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NYS Budget 2025 Update: What You Need To Know

The Situation Report | May 12, 2025

The 2025-26 State Fiscal Year (SFY) Budget, passed by both houses and signed by Governor Hochul on May 9, totals $254.3 billion, $17 billion higher than last year’s final, enacted State Budget, which was the largest ever.

As HCANYS reported extensively, there were priority issues impacting the home healthcare and managed care sectors that were actively pending through the end of the negotiation period.

The following preliminary overview of the budget bills provides a high-level view of where those priority issues landed; HCANYS is finalizing its comprehensive memo, which will be issued in the next day or two as further details are sorted. There are developments in Washington today that could change the trajectory of some of the health care spending items in the new budget.

OVERALL:

  • A major priority of HCANYS was the inclusion of home care funding. In response to HCANYS, the Senate and Assembly one-house budget bills included $30 million in combined state/federal funding for certified home health agencies. That funding remained on the table until the final days, perhaps hours, of the budget negotiations when final additions in the overall state budget were decided. Regrettably, without the Governor as a partner in the funding add for home care, the Legislature was not able to sustain the $30 million addition on the final ledger within the amounts available for budget adds. The Governor’s original budget proposed $45 million through the State Office for the Aging for programs and services provided to older New Yorkers across the State, of which home care will be part, and the Legislature agreed to the final budget with this Executive appropriation. We look forward to the benefit of the NYSOFA appropriation, and will continue to appeal to the Executive and Legislature post-budget to provide the urgent funding for home care that HCANYS and the Legislation joined together to advocate. HCANYS has already requested immediate action by the Legislature to advance legislative bills for S.6981/A.1493 and S.7052/A.7013, respectively, fund an annual state aid program for home care, and provide rate support for the certified home health agency episodic reimbursement system.

  • For the third year in a row, despite considerable advocacy from across the healthcare continuum, the final budget falls short in the delivery of much-needed support for all sectors during a period when crises in care delivery are plaguing the entire system due to shortages in workforce, financing and capacity. And while, the final budget does include some supplemental funds for designated sectors (hospitals, nursing homes, physicians, clinics, assisted living programs and hospice), the MCO tax being used to finance these adds is right now being reported to be under the microscope in both Congress and the Administration, with both legislation and regulation to curtail and/or to otherwise reconsider it. HCANYS is monitoring the federal response very carefully and up to the minute.

  • The Legislature rejected in the final budget Governor Hochul’s proposal to allow hospitals to provide care in the home without an Article 36 or 40 license, or without a licensed or certified partner. In our advocacy to the Legislature and Executive, HCANYS staff, Board and members presented the extensive and exemplary hospital-home care collaborative models being operated across the state. These models are providing acute and critical care, primary and preventive care, emergency room diversion, pre- and post-surgical programs, and other services, demonstrating effective and appropriate approaches for pursuing “acute care at home” models based on hospital-home care partnering. HCANYS provided the Governor and Legislature with alternative language built around these collaboration models, and explaining to the Governor and Legislature that the Executive proposal was both an unnecessary route and one that would amount to a flagrant violation of state licensure requirements and policy. As the Executive was not amenable to amendment of its proposal during the budget, the Legislature rightly rejected and omitted this Executive proposal from the final budget.

  • The budget restores the MLTC/PACE plan quality pools, which was also an HCANYS priority. The amount of the restoration is not available at this time and HCANYS will report that funding level as soon as we have it.

  • While the Governor’s proposed language capping NHTD was not stated as such in the final budget the Legislature has informed HCANYS that the cap was agreed to, effective July 1, 2025. HCANYS strongly opposed this cap, as the program provides an important option for services for consumers and caregivers, and is also helpful to MLTCs, MCOs, and system-wide. With respect to housing subsidies through the NHTD program, the final budget does provide level funding of $1.842 million for this purpose.

  • As in the proposed budget, there was no modification of the Consumer Directed Personal Assistance Program (CDPAP) in the final budget. Additionally, there was no mention of increased hospice funding, nor the Nurse Licensure Compact Program.

HCANYS is continuing to decipher the final budget; we willreport back with our further analysis as soon as possible.

Our work is not over. And we will need everyone’s voice through the end of session.