Kathy Hochul's Health Care Push Runs Into Gop Wall

ALBANY, New York — Gov. Kathy Hochul wants to work with House Republicans to ensure noncitizens and low-income New Yorkers continue to receive health care coverage beyond July. Finding any takers inside the Empire State’s GOP delegation hasn’t been easy.

At stake is health care for roughly 1.5 million New Yorkers who may lose coverage following approval of President Donald Trump’s sweeping tax-and-spending package.

The moderate Democratic governor, facing a tricky reelection, is trying to persuade recalcitrant House Republicans to advocate for a waiver from the federal government that would preserve coverage for roughly two-thirds of the people slated to lose benefits. The rift between the two parties is playing out as health care coverage remains in doubt for New Yorkers who aren’t citizens but are living in the country legally, or earn too much to qualify for Medicaid.

“To have that much money at stake, certainly if the governor and majority members in the House were on the same page, it would help to have dual advocacy,” Republican state Assemblymember Josh Jensen told POLITICO. “But it’s difficult to work with them one day and publicly slam them the next.”

For the majority of last year, Hochul’s team tried to raise the alarm over the fate of the program known as the Essential Plan with New York Republicans, as evidenced by a half-dozen pages of correspondence between GOP lawmakers and the governor’s office. The emails were shared by the governor’s office and reviewed by POLITICO.

But as the governor’s office tried to corral Republican assistance, the underlying toxic politics were difficult to avoid.

The House GOP delegation is stocked with Hochul’s political foes, including Rep. Mike Lawler, who contemplated running against her, as well as Rep. Elise Stefanik, a former candidate for governor who routinely blasts her as “the worst governor in America.” Yet Hochul must work with these blue-state Republicans, some of whom face their own tough races this year.

New York Republicans remain shut out of statewide office and lost their final toehold on power in Albany nearly eight years ago when Democrats flipped the state Senate. The GOP holds seven of the state’s 26 House seats, however, and given the party’s narrow majority, outsize importance in Washington. The state is home to several swing seats that could determine control of the chamber next year and the course of Trump’s final two years in office.

Hochul, a former House member from a red district in western New York, has long asserted she can work with anyone in spite of the poisonous political climate. She has also expressed sustained frustration with House Republicans, frequently joking that she misses the Tea Party from the prior decade. Yet GOP lawmakers assert she has not done enough to build partnerships with their delegation — making it all the harder to work together.

“Gov. Hochul has shown little interest in, or ability to, build even the basic working relationships with New York’s seven House Republicans that should exist, especially on issues where a bipartisan, pro-New York consensus is achievable,” Long Island Rep. Nick LaLota said in a statement. “On rare occasions, her staff checks in with some of my colleagues’ offices, but it often feels more like political box-checking than genuine governing. While Andrew Cuomo certainly had his flaws, working across the aisle to advance New York’s interests generally was not one of them.”

Hochul’s office in a statement said the state warned House lawmakers their votes for Trump’s signature domestic policy package would have lasting harmful consequences.

“New York's Republican members of Congress voted to rip health care away and send costs skyrocketing for millions of families across the state and are now pretending they didn't know the impacts of their heartless decision,” Hochul spokesperson Jen Goodman said. “Gov. Hochul made a difficult decision to revert back to the Basic Health Program to protect coverage for over 1.3 million New Yorkers, but no state can backfill the immense cuts in federal funding enacted under H.R.1 and Republicans in Washington know that.”

That high-pressure political environment makes policy fights over fraught issues like health care treacherous for Republicans — especially as Democrats signal plans to target costly medical bills as part of their campaign focus on affordability.

The battle over New York’s Essential Plan is a case in point.

The public health plan offers affordable coverage to 1.7 million New Yorkers through the Affordable Care Act. The coverage extends to more than 700,000 lawfully present immigrants who will become ineligible in July due to Trump’s One Big Beautiful Bill Act. The Hochul administration is looking to revert to a former iteration of its public health plan, which would allow the state to access an accumulated surplus of federal funding. If approved, that money would cover 1.3 million enrollees who would otherwise lose coverage or get rolled into the state’s Medicaid program. Hochul’s proposal would still leave roughly 470,000 Essential Plan enrollees without coverage. 

Hochul’s office provided six pages of correspondence to GOP lawmakers scheduling and outlining meetings with top staffers and state Health Commissioner James McDonald. A Hochul spokesperson noted that there are dozens of pages of communication between House delegation staff and her office. The governor’s team also sent lawmakers statistics on the impact of the cut, including how many people in their House districts would lose coverage.

House Republicans who spoke with POLITICO say the governor is not doing enough to cultivate a working relationship with the delegation. Lawler said he invited the governor and members of her staff to participate in a meeting with Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in December, but got no response.  

Goodman said the Hochul team was unavailable to attend the December meeting, but has been working to reschedule. She also said the governor has never received a request to speak directly with members of the delegation.

The meeting included health care lobbyists, and seemingly swayed Oz to approve an extension of a lucrative health plan tax that will bring the state more than $1 billion. Hospital lobbyists, who are now vying for a cut of the added funding, notably thanked Lawler and House Republicans following the announcement of the extended tax with no mention of Hochul’s involvement.

Lawler said he doesn’t consider the meetings with his staff and informational charts shared by Hochul’s office to be considered meaningful outreach. He said he would like a direct line to the governor to discuss her priorities.

“When you're talking about issues impacting the state, you would expect the governor would think it worth her time to meet with members of the majority in Congress, but seemingly she doesn’t think it’s a priority,” Lawler told POLITICO. “From my vantage point, even if you disagree on politics and policy, you still sit down and talk. You would think she would be a little more engaged, whether it be on health care or on a myriad of issues that impact New York.”