Disability touches every aspect of an individual’s life, which often means Disabled folks are much more likely to interact with and be impacted by systems, policies, and programs than others. Therefore, when analyzing Governor Hochul’s proposed budget for State Fiscal Year (SFY) 2026-27, it must be viewed through a holistic framework. This document provides an analysis of the budget and the policies that impact Disabled New Yorkers. Policies are grouped by budget area and in the order they appear.

The Executive Budget projects a 9.9% increase in state revenue collections, with total SFY 2026–27 spending projected at $260 billion, a 0.7% increase. The budget contains an operating budget of $157 billion, reflecting a 5.7% increase. Proposed Medicaid spending in the Executive Budget proposal totals $38.2B, an 11.4% increase. The Governor has emphasized that this is not an austerity budget; there is little evidence to support that claim with respect to independent living services and programs that promote deinstitutionalization. Perhaps the most problematic and glaring example is the complete lack of a mention or funding towards the Olmstead Plan and its goals.

While the budget includes several recurring items that CDR recognizes will have a tangible impact on Disabled New Yorkers, such as program extenders for the Committee on Special Education, managed care penalties, and the Enriched Social Adult Day Services demonstration, these provisions are limited in scope. Many other items are ancillary to advancing independent living, including technical amendments to sections of the Public Health Law, Insurance Law, and State Finance Law.

While there was nothing on CDPAP in the budget, it did take up a disproportionate amount of time in both the Governor’s and her budget director’s addresses. The Governor and her budget director claimed that the shift to PPL has already saved the state $1.2 billion in Medicaid funds, $700 million more than what was in the state financial plan. She maintained that these funds were reinvested into Medicaid; however, it is noted that no additional programs or funding are available for Disabled New Yorkers who use CDPAP, home care, or any other community-based supports. Indeed, it appears that these funds were used to offset Federal cuts that, at this point, primarily affect hospitals, nursing facilities, and other institutional providers.

This continued prioritization of institutional care is best reflected when examining the distribution of $1.2 billion generated by the Managed Care Organization (MCO) tax, which the budget director’s presentation notes, goes to health care facility transformation, providers, hospitals, nursing facilities, and assisted living programs. The slide further notes an additional $750 million in new resources, presumably comprised of the additional savings from CDPAP, which is invested specifically in hospitals and nursing facilities. This $2 billion in funding for institutional providers all occurs while access to community-based programs are suffering, which, when combined with other policies and funding decisions in this budget, signals a shift in almost five and a half decades of policy that started with the expose of Willowbrook to address Disabled and older New Yorkers’ desire for deinstitutionalization.

The NHTD Waiver was also highlighted in discussions of Medicaid cost containment in both the Executive Budget Briefing Book and the Governor’s address. While the current Executive Budget includes no proposed changes to the program, we note that enrollment has been stopped by the Department, as the State has reached the enrollment cap under the Federal waiver. CDR remains concerned about the lack of oversight on managed long-term care plans and the impact their behavior is having on enrollment in the waiver. While everyone in the waiver has been assessed to qualify through independent third parties, reports that plans are encouraging those who need longer authorizations to go to the waiver pose the conflict that some who are in need of the comprehensive set of benefits will be forced to go without, so managed long-term care plans can bolster their bottom lines. CDR will continue to monitor this closely to ensure the integrity of the waiver and that its role in supporting community-based living is not undermined.

Ultimately, despite extending certain programs and advancing technical amendments to facilitate implementation of existing statutes, the vast majority of spending in the $260 billion budget fails to meaningfully advance independent living or the broader goal of deinstitutionalization for Disabled New Yorkers.

Aid to Localities Appropriations

Independent Living Center funding
It is not lost on CDR that organizations led by Disabled people for Disabled people are treated differently from those led by non-disabled individuals. ILCs are routinely denied the same recognition and influence, despite unique expertise and effectiveness. This perpetuates an ableist system that continues to devalue Disabled leadership and lived expertise. Rather than reinforcing this inequity, New York must prioritize meaningful investment in disability-led organizations.

The Aid to Localities budget proposes $16 million for Independent Living Centers (ILCs) statewide, representing a cut of $750,000 from last year’s enacted budget. These funds were added by the Legislature last year based upon the amount available at the budget negotiating table. In reality, while the increase was appreciated, it falls short of the $9 million increase that ILCs have requested for years and remains woefully insufficient. This is especially concerning given that ILCs have saved New York State an estimated $2.5 billion over the past 25 years. Chronic underfunding has left many ILCs struggling to maintain services for Disabled New Yorkers and retain staff, and it has prevented innovative new programs that could further bolster supports from taking root. For these reasons, CDR calls for a $9 million increase in ILC funding, including the restoration of the governor’s proposed cut, to $25 million total.

