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Essential Plan on the line, free HIV tests, and the infectious disease weather report

The NY Dose

Marisa Donnelly, PhD Feb 19 REPRINTED WITH PERMISSION

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The cost of health care and insurance in this country is outrageous, and it looks like it’s not going to get better in New York.

This is because health coverage for 1.7 million New Yorkers who rely on the Essential Plan (the low-cost state health insurance plan) is under threat, but there is an interesting workaround solution.

I dive in below. I also share how to access free at-home HIV tests, report on a contained outbreak of eye fungus at a clinic in NYC, and provide updates on infectious diseases.

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The cuts keep coming: New York health insurance coverage

For 1.7 million New Yorkers, the Essential Plan is the safety net that makes health coverage possible when Medicaid, Medicare, or employer insurance isn’t an option. But new federal policy changes could make that coverage harder to keep.

The “Big Beautiful Bill” includes a major provision that restricts how federal dollars can be used to cover non-citizens. This change is expected to reduce federal funding for New York’s Essential Plan by about $7.5 billion each year.

The rollout has already begun and will continue in a phased approach. Starting in October 2026, federal Medicaid matching funds will no longer cover many legally present non-citizens, including green card holders in the U.S. less than 5 years, refugees, asylees, and trafficking victims (with limited state options remaining for lawfully residing children and pregnant people in states with those options).

This comes just weeks after another hit: the loss of enhanced ACA subsidies—extra financial help that lowered monthly marketplace premiums for many middle- and low-income enrollees. This loss made marketplace coverage more expensive for about 140,000 New Yorkers. (See more about that here in a previous YLE post in January.)

What is the Essential Plan?

To understand what’s at stake, it helps to understand the several ways New Yorkers are covered by health insurance:

1. Employers: they cover about half of New Yorkers.
2. Medicare/Medicaid: funded by both the state and federal government.
3. Health coverage from the marketplace: paid out of pocket and/or subsidized by the federal government.
4. Essential Plan: a New York-specific program that is funded through the federal government.

The Essential Plan (#4 above) is important because it’s designed to fill a gap for people who earn too much for Medicaid but not enough to afford marketplace plans (and who don’t have employer-based coverage). It also includes many lawfully present non-citizen immigrants (about 750,000 in New York), such as permanent residents with green cards and DACA recipients, who may face eligibility barriers in other programs. The $7.5 billion cut puts all of the Essential Plan coverage at risk.

Is there a workaround? Maybe!

To lessen the blow and keep as many people insured as possible, the governor’s office seems to be trying by moving people around in a pretty creative way.

Some of those in the Essential Plan qualify for Medicaid, so the state will cover them (which will cost $3 billion).

But that doesn’t cover everyone.

For those who can’t move to Medicaid, because of income limits or immigration status, the governor is proposing to shift the Essential Plan back to an older funding model, one that isn’t bound by the new federal immigration restrictions. The trade-off? The old model only allows eligibility up to 200% of the federal poverty level (FPL).

The governor’s Essential Plan change proposal (note: it hasn’t passed yet) tightens eligibility. As a result, ~460,000 New Yorkers would lose insurance coverage.

This is a balancing act—one that aims to preserve health care coverage for the greatest number of New Yorkers, despite federal cuts. The move would maintain coverage for about 1.3 million New Yorkers, but leave 460,000 without the Essential Plan.

Here is the problem: The governor’s Essential Plan change proposal requires approval from the federal government (Centers for Medicare & Medicaid Services to be exact). If CMS says no (which I think is likely—I don’t think the same administration that cut funding in the first place would approve a workaround), the entire Essential Plan may be cut. If that’s the case, it would likely result in 1.7 million New Yorkers without coverage.

What you can do

• Get help with applying for insurance coverage if you need it: https://communityhealthadvocates.org/
• Check in on neighbors who may be on Medicaid or need help with renewal forms. The New York State Medicaid Help Line is (800) 541-2831.
• Call your senators and congressional representatives to advocate for the issues that matter to you. (Find their contact information here.) Some apps provide representative info as well as scripts for specific topics.

