Mayor Eric Adams’ executive budget proposal adds hundreds of millions of dollars to the current spending plan to stave off some short-term funding shortfalls for Medicaid and other public health services.
The mayor’s $115.1 billion plan, unveiled at Bayside High School, his alma mater, on Thursday, includes money to support some recurring programs, including multiple health initiatives, that had not been fully funded in the preliminary budget proposal Adams released in January.
The additional funding commitments come at a time when the city faces the threat of $100 million in cuts to the Health Department’s disease prevention and control work and economic headwinds stirred by President Donald Trump’s tariff policies. The mayor and his budget team will negotiate the details of the spending plan with leaders in the City Council over the coming weeks ahead of the July 1 start of the city’s fiscal calendar.
The new proposal adds $251 million to fund the city’s share of Medicaid in the current fiscal year 2025 budget as Congressional Republicans mull drastic cuts to the government-backed insurance program. Roughly half of the city’s 8.5 million residents rely on Medicaid.
The funding will allow the city to fulfill the local share requirement for the program in the current fiscal year, bringing that spending total to $6.4 billion. That share would rise to $6.6 billion in fiscal year 2026 under the spending plan.
Health care providers, watchdogs and advocacy groups have raised alarms that cuts, like a proposed work requirement that would limit eligibility for Medicaid, could devastate the health of low-income New Yorkers. Those risks come as the city pursues one of Adams’ signature health initiatives, Healthy NYC, aimed at raising life expectancy in the five boroughs by targeting the factors that contribute to chronic disease, particularly among Black residents and people living in poverty, who live years less than their white counterparts.
The budget also invests an additional $43.1 million in the current fiscal year and $45.7 million in the next to the city’s HIV/AIDS Service Administration, which provides housing and case management for people living with the conditions, including connecting individuals to Medicaid, food stamps, home care, mental health care and other services. That program has been under budgeted in recent years, facing a $69 million shortfall in the current fiscal year, according to a tracker of fiscal cliffs released by the state comptroller’s office in December.
The figures included in the executive budget for the HIV/AIDS Service Administration represent additional funding from the city tax levy, which will sufficiently fund the city’s portion of the program in the current and next fiscal years, according to the Mayor’s Office of Management and Budget. That funding comes as Trump and Health and Human Services Secretary Robert F. Kennedy Jr. take steps to gut federal health agencies focused on testing, prevention and treatment.
The budget also includes spending of $298 million for school nurses, which would grow to $307 million in fiscal year 2028 under the plan. In recent years, that funding has been added on a year-by-year basis and fiscal watchdogs previously pointed out that the preliminary budget left the program unfunded in fiscal year 2026 and onward.
