Month: October 2025
Local food pantries likely to feel pressure from shutdown benefit disruption
Local food pantries likely to feel pressure from shutdown benefit disruption
NYHealth Testimony on Needs of Older Veterans in New York City
NYHealth Senior Program Officer Derek Coy submitted the following testimony to the October 23, 2025, New York City Council Committee on Veterans jointly with the Committee on Aging Oversight – Needs of Older Veterans in New York City.
Thank you, Chairpersons Holden and Hudson, and members of the Committee, for the opportunity to testify on behalf of the New York Health Foundation (NYHealth). NYHealth is a private, independent, statewide foundation dedicated to improving the health of all New Yorkers, including the approximately 135,000 veterans who call New York City home. My name is Derek Coy; I’m a Senior Program Officer at NYHealth. I am also a proud veteran, having served as a Sergeant in the United States Marine Corps.
For more than 15 years, NYHealth has worked to understand and support the health needs of New York’s veterans. We do this through grantmaking, policy analysis, advocacy, research, and convenings. Our work has identified service gaps and helped develop innovative, community-based programs that meet veterans where they are. Over the years, we have had the opportunity to partner closely with City agencies and partners to ensure New York’s veterans receive high-quality, culturally competent care and support.
In New York City, approximately 50% of veterans—more than 70,000 veterans—are over the age of 65.[1] These older veterans represent a diverse and resilient group who have served our country and continue to contribute meaningfully to our communities. Yet, many face serious challenges, including chronic health conditions, mobility limitations, mental health concerns, social isolation, and difficulty navigating complex systems of care. Supporting the needs of older veterans today will strengthen systems for the future, ensuring more support for younger veterans as they age, helping mitigate and address similar challenges.
Understanding The Complex Care Needs of Older Veterans
As veterans age, their health and social needs evolve, often becoming more acute. Health care access, affordable housing, transportation, social support, and mental health services are especially critical. Unfortunately, older veterans in New York City can fall through the cracks—facing difficulty accessing federal benefits, unawareness of available services, or barriers like stigma, transportation, and physical disability.[2,][3]
Recent research from Columbia University’s Mailman School of Public Health also shows that as veterans age, physical and mental health challenges often go hand in hand—especially for those who have seen combat. One long-term study of Vietnam War veterans found that combat exposure and post-traumatic stress disorder (PTSD) are strong predictors of mental health outcomes and chronic illnesses such as heart disease.[4] Another Columbia University study found that many older veterans experience sub-threshold PTSD, which is defined as having symptoms not severe enough for a clinical diagnosis. Sub-threshold PTSD was associated with negative health, social, and family outcomes.[5]
Additionally, NYHealth’s 2024 report, Deaths of Despair and Suicide Among New York City Veterans, highlights the need for focused suicide prevention services for older veterans. Veterans aged 65 and older die by suicide at two to three times the rate of their civilian counterparts. Veterans aged 75 and older experienced some of the highest suicide rates among all age groups, and in Brooklyn and Staten Island, they had the highest rates of any age group.[6]
Together, these findings demonstrate older veterans’ need for robust navigation and care for their physical and mental health as well as for social needs.
To support older veterans, we offer the following recommendations:
Strengthen Veteran-Centered Care Navigation
Navigating the intersection of the Department of Veteran Affairs (VA), Medicaid, Medicare, and other local programs and services is challenging even for the most resourceful individuals. A recent NYHealth publication shows that more than half of veterans in New York State enrolled in Medicaid are aged 65 and over, often as a supplement to other forms of coverage, especially for those with complex health care needs.[7] To help older veterans navigate available services, New York City should continue investing in outreach and service coordination programs like VetConnectNYC. This program refers veterans to appropriate community-based organizations, connecting them to services including housing, health, and employment. New York City should also increase collaboration between its agencies, community-based organizations, and health care providers to ensure that veterans can successfully navigate related programs and services.
Expand Access to Mental Health and Peer-Based Support
NYHealth has long championed the peer support model, particularly the Joseph P. Dwyer Peer Support Program, which successfully reduces isolation, connects veterans to services, and improves their wellbeing. We have also partnered with New York Cares and the New York City Department of Veterans’ Services (NYC DVS) to operate Mission: VetCheck. This program uses peer-based outreach to provide veterans with wellness check-ins, suicide screenings, and referrals to critical resources. These programs have reached thousands of veterans and built a robust referral network for behavioral health, benefits counseling, and housing support. The City should explore opportunities to expand upon this program model to meet the specific needs of older veterans.
