REGION – Marla Puccetti, a Narrowsburg resident and co-owner along with her partner Paul Nanni of The Heron restaurant in Narrowsburg, had gone much of her life without health insurance.

But that changed when she was diagnosed with cancer in 2021.

“We didn’t have insurance because we couldn’t afford it,” she said. “So then I get diagnosed with cancer and we’re freaking out.”

She and Nanni signed up for a plan from United Healthcare on the New York State Marketplace, paying around $4,000 a month, but after a few years couldn’t afford it. So she called an insurance broker who told her about the Essential Plan—a New York State program that provides health insurance at lower costs or no cost.

But now, she was notified that the plan was canceled.

The Fiscal Policy Institute reported that 470,000 New York residents enrolled in the Essential Plan have lost their health insurance after changes in the Trump administration’s “One Big Beautiful Bill Act” went into effect.

The bill, which was signed into law in July of 2025, includes changes to the way states implement health insurance policies, including eliminating federal funding for immigrants.

New York State lawmakers in response restructured the state’s Essential Plan—a program enacted in 2015—to reduce eligibility from 250 percent of the federal poverty level (for one person: $40,000 per year) to 200 percent (for one person: $31,920).

Planning for the future

On October 29 U.S. Senate Democratic Leader Chuck Schumer announced new legislation, the Restoring Essential Plan Coverage Act, to repeal these cuts and restore health insurance for New Yorkers who do not qualify for job-based insurance or Medicaid coverage.

“The ‘Big, Ugly Bill’ has been a disaster that has left New York families sicker, poorer, and less safe,” Schumer said at a press conference in Kingston announcing the proposed legislation. “Trump and Congressional Republicans promised lower health care costs, but instead they delivered soaring premiums, sky-high deductibles, and coverage ripped away from millions.”

“Access to affordable health insurance is fundamental to building healthier communities,” said Jonathan Schiller, President and CEO of Garnet Health. “When individuals and families have reliable healthcare coverage, they are better positioned to seek preventive care, manage chronic conditions, and receive timely treatment, and helps to sustain the hospitals and healthcare services our communities depend on.”

Schumer’s bill would repeal the premium tax credit eligibility restrictions, fully restoring funding for New York’s Essential Plan and providing all states with the option to expand coverage from 200% to 250% of the federal poverty level without requiring the administration’s approval.

‘We can’t afford this’

It is estimated that 178,000 New Yorkers who lost coverage have been unable to afford or secure other insurance and remain fully uninsured.

For Puccetti, navigating the insurance landscape has been difficult.

“We got letters in the mail this past week from [New York State] Marketplace saying you have to pick a new insurance company,” Puccetti said. “But it didn’t really give much information. They make things hard, I feel like you have to read between the lines.”

When she and Nanni had the United Healthcare plan, they were also able to offer it to their employees at The Heron, but none of them used it because of the high cost and because they were able to get insurance through family instead.

“After a few years we were like, ‘we can’t afford this anymore,’” Puccetti said. “We didn’t have any money at the end of the month for anything except insurance and living expenses.”

It was then that she called an insurance broker who told them that they qualify for the Essential Plan. They were both able to get on the plan, which was free, and had it for about one year before the recent changes canceled it.

“It was covering everything—all of my chemo, my radiation, my doctors, with very minimal prescription costs,” Puccetti said. “It was amazing.”

She was traveling to Memorial Sloan Kettering in New Jersey, and under the United Healthcare plan the costs were racking up. A GoFundMe was started to help cover those costs, and she also received gas money through Ride 2 Survive, a volunteer organization that assists with transportation expenses for Sullivan County residents undergoing cancer treatment.

“What a great organization Ride 2 Survive is,” she said. “That was a blessing.”

What’s the plan?

When she found out her Essential Plan was being canceled, she went back to Marketplace and it let her sign up for the Essential Plan again, saying she was covered through 2027.

But when she was driving to Sloan Kettering they called and said to turn around because she was no longer covered by health insurance. For about a month she missed a round of chemo and doctor’s appointments.

She again returned to the Marketplace and picked out another plan through Fidelis, with a payment of $300 per month, but then found out that it was being discontinued. As it stands now, she says Fidelis told her they will be moving her to a new plan.

“But they didn’t say how much it is, and I don’t know if Sloan is going to take it or not,” Puccetti said.

As she awaits more information, she worries about being able to afford it.

“With everything being so much more expensive [right now], especially the restaurant costs—our electric bill has gone up exponentially, I just paid $3,500 for electric. That was a gut punch,” she said.

As one of thousands in the region who have lost the Essential Plan, Puccetti says she is more worried about others, especially those who are elderly, and has heard from other small business owners who have also lost their coverage.

“To have to navigate [health insurance] yourself is so difficult,” she said. “On top of running a business and trying to figure out my treatment plan. The whole process has been very overwhelming.”