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FYI—Free HIV tests available to New Yorkers

New York State just launched a free HIV self-test giveaway campaign with nearly 2,000 kits available statewide.

• If you live in New York outside NYC, you can take the eligibility survey to see if you can get a free at-home kit mailed to you.
• If you live in NYC, request a free kit through an agency listed on the NYC Health Map and (click “HIV Testing”).

Free testing helps people get care earlier and prevents transmission:

• Antiretroviral therapy treatment (ART) can make HIV undetectable—meaning it can’t be passed through sex (undetectable = untransmittable).
• Pre-exposure prophylaxis (PrEP), medication that can be taken before sex, injection drug use, or other potential HIV exposures, can prevent HIV.
• Post-exposure prophylaxis (PEP) can reduce risk if started within 72 hours of potential exposure. (Visit the New York State PrEP website for more info.)

These treatments and medications are truly remarkable for HIV prevention and treatment, but early testing, diagnosis, and access to care are essential.

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Good news: An eye fungus outbreak stopped in its tracks

This week, disease detectives at the NYC Department of Health published an investigation that underscores the critical importance of infection prevention in health care settings. In December 2024, three people developed serious fungal eye infections after elective laser eye surgery at a single NYC ophthalmology clinic. All three had vision loss, and one required a corneal transplant.

The clinic reported the trend after noticing that three of 11 patients (27%) who underwent surgery over a two-week period developed eye infections. After testing, Purpureocillium lilacinum, an environmental mold that rarely infects healthy people but can be dangerous to the eyes, was found to be the culprit.

After an investigation, there were many things that went wrong at this clinic:

• Incomplete sterilization logs.
• No EPA-registered disinfectants for work surfaces.
• Expired eye medications.
• Notably, cool-mist humidifiers in the procedure room. (CDC specifically warns against cool-mist humidifiers in health care settings because they can aerosolize mold spores.)

A single definitive “smoking gun” source wasn’t confirmed, but fungal DNA was detected in the tubing of one surgical device.

The good news was that after the clinic paused surgeries, fixed infection control problems, and resumed operations in January 2025, no new cases occurred. This is a solid example of how fast action and cooperation can stop an outbreak.

What this means for you: If you’re considering LASIK or similar procedures, ask your clinic about infection prevention practices: how they sterilize instruments, whether they use EPA-registered disinfectants, whether they check medication expiration dates, and if cool-mist humidifiers are used near procedure rooms. If you’ve had recent eye surgery and develop pain, vision changes, or discharge, seek care immediately—eye infections require fast treatment to prevent permanent damage or vision loss.

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Infectious disease “weather report”

Measles: NYC reported the first measles case of the year—an unvaccinated infant with a history of international travel. Contact tracing by the health department is underway, and people who may have been exposed are being notified.

Measles is of increasing concern in the U.S., including in New York. (See YLE National’s updates.) Last year there were 48 cases in New York, including 20 in NYC.

The most important thing to do is check the MMR status for everyone in your household, and get vaccinated if eligible and not fully vaccinated, especially if you will be traveling internationally or to any U.S. region with a measles outbreak. Two doses are about 97% effective at preventing measles.

Flu: Cases increased slightly in NYC, but ED visits and hospitalizations continue to fall. With severe indicators continuing to decline, this small increase in cases isn’t a big concern.

Flu emergency department visits in NYC. Figure from the NYC Department of Health Respiratory Illness Dashboard. Annotations by YLE.

RSV: RSV cases went up while ED visits slightly decreased, a sign that activity is still elevated but that severe infections are going down. If you’re an older adult or have small children, it’s still worth continuing to take precautions like masking in indoor crowded spaces.

RSV cases in NYC. Figure from the NYC Department of Health Respiratory Illness Dashboard. Annotations by YLE.

Covid: ED visits and hospitalizations for Covid slightly increased, but overall remain low compared to previous winters.

Covid cases in NYC. Figure from the NYC Department of Health Respiratory Illness Dashboard. Annotations by YLE.