Cost of living adjustments (COLAs)
Once again, Governor Hochul proposes COLAs for a number of human service and health care-related organizations. Once again, Governor Hochul omits ILCs from this COLA increase. At a bare minimum, ILCs must be treated equitably. CDR continues to call for establishing parity in funding increases for COLAs between Independent Living Centers and other human services organizations.

Capital Projects Appropriations

Access to Home
The governor’s budget cuts funding for Access to Home by 80% – from $5 million in last year’s enacted budget to $1 million in her proposed budget. Access to Home is an investment that allows for dramatic cost savings as a result. The program that provides grants for home modifications that help older and Disabled New Yorkers remain in their homes and avoid institutional placement. This program allows the state to increase accessibility in single-family homes incrementally. The proposed cuts are the definition of penny-wise and pound-foolish, as they will force countless individuals into nursing facilities when a relatively low-cost modification would allow them to remain healthy in the community. CDR calls on the state to not only restore the funding cut to the program, but also double last year’s allocation to $10 million, while expanding the currently limited list of counties to make these funds available statewide.

Education, Labor, Family Assistance (ELFA)
Article VII
Part K – Committee on Special Education Financing
In 2020, the State shifted an 18.424% State payment for the placement of children needing special education services in a residential setting to the local school districts that placed the children, bringing these districts’ share of the cost to 56.848%, up from 38.424%.

The 2020 change also eliminated the 50% state share payment that the State had made for some children to the New York State School for the Deaf and the New York State School for the Blind, shifting this payment entirely to the local school districts as well.

These changes brought payments by school districts outside of New York City in line with those made by New York City, which had not previously had the state paying any portion.

These changes were set to sunset in 2026. The Governor proposes to make them permanent. CDR recommends a two-year extension so that the full implications can be evaluated.

Part L – Supplemental Security Income (SSI) pass-through payments for personal needs allowances and state payments
This provision adjusts the payments under programs that allow both individuals who have applied for and those who are in receipt of Federal Social Security Insurance (SSI) payments in residential facilities, with an increase in their entitled personal needs allowance (PNA) due to corresponding increases at the Federal level.

However, while this change is necessary to prevent the state from keeping funds meant for Disabled New Yorkers, we note that the current SSI system, regardless of residence, still disproportionately penalizes married SSI recipients. This means that while New York has led the way in ensuring marriage equality for the LGBTQ+ community, Disabled New Yorkers still face a “marriage penalty.” Married couples on SSI receive less than unmarried recipients, leading some Disabled New Yorkers to forgo marriage or maintain separate residences to avoid exceeding income limits. New York can take a meaningful step toward addressing this issue by using state funds to eliminate the marriage penalty. CDR supports the Governor’s proposal and calls on the Governor and Legislature to work with the Disabled Community to develop a five-year plan to eliminate the SSI marriage disincentive in New York State and give all Disabled New Yorkers marriage equality.

Health and Mental Hygiene
Article VII
HMH Part A – Medicaid Global Cap
Former Governor Cuomo, in an effort to get what he called runaway Medicaid growth under control, instituted a cap on Medicaid growth. This cap is based on a formula using the seven years’ worth of inflation data for health care expenses, as reported in records maintained by the Federal Centers for Medicare and Medicaid Services (CMS). This is known as the Medicaid Global Cap. This budget seeks to extend the cap for another year through the State Fiscal Year (SFY) 2027-28 budget.

CDR highlights that the Medicaid Global Cap is an artificial cap placed on the growth of Medicaid by a fiscal formula, instead of allowing need to dictate spending. The cap disproportionately impacts Disabled and older New Yorkers, who use more expensive programs that have repeatedly faced cuts due to the artificial spending limits. CDR has opposed the global cap, and continues to do so, noting that Medicaid funding should be based on need, not an arbitrary cap that disproportionately harms Disabled New Yorkers.

HMH Part E – Miscellaneous Public Health Savings
Repeal of the Enhancing Quality of Adult Living (EQUAL) grant program and the enriched housing subsidy program
Governor Hochul proposes to cut the EQUAL program, a grant program that allows residents of adult homes and enriched housing facilities to enhance their quality of life by working with operators to identify quality of life improvements, such as air conditioning, improved food quality, and improved clothing allowances, by $6.5 million. She would also cut a similar program called the Enriched Housing Subsidy Program by $380,000. While CDR believes that everyone can and should live in the community, until we reach that goal, programs like EQUAL, which provide dignity and respect to individuals in facilities that have repeatedly been identified as squalid, are vital. CDR opposes this cut and calls for full restoration.

