Governor Kathy Hochul today unveiled a series of proposals to strengthen New York's health care system, improve health outcomes, increase efficiency, lower costs, and support health care workers as part of her 2026 State of the State. These initiatives include investing in the Safety Net Transformation Program, improving health equity statewide, protecting affordable health insurance options, and utilizing technology to improve quality of care.

"Access to affordable, high-quality health care is essential to New York families," Governor Hochul said. "While Washington cuts and destabilizes care, New York will continue investing in patients, providers, and protections to ensure health remains accessible across the state."

Strengthening the Health Care Delivery System

Expanding the Safety Net Transformation Program

Safety net hospitals care for the most vulnerable New Yorkers, but face serious challenges in maintaining financial resilience and stability. To address this, Governor Hochul established the Safety Net Transformation Program, providing financial support and regulatory flexibility to encourage strategic partnerships that strengthen these hospitals. Since its passage, Governor Hochul has awarded more than $4.3 billion to support fourteen partnerships across the state.

This year, Governor Hochul will provide additional funding to continue supporting new projects under the program. In addition, the Governor will announce special focus areas including partnerships that focus on regional planning to improve coordination of care and reduce duplication of health care services, and partnerships that utilize AI to improve efficiency and quality of care.

Expanding the Use of Artificial Intelligence Technology in Health Care Safely and Equitably

The use of artificial intelligence (AI) in health care is rapidly advancing with promises to improve operational efficiency and patient care if carefully adopted. It is essential to coordinate AI advancement within the health care delivery system in a way that promotes greater access, quality, and equity in care delivery at a lower cost for all patients.

Governor Hochul will direct the Department of Health (DOH) to establish a consortium of health care and AI experts to share data and best practices and strengthen cross-sector collaboration around building, testing, and deploying safe and effective AI tools. To ensure equitable access, Governor Hochul will incentivize partnerships between safety net hospitals and other health care partners to implement AI solutions that improve quality of care and strengthen operations. In addition, the State will develop systems to evaluate and launch best-in-class AI tools within DOH, the Medicaid program, and the Office of the Medicaid Inspector General to strengthen program integrity.

Strengthening Oversight on Health Care Transactions

Since 2023, the New York Material Transactions Law requires health care entities to report transactions that increase revenues by $25 million or more. This reporting is the first step to understanding the expected and initial impact of these private transactions on cost, quality, access, equity and competition in the New York health care delivery system.

To strengthen oversight of these entities, Governor Hochul will expand this law to require ongoing reporting on the actual impact of closed material transactions, along with external reviews for high cost, high impact transactions. These changes will ensure that New Yorkers can continue to access affordable, high quality, and equitable care for the long term.

Enabling Transformation of the Health Care Delivery System

Health care providers are required to follow regulatory requirements, including the Certificate of Need (CON) process, to receive approval for certain health care projects. While it is a critical process, it can be time-intensive for both providers and the Department of Health. Governor Hochul has already made progress by streamlining the application and review process for certain projects and significantly raising the thresholds for applications that require a more detailed review.

To reduce the burden further, there are more changes that can be made. Governor Hochul will direct DOH to make the CON process more efficient and targeted to improve the experience of providers and expedite important health care projects across the state.

Empowering the Health Care Workforce

Reducing Reliance on Temporary Staff To Stabilize New York's Health Care Workforce

During the Covid-19 pandemic, reliance on temporary staff and traveling nurses skyrocketed. Years after the height of the pandemic, this reliance continues. In 2024, health care facilities paid temporary staffing agencies more than $2.6B, and the agencies kept $1B of that in profits. And these are not workers coming on temporary assignment from other states. New York residents make up 72% of the temporary workforce, and the majority of these New York residents permanently live within 25 miles of their "temporary" work location.

Governor Hochul will introduce legislation to ensure health care dollars are supporting the delivery of care and not middlemen. In addition, the Governor will direct the Department of Health to develop guidance and share best practices to ensure health care organizations have the information they need to secure temporary staff when it is necessary.

Removing Unnecessary Restrictions on Health Care Workers

Health care workforce shortages limit and delay patient access to care, from registered nurses and physicians to nursing assistants. This issue is compounded by New York State law, which often unnecessarily restricts which services health care workers may perform within their licensed scope of practice. This means more advanced clinicians spend their time performing tasks that could be done by lower-level staff.

Governor Hochul will propose legislation to expand scope of practice for several critical workers, including allowing certified nursing assistants to administer medication in nursing homes, physician assistants with sufficient training to practice independently, and medical assistants to administer vaccinations. Finally, Governor Hochul will change state law to allow the Department of Health to oversee and make additional decisions about licensed health care professionals' scope of practice.