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Bottom line

Health coverage for up to 1.7 million New Yorkers is on the line, and the state’s workaround would still leave hundreds of thousands uninsured. If you or someone you know is affected, now is the time to plan: get enrollment help, watch for renewal paperwork, and talk to your representatives about your concerns.

Love,

Your NY Epi

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Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.

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County Police working to assist municipal law enforcement with planning and response

(Hawthorne, NY) – The Department of Public Safety and its Real Time Crime intelligence center are monitoring social media activity and working with municipal law enforcement partners to discourage so-called called teen-ager “takeovers” of retail venues and other public spaces.

In addition, the Department’s patrol officers are prepared to respond to assist any municipality if needed in the event a disruptive takeover occurs.

Commissioner Terrance Raynor said,

“We are asking teens to take our advice about takeovers: do not participate in this kind of activity. You can get hurt, other people can get hurt and you can be subject to arrest. We are also urging parents to speak with their children and advise them to ignore this dangerous ‘challenge’ being presented to youths via social media.”

On Monday, several hundred teens “stormed” the Bay Plaza shopping center in the Bronx, causing chaos and property damage and prompting a large response by the NYPD to control the crowd.  Eighteen people were arrested and several persons were injured.

Raynor urged business owners and other members of the public to alert police immediately if they observe any mass gathering of youths at public spaces such as malls, individual stores or shopping centers, libraries and other public venues.

County and local police are aware of social media posts identifying various locations in Westchester as potential sites for a takeover. Raynor urged the public to share any information they have about potential takeover targets or events.

The County Police maintain telephone and electronic tips lines so the public can provide information confidentially or anonymously.

·         Voice Tip Line: (800)898-TIPS (8477).

·         Electronic Tips: Send email, text messages and small video clips to tips@wccops.com.

·         Via Mobile App: The WCPD Mobile App contains a home screen Submit a Tip button to enable tips to be sent confidentially or anonymously. It is available for Apple and Android phones. Enter Westchester County PD in the app store search bar to locate and download it.

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WESTCHESTER COUNTY EXECUTIVE KEN JENKINS STATEMENT ON THE PASSING OF REVEREND JESSE JACKSON

“We mourn Rev. Jesse Jackson, a man who remained steadfast in his belief in building common ground. His call to “Keep Hope Alive” was more than a slogan; it was a moral directive. He demanded dignity and respect for those too often denied both, and he carried a progressive vision that pushed the nation to confront its conscience.

“His life’s work challenged America to be better, braver, and more inclusive, and that legacy will endure for years to come.”

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WPCNR MILESTONES. Reprinted from the WPCNR ARCHIVES. February 15, 2026:

February 22  Next Sunday is George Washington’s Birthday.

All week this week is President’s Week.

The time when we remember the first leader and why he is the best.

It is instructive to look at our first leader, George Washington, the father of our nation — America — that used to be.

One cannot help be reminded of the snowy winter at Valley Forge, when the bedraggled, poorly equipped rebel army suffered but held together.

They attacked the German troops in Trenton on Christmas Eve, 1776, crossing the Delaware River at night. What kind of man was he that George Washington could inspire his troops against all odds? What kind of men were they who would risk certain death if wounded (no med-evacs in 1776) for an idea: rights and freedom?

Washington was a man of tremendous character. Of principle. Where did he get this character?

He specialized in self-control at an early age. That congressmen, lobbyists, and pundits and yes, Presidents,  means mind-control, reason and responsibility, and humanity.

According to  the book, The American President, Washington, at sixteen, had formed a code of conduct. He had written a book of etiquette with 110 “maxims” to guide his conduct in matters. In this etiquette book he had written:

Every action done in company ought to be done with a sign of respect to those who are not present. Sleep not when others speak; sit not when others stand; speak not when you should hold your peace; walk not when others stop;…Let your countenance be pleasant but in serious matters somewhat grave…Undertake not what you cannot perform but be careful to keep your promise.