HMH Part H – Strengthening Oversight on Healthcare Transactions
This would require health care investors to submit additional background information to DOH prior to the completion of a material transaction and continue reporting on the impacts of said transaction for a period of 5 years following closure. It would also authorize DOH to conduct a full cost and market impact review of transactions valued at over a certain threshold or otherwise, if DOH believes the transaction will negatively impact cost, quality, access, health equity, or competition in impacted markets, and allow DOH to collect fees from the parties to transactions to offset the cost of review. Under this bill, DOH would be authorized to share the findings of its cost and market analysis with the Office of the Attorney General for use in supporting investigations, reviews, and other actions.

CDR notes that this should include a larger conversation about the profit-making status of health care providers, particularly those in Medicaid. In particular, we call on the state to ban private equity in Medicaid, as these groups remove millions of taxpayer funds from Medicaid in the form of profit.

HMH Part K – Hospital at Home

The governor proposes to implement the Acute Hospital Care at Home demonstration program. It allows hospitals to provide care in patients’ homes without obtaining a license as a home care agency, as long as the services provided can be provided in a hospital. This includes all or nearly all services offered by various levels of home care. It appears the service would be limited to the length of the acute incident sparking service.

CDR opposes this proposal, noting that this would significantly undermine an already struggling home care industry, causing irreparable harm and destabilizing the sector even further.

HMH Part L – Long-Term Care Proposals
Nursing home funding
The Governor proposes to restore the 10 percent reduction to the nursing home capital rate component, which was enacted in FY 2025. There is a corresponding cut to a fund meant to aid safety net nursing homes. Overall, it is a net $8.1 million increase in nursing home funding.

CDR opposes this additional funding for institutions at the expense of community-based services.

Medicaid Buy-In for Working People with Disabilities
The Medicaid Buy-In for Working Persons with Disabilities (MBI-WPD) program’s premium structure, established with the expansion of the program two years ago, would be modified based on requirements imposed by the Federal government to secure approval. Previously, premiums began at 4% of the premium for those at 250% of the federal poverty level (FPL) ($39,125 annually for an individual in 2025). A new 3% co-premium would be added for those at or above 150% FPL ($23,475 annually for an individual in 2025).

CDR does not support higher co-pays or co-premiums and is unsure why higher limits than authorized in law were included in the SPA. We do, however, note that Disabled New Yorkers are waiting for the Medicaid Buy-In expansion, and we desire implementation.

Part M – Managed Care Related Proposals
Essential Plan changes
Several years ago, the budget changed the Essential Plan, a free or subsidized health plan for those ineligible for Medicaid, to include long-term care services. This proposal has never been enacted because the state has not secured Federal approvals. The budget proposes to cut the benefits from the Essential Plan under the premise that it has not been implemented.

While the services were not implemented and are unlikely to be authorized under the current Federal administration, there is no reason to repeal the law. By retaining these provisions, upon a change of administrations in Washington, we can seek authorization for this important change.

CDR opposes the elimination of long-term care from the Essential Plan.

Part N – Change the scope of practice for some professions
Technical changes changing “physician” to “qualified health care provider acting within his or her scope.”

This group of proposals would update several laws to allow “any qualified healthcare professional acting within his or her scope of practice” to provide clearances and authorizations in a number of areas, instead of only a physician. This is consistent with how health law has been written for many years now and updates outdated provisions. It does not actually change anyone’s scope of practice. Relevant provisions change laws for:

Temporary provision of accessible parking placards;

The provision of an exemption to mandatory seat belt laws due to a disability that prevents their usage.

Authorizing higher levels of tint on windows for vehicles where the driver or a common occupant cannot be exposed to high levels of sunlight.

CDR supports these changes, as they would make it easier for Disabled New Yorkers to apply for and receive necessary exemptions under the law, in a manner consistent with the Public Health Law.

Allowing certified nurses aides (CNAs) in nursing homes to administer medications
This would expand the scope of practice for CNAs to create a subcategory called “certified medication aides.” These CNAs would be allowed to administer routine medications to residents under the supervision of a registered nurse within certain circumstances.

Ensuring proper medication administration is critical everywhere, particularly in nursing facilities where individuals are completely at the mercy of staff. This is a service that should remain with staff currently authorized to provide such services.

CDR opposes this proposal.