Expanding Health Care Access Through Workforce Investments

While New York State has made significant strides in expanding health care coverage, statewide workforce shortages in the health sector mean that even those with coverage may struggle to get the care they need. To address this, New York launched two initiatives through its federal 1115 waiver aimed at bolstering the health care workforce in underserved areas. In late 2024, the State launched the Career Pathways Training (CPT) Program with $646M in federal funding for tuition, textbooks, and education and career supports for health, behavioral health, and social care workers who make a three-year commitment to serving Medicaid members. Last year, New York also launched the Health Care Access Loan Repayment Program (HEALR), which will provide loan payments for high-need titles serving Medicaid members

To date, the CPT program has already recruited nearly 12,000 participants. This year, the program will graduate thousands of new nurses, physician assistants, social workers, community health workers, and other critically needed health titles into the workforce. This spring, the HEALR program will award nearly $50M in loan repayment for psychiatrists, primary care physicians, dentists, nurse practitioners, and pediatric clinical nurse specialists who make a four-year commitment to serving Medicaid members. Taken together, these two initiatives represent a nearly $700M investment in strengthening New York's health workforce and ensuring that New Yorkers have timely access to the care they need.

Improving Health Care Coverage, Access and Affordability

Protecting and Expanding New Yorkers' Access to Quality, Affordable Health Coverage

Despite achieving one of the lowest uninsured rates in the nation, recent federal actions threaten the continued affordability and accessibility of health coverage in New York. Federal cuts to New York's Essential Plan totaling $7.5 billion, more than half of the program's annual funding, endanger the program's continued viability. The expiration of federal enhanced premium tax credits means that 140,000 New Yorkers are paying 40% more for premiums in 2026. Taken together, these federal policies are poised to roll back more than a decade of progress in bringing affordable health coverage to New Yorkers.

To safeguard hard-won gains, Governor Hochul will direct the Department of Health to take steps to protect and strengthen existing coverage and explore new coverage options. To mitigate coverage losses, Governor Hochul directed DOH to submit an application to the Centers for Medicare and Medicaid Services to return the Essential Plan to a Basic Health Program, a move which will preserve coverage for 1.3 million New Yorkers for whom the premium-free program is a critical lifeline. For the 450,000450,000 New Yorkers who will lose their current Essential Plan coverage in this transition, Governor Hochul will direct the Department to negotiate with the federal government to develop affordable coverage options to ensure continued access to affordable health care for those impacted by Federal cuts.

Leveraging New York's Purchasing Power to Drive Down Drug Costs

Since the 2023 transition of New York's Medicaid pharmacy benefit to the streamlined NYRx program, which garnered the State more than $600M in new drug rebates, New York has become a nation-leader in pharmacy benefit management and reform. However, given the State's size and market share, New York's supplemental rebates - the state negotiated discounts Medicaid receives on top of federally-mandated rebates - are only average by national standards, while overall drug prices nationwide continue to soar.

To address stubbornly rising pharmaceutical prices and leverage New York's purchasing power, Governor Hochul will direct the Department of Health to identify and target specific classes of high-cost drugs for direct negotiations with manufacturers to achieve better discounts for the State. The move will drive significant savings for the Medicaid program at a time of significant cost pressures arising from federal cuts, while also laying the groundwork for future initiatives to lower pharmaceutical prices statewide.

Reforming Prior Authorizations To Improve Patient Care

New Yorkers seeking timely medical care too often face delays, denials, or disruptions due to opaque insurance review processes - most notably, prior authorizations. These processes require healthcare providers to obtain approval from insurers before delivering certain treatments, tests, or prescribing medications. While well intended to control costs and ensure appropriate care, prior authorization has increasingly become a barrier to treatment.

Governor Hochul will expand health care coverage protections for New Yorkers by reforming and creating more transparency in the prior authorization review process. Specifically, she will:

-Require formularies - the lists of medications covered by health insurance plans - to be posted not just publicly but clearly via a standard, accessible format.

-Ensure prior authorizations for designated chronic conditions remain valid longer so time isn't wasted on unnecessary reviews for ongoing, stable treatments.

-Expand "continuity of care" - the period insurers must cover out-of-network treatment for new patients - from 60 days for life-threatening conditions or late-stage pregnancy to 90 days for all health conditions and the full postpartum period.

-Expand the data health insurers must report on their claims processes, including how often claims are subject to prior authorization and how often those requests are denied.

-Launch a public education campaign highlighting resources that help both consumers and providers navigate insurance challenges.

These reforms will improve access to care by removing unnecessary administrative burdens on providers and making sure critical care is neither delayed nor denied.
Increasing Access to Medical Care for Injured Workers

New York is one of only a handful of states that requires special authorization for healthcare providers treating workers' compensation claimants. Only about 10 percent of eligible providers have gone through this authorization process, forcing injured workers to wait for appointments or travel long distances to receive care.