Support Robust and Specific Data Collection
Routine, comprehensive data are needed to understand the older veteran populations in New York City adequately. New York City’s Bureau of Vital Statistics and NYC DVS should make relevant local data available and leverage it to aid government and nonprofit organizations in their service delivery and evaluation efforts. More precise and regular publications of data will inform policy development and service outreach. Future data efforts should also ensure data are disaggregated by age, race, ethnicity, and borough to inform tailored programs better and address disparities in veteran outcomes.
Conclusion
NYHealth is committed to supporting New York City’s efforts to support the needs of older veterans. It is our shared responsibility to ensure veterans age with dignity, security, and good health. Addressing these issues today is not only a moral obligation to the current generation but a strategy to ensure that future veterans do not suffer the same physical and mental health burdens.
We appreciate and share the Council’s commitment to New York City’s veterans. I hope you will look to the New York Health Foundation as a partner and resource for this work. You can learn about our veterans’ health work by visiting our website, www.nyhealthfoundation.org.
References
[1] New York City Department of Veterans. Data Analytics and Reporting. Accessed October 9, 2025. https://www.nyc.gov/site/veterans/about/public-reporting.page
[2] M. R. Augustine, T. Mason, A. Baim-Lance, and K. Boockvar. “Reasons Older Veterans Use the Veterans Health Administration and Non-VHA Care in an Urban Environment.” Journal of the American Board of Family Medicine 34, no. 2 (March-April 2021): 291–300. https://doi.org/10.3122/jabfm.2021.02.200332
[3] R. K. Blais, J. Tsai, S. M. Southwick, and R. H. Pietrzak. “Barriers and Facilitators Related to Mental Health Care Use Among Older Veterans in the United States.” Psychiatric Services 66, no. 5 (May 2015): 500–506. https://doi.org/10.1176/appi.ps.201300469
[4] S. D. Stellman, A. Pless Kaiser, B. N. Smith, A. Spiro, and J. M. Stellman, “Impact of Persistent Combat-Related PTSD on Heart Disease and Chronic Disease Comorbidity in Aging Vietnam Veterans,” Journal of Occupational and Environmental Medicine 67, no. 5 (May 2025): 299–305, https://doi.org/10.1097/JOM.0000000000003302
[5] S. D. Stellman, A. Pless Kaiser, B. N. Smith, A. Spiro, and J. M. Stellman, “Persistence and Patterns of Combat-Related Posttraumatic Stress Disorder (PTSD), Medical, and Social Dysfunction in Male Military Veterans 50 Years After Deployment to Vietnam,” Journal of Occupational and Environmental Medicine 67, no. 5 (May 2025): 306–12, https://doi.org/10.1097/JOM.0000000000003321
[6] New York Health Foundation, Navigating the Crisis: Deaths of Despair and Suicide Among New York City Veterans, (2024), Accessed October 2025. https://nyhealthfoundation.org/resource/nyc-deaths-of-despair-suicide/
[7] New York Health Foundation, Medicaid and New York’s Veterans, (2025), accessed October 16, 2025. https://nyhealthfoundation.org/resource/fact-sheet-medicaid-and-new-yorks-veterans/
Health Care Is the Off-Ramp Out of the Shutdown
The question about the federal government shutdown isn’t just when it will end, but how?
If it ends well, millions of Americans will continue to afford health insurance. If it ends badly, premiums will soar, families will be priced out, and coverage will vanish.
The main sticking point in shutdown negotiations is whether Congress will extend the Affordable Care Act (ACA) marketplace subsidies. The marketplace is often the best, and sometimes the only, path to health coverage for many people: those with low incomes, those without employer-sponsored insurance, and those who earn too much to qualify for public programs but can’t afford private coverage on their own. ACA enhanced premium tax credits were introduced in 2021 and then extended through 2025.
Nationally, enrollment in ACA plans surged from 11 million to a record 24 million people due to these expanded subsidies. They allowed some lower-income enrollees to access health plans with no premiums and capped the amount higher earners pay for premiums to 8.5% of their income. They also expanded eligibility for middle-class earners. Here in New York State, more than 140,000 people rely on these enhanced tax credits to access quality, affordable health coverage.
Without subsidies, the math simply doesn’t add up. A single person earning between 133% and 400% of the federal poverty level makes roughly $15,000 to $60,000 a year. Yet private insurance for an individual costs about $12,000 annually on average. Paying $12,000 out of a $60,000 income is impossible if you also want to eat and have a place to live.
These highly effective enhanced credits are set to expire at the end of this year. If that is allowed to happen, get ready for some whopping sticker shock. Nationally, expiration of the credits is estimated to more than double what subsidized enrollees currently pay annually for premiums — a 114% increase. For some, like a 60-year-old couple making just over the poverty line, the increase could be more than $22,600 per year, potentially consuming a quarter of their income.
