Pulse Analysis: “New York’s Healthcare System Is Reaching a Breaking Point,” says Insurance Specialist James Donnelly
- dhalperin1
- Jul 9
- 2 min read
Updated: Aug 2
Premium spikes, insurer withdrawals and exploding medicaid spending spark alarm over patients' safety
With health insurance premiums in New York skyrocketing and major insurers withdrawing from the state, healthcare experts and patient safety advocates are warning that the system is teetering on the edge of collapse.
On June 9, Governor Kathy Hochul acknowledged the growing financial burden, stating:
“We are seeing unavoidable increases in the individual market as medical costs continue to climb nationwide. The average monthly premium for an individual plan in 2025 is expected to rise by $114, and $238 for couples. These are difficult realities, but we remain committed to protecting access to care.”
But critics warn that commitment is rapidly slipping out of reach.
Oxford UnitedHealthcare has submitted a request for a 38% rate increase, while Aetna has announced its withdrawal from New York’s Affordable Care Act (ACA) marketplace in 2026, leaving thousands of New Yorkers with fewer—and costlier—coverage options.
Meanwhile, state Medicaid spending is projected to grow by $4.3 billion in 2025, prompting serious concerns about sustainability and the growing risks to patient safety.
“This Is No Longer About Policy—It’s About Survival,” Warns Donnelly
“Families are being priced out of basic care,” said James Donnelly, health insurance specialist, founder of Safe Haven Insurance Agency, and Board member at Pulse Center for Patient Safety, Education & Advocacy.
Ilene Corina, BCPA, President of Pulse, a Long Island-based patient safety and advocacy organization comments, “If these trends continue, we’re going to see more delayed diagnoses, skipped medications, and preventable hospitalizations. This cost crisis is no longer just financial—it’s deeply human.”
Donnelly emphasized that reduced insurer competition and soaring premiums will hit rural and working-class communities the hardest, where provider options are already scarce.
Donnelly is urging state legislators to take immediate steps to stabilize the system.
“We need comprehensive rate review reform, stronger protections for enrollees, and real insurer accountability,” he says. “This isn’t about red or blue—it’s about protecting New Yorkers’ lives.”
Without reform, increased Medicaid spending could worsen the problem:
“We can’t keep pouring billions into Medicaid without innovation and oversight,” he concludes. “That’s not sustainability—it’s just inflating the bubble.”
To learn more, contact: James Donnelly Safe Haven Insurance Agency james@safehaveninsuranceagency.com
(631) 608-1137
Ilene Corina, BCPA, President, Pulse Center for Patient Safety Education & Advocacy
(516) 579-4711
Comments