New Yorkers who get hurt at work should be able to see the doctors they trust, get healthy, and get back to work. While ensuring that qualified doctors are serving patients, Governor Hochul will eliminate this cumbersome and outdated authorization process, allowing any eligible licensed medical provider in good standing to treat workers' compensation claimants if they choose. Cutting this red tape will open the door to thousands more primary care providers and specialists who can help people heal and get back to work faster.

Improving Health Equity & Public Health

Improving Vital Records Access for New Yorkers

New York State maintains millions of vital records dating back to the 1800s, including birth, death, marriage, and divorce certificates, all requiring indefinite preservation and access. However, the current system for retrieving these records is out-of-date and inefficient, creating unacceptable delays and frustration for thousands of New Yorkers seeking their own records. Outdated manual processes and aging storage systems have created a mounting backlog.

Governor Hochul will make overdue technological improvements to the vital records system, launching an effort to digitize records for genealogical requests. Digitized vital records are significantly easier to search, retrieve, issue to requestors and protect from physical deterioration or disaster loss. This will help address the current backlog of over 12,000 genealogical records requests.

In addition, the Department of Health (DOH) will tackle the living records request backlog, and improve operational efficiency for future requests. This will directly reduce customer complaints related to long wait times and enhance customer service with more timely communication and responses.

Strengthening Cardiac Emergency Readiness Across New York State

Sudden cardiac arrest remains a leading cause of death in New York, and survival often depends on whether help arrives in the first critical minutes. While progress has been made in schools and youth programs, many communities still lack widespread CPR training and easy access to automated external defibrillators (AEDs). Governor Hochul will protect New Yorkers by implementing a multi-faceted proposal that equips communities around the state with the tools they need to effectively respond to cardiac emergencies and save lives.

The Governor's plan will significantly strengthen cardiac emergency readiness statewide by building on a successful model pioneered at the University at Buffalo to establish regional training hubs and ensure communities know how to use AEDs and support new, scalable approaches to hands-only CPR education, focused on simple chest-compression techniques for bystanders.

The Governor will also modernize AED regulations to keep communities safe and create New York's first statewide AED registry. This registry will map the precise location of every AED across the state, enabling emergency dispatchers to direct bystanders to the nearest device during cardiac events. The registry can be accessible to the public through a mobile application, so every New Yorker can access their nearest AED if needed. The Governor will also make investments in self-directed CPR-training kiosks and AED placements across the state.

Modernizing Pain Management Guidance and Care

New York has made significant progress in reducing overdose deaths, with provisional data showing approximately a 28 percent decline in 2024 compared to 2023 - the lowest level since before the pandemic. Despite this progress, New Yorkers continue to lose their lives to opioid use. The State's progress reflects expanded harm reduction efforts, including broader access to naloxone and drug testing strips, and increased investment in prevention, treatment, and recovery services.

The health care system can play an important role by standardizing pain management approaches and updating clinical guidelines. Governor Hochul will direct the Department of Health to support providers as they balance effective pain relief with patient safety and ever evolving standards of care. The Department of Health will develop a comprehensive Pain Management and Drug Control Strategy focused on preventing opioid misuse, strengthening prescription oversight, and promoting best practices in pain management across the healthcare continuum.

Protecting Immunization Access

New York's immunization policies rely on federal vaccine schedules that, under the current administration, are becoming less and less anchored in science. This creates uncertainty for schools, health care providers, and New Yorkers in general; it also puts the health of our communities at risk and, in some cases, increases patient costs.

To keep New Yorkers healthy and keep money in their pockets, Governor Hochul will advance legislation to ensure New York can set its own immunization standards based on accepted medical science and public health needs. The proposal will authorize the Commissioner of Health, in consultation with recognized medical organizations, to establish immunization requirements that guide school eligibility, clinical practice, and insurance coverage. This will provide clarity for providers and insurers, protect access to vaccines, and strengthen public health statewide.

Protecting Summer Campers from Extreme Weather Threats

Summer camps should be places of joy and community, helping young New Yorkers create lifelong memories and friendship. But as extreme weather events become more frequent and severe, summer camps across the state and country face growing risks from flooding, extreme heat, and other climate-related hazards that threaten the safety of children and staff.

In partnership with the Division of Homeland Security and Emergency Services and local health departments, Governor Hochul will direct the Department of Health to strengthen oversight and preparedness measures for camps at greatest risk, including those located in FEMA-designated floodplains. This effort will help camps to incorporate extreme weather readiness into their annual safety plans and ensure clear evacuation, sheltering, and communication protocols are in place. The State will also issue updated guidance and training to support local health departments in reviewing and enforcing these readiness measures. By improving preparedness before emergencies occur, New York will better protect children, and ensure families can trust that summer camps are equipped to respond to extreme weather events.