The character sketch provided by the authors of The American President, indicates this personal “rulebook” was a book that Washington wrote over the years and referred to it often, for, they write, for the following reasons:

“for self-control, to avoid temptation, to elude greed, to control his temper. Reputation was everything to him. It had to do with his strength, his size, his courage, his horsemanship, his precise dress, his thorough mind, his manners, his compassion. He protected that reputation at any cost.” 

Earning respect by example. Quelling rebellion with a few words. He sets an example today for those who would take advantage of America’s weakness and seize power by opportunism. Washington inspired by example.

He lived with his troops. He shared hardships with them, and there was so much respect for him that he was able to talk them out of armed rebellion at the end of the American Revolution. Washington had been asked by the army to join them to overthrow the Continental Congress, and make himself King.

Washington had been asked by one of the officers of the rebels to join them, and he wrote them, You could not have found a person to whom your schemes are more disagreeable. Banish these thoughts from your mind. Hearing that the rebels who were planning insurrection (back in 1783, they knew what insurrection was) against the new country due to paid  withheld by the Continental Congress, Washington rode to Newburgh, New York, (not far from White Plains, NY,USA) on March 15, 1783, to meet with the dissident insurgents. Washington spoke to the rebellious group, saying,

“Gentlemen, as I was among the first who embarked in the cause of our common Country; as I never left your side one moment, but when called from you on public duty; as I have been the constant companion and witness of your Distresses…it can scarcely be supposed …that I am indifferent to your interests. But…this dreadful alternative, of either deserting our Country in the extremest hour of her distress, or turning our Arms against it…has something so shocking in it that humanity revolts from the idea…I spurn it, as every Man who regards liberty…undoubtedly must.”

The would-be rebels fell silent, digesting what he had said. Then Washington withdrew a letter from Congress, but could not read the text, withdrawing some eyeglasses from his tunic, remarking,

“Gentlemen, you will permit me to put on my spectacles for I have not only grown gray but almost blind in the service of my country.”

The men present were reported to have tears in their eyes at this gesture of Washington’s and abandoned their plot out of respect for their leader.

Washington retired from the military, surprising the entire new country. His action surprised King George III of England, who was astonished that Washington had refused to hold on to his military authority and use it for political or financial gain. The defeated King of England, remarked, “If true, then he is the greatest man in the world.” Washington was.

Seeker of Diverse Views. How to pick a cabinet.

As President, George Washington invented the Presidential Cabinet, whom he referred to as “the first Characters,” persons who possessed the best reputations in fields and areas of the jobs he was filling. Washington said on political appointments: “My political conduct and nominations must be exceedingly circumspect. No slip into partiality will pass unnoticed…”

Washington tolerated the relentless clashes between Thomas Jefferson, Secretary of State, and Alexander Hamilton, Secretary of the Treasury, but lectured them on the necessity for tolerance and moving beyond partisanship:

“I believe the view of both of you are pure, and well meant. Why then, when some of the best Citizens in the United States, Men…who have no sinister view to promote, are to be found, some on one side, some on the other…should either of you be so tenacious of your opinions as to make no allowances for those of the other? I have great esteem for you both, and ardently wish that some line could be marked out by which both of you could walk.”

The Constitution Should be Protected

When George Washington left office after two terms, he made a farewell address which warned future generations of Americans about foreign entanglements and partisanship in the republic:

“I shall carry to my grave the hope that your Union and brotherly affection may be perpetual; that the Constitution may be sacredly maintained; and that free government…the ever favorite object of my heart…will be the happy reward of our mutual cares, labors and dangers.”

Washington died in 1800, three years after leaving office in 1797. He was saluted on the floor of congress as being “First in war, first in peace, first in the hearts of his countrymen.”

He was the first and best.

The ultimate role model for any leader, February 22, 2024 is a day that tries Americans’ souls. It is hoped that some of our “leaders” in Westchester, in Albany, in Washington might read the words I have quoted above and take them to heart in future deliberations.

Work a little.

It’s not all about you.

It’s about doing what is best for us all. George Washington’s vision of his country is being challenged by those who know not what they do. Or want to do to voices that disagree with them. But we who remember, and read these words must refocus.

I hear you, Mr. Washington, and we heed, so help us God.

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