Approximately 4 to 7.3 million Americans could lose their health insurance coverage if the enhanced tax credits expire, with estimates suggesting millions more could become uninsured over the next decade.
New Yorkers will feel this. The State estimates average premiums statewide will rise by nearly 40%, an average monthly increase of $114 for individuals and $228 for couples. The Department of Health provides an excellent breakdown here of the expected local effects.
Premium jumps like that will likely induce a “death spiral.” That means premiums for everyone would likely rise as the risk pool becomes less healthy. Many younger, healthier people might opt out of insurance due to the higher cost, leaving a higher concentration of sicker, more costly enrollees.
Extending these health care subsidies is the issue at the heart of the shutdown. But ending the impasse would also restore paychecks for about 115,000 federal workers in New York, stabilize funding for antihunger programs like SNAP and WIC, and get Social Security and veterans’ benefits processing back on track.
There are no winners in a government shutdown. Extending health care subsidies in an enduring way will both end the stalemate and keep Americans healthier. There is an obvious offramp out of this mess; policymakers need to take it.
NYHealth Comments on New York State’s Request to Terminate the Section 1332 State Innovation Waiver and Return to the Basic Health Program
NYHealth submitted the following comments supporting New York State’s decision to terminate its Section 1332 State Innovation Waiver and return to the Basic Health Program (BHP) in response to catastrophic federal funding cuts to the Essential Plan.
October 10, 2025
Danielle Holahan
Executive Director
New York State of Health
Attn: 1332 Waiver
Empire State Plaza
Corning Tower, Room 2580
Albany, NY 12237
RE: New York State’s Request to Terminate the Section 1332 State Innovation Waiver and Return to the Basic Health Program
Dear Commissioner McDonald and Executive Director Holahan,
The New York Health Foundation (NYHealth) appreciates the opportunity to comment on the New York State Department of Health’s decision to terminate its Section 1332 State Innovation Waiver and resume operation of the Basic Health Program (BHP) under Section 1331 of the Affordable Care Act.
NYHealth is a private, independent, statewide foundation dedicated to improving the health of all New Yorkers—especially people of color and others who have been historically marginalized. Since our inception, NYHealth has shared a goal with the State: to expand health insurance coverage to all New Yorkers. We have invested millions of dollars to do so and have proudly partnered with the State on many initiatives, including the development of the Essential Plan. Most recently, we partnered with the State during the unwinding of the pandemic-era continuous enrollment provision to help ensure that as many New Yorkers as possible maintained coverage.
The recently enacted federal budget (H.R. 1, Public Law No: 119-21) represents a devastating reversal of decades of progress in coverage expansion and threatens New York’s historic coverage rates. Due to changes in premium tax credit eligibility, the State stands to lose $7.5 billion annually in funding for the Essential Plan alone, threatening coverage for 1.7 million New Yorkers. H.R. 1 will also cause massive funding losses for hospitals, community health centers, and food assistance programs. We have joined with fellow philanthropies in calling this law disastrous—it will deeply harm the health and wellbeing of the people we serve for a generation, leaving people poorer, sicker, and hungrier.[1]
We support the State’s request to terminate its 1332 waiver and return to the BHP in response to these catastrophic funding cuts.
New York is confronting the painful consequences of H.R. 1 with clarity and resolve. Faced with no good choices, the State has opted to terminate the 1332 waiver and return to the BHP to preserve coverage for as many New Yorkers as possible. Absent federal action to eliminate or delay the cuts to the Essential Plan, we concur that returning to the Basic Health Program is the most viable path forward. Nonetheless, roughly 450,000 New Yorkers who have benefited from the 1332 waiver’s expansion will lose access to zero-premium comprehensive health insurance.
NYHealth remains committed to working with the State and other stakeholders to mitigate these coverage losses and ensure an orderly transition in the coming months. New York is doing what strong leadership requires: making hard choices to protect as many people as possible and limit the damage of reckless federal policy, and we stand ready to partner to develop solutions.
Sincerely,
David Sandman, Ph.D.
President and CEO
New York Health Foundation
References
[1] Kuhlenbeck M, Sandman, D, OBrien-Suric N. Joint Statement: New Budget and Tax Law Threatens Health of New Yorkers. 2025. https://nyhealthfoundation.org/2025/07/08/joint-statement-budget-cuts/?utm_source=JULY+2025+Statement+Joint&utm_medium=email&utm_campaign=JULY+2025+Statement+Joint, accessed October 2025.