Part P – Cost of Living Adjustment for certain workers
Unfortunately, not all human services programs are treated equally. The Executive Budget puts forth a proposal to provide a 1.7% targeted inflationary increase for eligible mental hygiene and other human services providers under OPWDD, OMH, OASAS, OCFS, and OTDA at a cost of $176 million. The purpose of these funds is to address rising operating costs and to offer more competitive wages to their staff. However, this funding excludes programs run by Independent Living Centers (ILCs), the only statewide network of disability-led organizations dedicated to helping people with disabilities live independently in the community.

ILCs have been chronically underfunded for years, leaving many struggling to provide services to Disabled New Yorkers so they can continue to pay staff. While CDR supports all providers who contribute to improving the lives of Disabled New York, we demand that ILCs be included in the human services programs eligible for a cost-of-living adjustment, as presented in previous budgets.

Items not included in the Governor’s Budget proposal that CDR believes should be in the Enacted Budget

Ensuring transparency in the Consumer-Directed Personal Assistance Program (CDPAP) and preserving the role of Independent Living Centers in the program.
Since the implementation of the statewide fiscal intermediary (SFI), much of the reporting and data that was conducted has been lost. There is little transparency regarding program operations, outcomes, or spending. This data is critical for the ongoing operations of CDPAP, ensuring that consumers are receiving the services they need, workers are being paid, adequate Medicaid integrity provisions exist, and that funds are being spent in a manner appropriate of taxpayer funds. The state should require DOH to provide quarterly reporting on CDPAP, similar to reports filed by both home care companies and managed care organizations.

CDR strongly supports legislation by Senator Comrie and Assemblymember Gonzalez-Rojas that would require basic, common-sense reporting and transparency in CDPAP.

Eliminate eligibility cuts to home care enacted by MRT II
The MRT II initiative enacted cuts to Medicaid eligibility that prevented individuals needing assistance with three or fewer activities of daily living (Showering, eating, transferring, etc.) from receiving home care services. This measure will prevent thousands from accessing much-needed home and community-based services, even though they could often meet the standard of care necessary for Medicaid to pay for a dramatically more expensive nursing facility placement.

CDR strongly supports the restoration of this draconian eligibility cut, noting it is a violation of the State’s obligations under Olmstead and disrespects the basic human dignity of those needing fundamental services.

Transportation and Economic Development (TED) Article VII

Part E – Autonomous Vehicle Technology Demonstrations

This bill would allow the Commissioner of the Department of Motor Vehicles (DMV) to authorize demonstrations and tests of autonomous vehicle technology (self-driving cars) and would permit the limited deployment of autonomous for-hire passenger vehicles (self-driving taxis), outside of New York City, pending the demonstration of several criteria established in law and by subsequent regulation of the Commissioner.

CDR notes the potential of autonomous vehicles to eliminate many of the transportation barriers faced by Disabled New Yorkers. However, there is no requirement in this proposal requiring accessibility. In a relatively new market, New York has the opportunity to be a national leader. CDR would support this measure if a requirement that autonomous vehicles be fully accessible were included. Without such a requirement, it must be opposed as yet another instance of discrimination and ableism.

Part HH – Prior Authorization Reforms
This bill would require insurance companies to improve the ability of individuals to compare plans, including:

Annually providing specified utilization review information, including pre-authorization claim request approvals and denials, appeals, and appeal success rates, for publication in an annual health insurance consumer guide;

The establishment of new requirements expanding the definition of “continuity of care” – the period insurers must cover out-of-network treatment – under certain conditions.

A requirement that insurers publish formulary prescription drug lists on their public websites.

The bill would also define a chronic health condition and limit the number of utilization reviews that can be conducted against an individual with a chronic health condition to once every twelve months. This is an important measure for many Disabled New Yorkers who face excessive utilization review requests as an effort to deny coverage for services that are not clearly still necessary through paperwork.

CDR supports provisions that prevent insurance companies from attempting to limit or deny necessary services by overwhelming Disabled New Yorkers and their health care providers with unnecessary utilization reviews.

Revenue (REV) Article VII

Part V – Expanding the Rent Increase Exemption for Senior Citizens and Persons with Disabilities
This bill would extend the Senior Citizen Rent Increase Exemption (“SCRIE”), and the Disability Rent Increase Exemption (“DRIE”) programs for two years, until June 30, 2028, expand the income eligibility thresholds for both programs from $50,000 to $75,000 in New York City, and allow for increased income eligibility thresholds by local option outside of NYC. If, in the future, a municipality or county were to adopt rent control regulations per a law passed last year by the Legislature, residents of that municipality would be able to use SCRIE and/or DRIE.

CDR supports these provisions; housing is a major issue for many Disabled New Yorkers, given the extreme lack of accessible housing. With the rising costs of rent, many Disabled New Yorkers could be forced into institutionalization due to the lack of affordable and accessible options.