Q: What are the latest reproductive health access and gender-related care issues impacting providers in New York?
A: Those who work in or with the healthcare provider community are closely watching the budget negotiations and the implications of the final enacted law to impact providers with respect to access to reproductive health. The health care access and coverage components of Governor Kathy Hochul’s proposal are best understood as a direct response to the 2025 federal reconciliation law (often referred to as One Big Beautiful Bill), which restructures Medicaid and restricts federal Medicaid payments to certain providers of reproductive-health services, such as Planned Parenthood affiliates. Governor Hochul’s proposal is primarily focused on stabilization—aimed at preventing service disruptions tied to federal funding changes. At the same time, New York’s policy posture has evolved beyond statutory protections: following the adoption of the state Equal Rights Amendment in 2024, protections against discrimination now explicitly extend to sex, gender identity and expression, pregnancy, and reproductive healthcare decisions, embedding these rights within a constitutional framework. Budget negotiations between the Governor and Legislature are ongoing as of the time of this writing with respect to key healthcare and funding provisions.
Substantively, the Governor’s proposal operates across three fronts: it backfills lost federal Medicaid funding to affected providers; second, it continues and expands grant-based support for reproductive-health services (designed to sustain medication-abortion access and clinic capacity); and third, it reinforces broader reproductive-health infrastructure through family planning support, operational funding, and targeted investments to stabilize provider networks serving Medicaid and low-income populations. The bill signals a deliberate policy choice: where federal law narrows funding streams, New York proposes to replace those dollars and preserve access across the continuum of care, including contraception, screenings, and preventive services, while also positioning itself as a “safe haven” for reproductive and gender-affirming care through expanded shield laws and protections for providers serving out-of-state patients.
Those who look favorably on the Governor’s proposal include reproductive-rights organizations and civil liberties groups. They highlight the effort to prevent immediate loss of care for Medicaid patients, preservation of a provider network that delivers a wide range of non-abortion services, and alignment with New York’s constitutional commitment to protect reproductive and gender-related rights. Critics of the plan, including pro-life advocacy groups and fiscally conservative policymakers, counter that the proposed plan would use state taxpayer funds to offset federal restrictions tied to abortion-providing entities, prioritizing a specific provider network over broader healthcare system needs, and fear repercussions from a state–federal policy divergence in a period of financial and fiscal sensitivity.
Q: What legal and operational risks should healthcare administrators focus on right now?
A: As described above, New York is moving beyond statutory protections, and lawmakers are making efforts to codify reproductive and gender-related rights. For many, the practical takeaway is that access to reproductive and preventive care in New York is likely to remain stable in the near term if funding is enacted, notwithstanding federal changes. For providers, particularly those reliant on Medicaid, the shift is complex: clinical decisions, coverage determinations, and administrative policies may now be scrutinized through a constitutional lens, increasing potential liability exposure where patients allege denial, delay, or disparate access, while ongoing interstate tensions around shield laws create additional uncertainty around enforcement, licensure, and malpractice risk.
The most immediate risks sit at the intersection of cross-state care, evolving standards, and health equity expectations. Telehealth, especially medication abortion, raises unresolved jurisdictional issues, including conflicts between New York law and restrictive states, and questions about judgments, licensure, and data privacy. Policymakers are also pushing beyond legal access toward actual access, focusing on barriers like transportation, language, and provider availability—signaling higher expectations for system-level equity efforts. Meanwhile, maternal health reforms are tightening standards around informed consent, documentation, and care for vulnerable populations, increasing scrutiny of clinical practices.
Providers should treat these developments as a part of a broader, significant regulatory shift. A practical approach is to take a fresh look at policies to ensure they reflect the expanded anti-discrimination protections, revisit telehealth practices, and reinforce training and compliance around informed consent, equity, and culturally competent care. Those who stay current and thoughtful with updates to their protocols will be in the best position to navigate in a new environment.
Reprinted with permission from the May/June 2026 issue of The Bulletin from the Monroe County Medical Society and available as a PDF file here.
David M. Tang is Co-Managing Partner at Underberg & Kessler LLP and serves as Chair of the firm’s Health Care and Creditors’ Rights practice groups. He advises health care providers, commercial lenders, nonprofits, and business clients on restructuring, governance, risk management, and complex litigation matters. David can be reached at dtang@underbergkessler.com or 585.258.2845.
