact your state assemblymember to express your advocacy for that bill.  The League of Women Voters Vote 411 website (www.vote411.org) is always a great resource to find any of your elected officials.

The wealth disparity in America is widely recognized.  Some people have concierge doctors and some are forced to choose between groceries and going to the doctor.  Some have multiple homes and some risk foreclosure on their homes because of staggering medical bills.  Many have limited access to affordable health care and the OBBBA has made it even less accessible.  The common thread is that it benefits ALL of us to have a healthy population.  Fighting for affordable health care is one way to achieve that goal.

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Please share these free resources with those who may need them:

• Health and Welfare Council of Long Island
• People who are presently receiving Medicaid and may be eligible for assistance with addressing social care needs (i.e. housing insecurity, food insecurity, transportation barriers, etc.) can contact HealiHelp [at] hwcli.com () or 516-505-4434.
• For Health Insurance Enrollment assistance with public programs like Medicaid, CHIP, and ACA : https://hwcli.com/work-we-do/direct-services/.
• SNAP Enrollment: https://hwcli.com/work-we-do/direct-services/snap/.
• Medicare Rights Center has a free telephone hotline staffed by trained counselors:  800-333-4114. 

Elise Antonelli is Co-Chair of the Issues and Advocacy Committee of the League of Women Voters of Huntington, a nonprofit nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. Visit https://my.lwv.org/new-york/suffolk-county or call 631-862-6860.