Lily Fang: What Happens When Affordable Coverage Disappears

When Lily Fang left a full-time job in 2025, she was taking a risk.

Like many Americans, she had long viewed employer-sponsored health insurance as one of the biggest barriers to making a career change. Although she was unhappy in her job, the security of health coverage made leaving difficult. It reached a point where she had to weigh the cost of staying. “The job was really stressful, but I wanted insurance — but then I was kind of thinking to myself, well, maybe staying is actually bad for my health.” She decided to leave and focus full-time on content creation, a goal she had been working toward for years.

She’d spent the last couple years working remotely and moving from place to place, but decided to settle in New York — partly because of the state’s Essential Plan. New York’s Essential Plan provided comprehensive coverage with no monthly premium and a $0 deductible. “I loved that it was like a totally free plan,” she said. For someone with variable income building a new career, that stability was crucial. “Health insurance has just been the biggest stressor as someone self-employed,” she said.

The alternative was stark. Similar marketplace coverage would have cost around $700 a month, including the premium tax credits, $1300 without, with lower-tier plans carrying deductibles around $4,000. “The coverage is just incomparable,” Lily said. Going from a $0 deductible plan to several hundred dollars a month for a huge deductible is insane,” she said.

For Lily, the Essential Plan did more than provide health insurance. It gave her the freedom to pursue self-employment without worrying that a health crisis could jeopardize her finances. Like any plan, it had its limits — provider networks were narrow, and some out-of-pocket costs remained high — but for someone building a business from scratch, having any reliable coverage at all made an enormous difference.

Earlier this year, she learned that coverage would end. Federal funding cuts will eliminate the Essential Plan for approximately 450,000 New Yorkers as of June 30, 2026. For Lily, the news immediately raised the question of what comes next. She and her partner are planning to obtain a domestic partnership so she can access his employer-sponsored insurance — an imperfect but necessary workaround that will add roughly $300 a month to his premiums and, because they are not married, her coverage will be counted as taxable income, leading to around a $500 total increase in costs. “I do feel that I’m in a privileged position,” she said, acknowledging that not everyone even has the option.

Without this access, she shared that  staying in the country simply wouldn’t have made financial sense. “I think I would have left the US, honestly.” She had lived in France before, where a doctor’s visit costs around €25, and saw firsthand what health care looks like when it isn’t tied to employment. The American alternative — $1,300 a month for a Gold marketplace plan with no subsidies, on top of New York City rent and self-employment taxes — made leaving feel like a rational, not radical, option.

Lily’s experience points to a consequence of affordable health coverage that often goes unacknowledged. The impact extends beyond access to doctors and prescriptions — it shapes decisions about work, stability, and opportunity. For Lily, losing the Essential Plan threatens more than access to care. It constrains the freedom to take professional risks without financial uncertainty. “I’d wanted to be self-employed for years, but I didn’t make the leap because of health insurance costs.” The Essential Plan made another path possible. Losing it means fewer Americans will feel free to take that chance.