Albany, NY – Assemblywoman Amy Paulin (D–Westchester), Chair of the Assembly Health Committee, announced today that the New York State Legislature has passed three of her bills addressing gaps in New York’s healthcare system. The legislation would require the state to study and report on heat-related deaths (A.755/S.5056), help ensure that eligible New Yorkers leaving incarceration are enrolled in Medicaid (A.269/S.614), and establish a permanent Rare Disease Advisory Council (A.1296/S.1287).

“A health system is only as a strong as how it treats its most vulnerable,” said Assemblywoman Amy Paulin. “These three bills reach New Yorkers our system too often misses: people facing extreme heat, families navigating rare disease, and individuals reentering society after incarceration.”

Confronting Extreme Heat

A.755 requires the New York State Department of Health to examine and publish an annual report on heat-related deaths statewide. As climate change worsens and temperatures continue to rise, heat poses a serious threat to New Yorkers. According to the New York State Climate Impact Assessment, the annual average temperature will rise by 4 to 6 degrees Fahrenheit by the 2080s and the number of days with a heat index above 95 degrees Fahrenheit is expected to increase.

Heat-related illness also disproportionately affect low-income individuals, people of color, and Indigenous populations who bear the brunt of systemic environmental injustices. These populations experience the “first and worst” consequences of environmental hazards, pollution, and climate change.

"Heat is one of the deadliest yet most overlooked threats facing New Yorkers, and that danger is only growing as our climate changes," said Assemblywoman Amy Paulin. "By requiring the Department of Health to track and publicly report heat-related deaths each year, this report will give us the data we need to save lives and confront the reality that low-income communities and communities of color are bearing the heaviest burden. We need the data to evaluate and act on it."

Eddie Bautista, Executive Director, New York City Environmental Justice Alliance, said, "Heat is the deadliest climate hazard and a public health threat. About 500 New York City residents die from extreme heat every year, according to NYC’s Department of Health. Black New Yorkers die from extreme heat at 2x the rate than white New Yorkers. With more accurate statewide tracking and monitoring of heat-related deaths, we can deliver the resources and policies needed to help New Yorkers across the state prepare and adapt to the rising heat threat. We thank Assemblymember Paulin for her leadership and recognition of this critical public health issue."

"Climate change-driven extreme heat is killing New Yorkers at a rate we can't even fully measure, and this bill will help us get a handle on the danger so we can save lives,” said Vanessa Fajans-Turner, Executive Director, Environmental Advocates NY. “By tracking extreme heat-related deaths more accurately, New York will have a scientific basis for setting policy that protects the groups and communities most at risk — including Black New Yorkers, who are twice as likely to die from heat stress."

"Extreme heat is one of the deadliest weather-related threats facing New Yorkers, particularly children, older adults, people living with lung disease, and communities disproportionately impacted by air pollution. The American Lung Association in New York is grateful to the Legislature for passing A.755, which will strengthen the state’s ability to understand, track, and respond to the growing health impacts of extreme heat. By improving the collection and reporting of heat-related illness and mortality data, this legislation will help identify vulnerable communities, guide effective public health interventions, and save lives. As climate change drives more frequent and severe heat events, we thank the bill sponsors and legislative leaders for advancing this critical public health measure and urge Governor Hochul to sign it into law," said Max Micallef, NYS Advocacy Manager – Clean Air Initiatives, American Lung Association.

“Extreme heat is deadly and vulnerable New Yorkers who cannot afford to run an air conditioner are the most at risk. Despite that, there is no statewide accounting of how many people are dying from or vulnerable to extreme temperatures. This legislation fills that gap and gives policymakers the evidence needed to expand affordable cooling programs, strengthen utility consumer protections, and ensure that all New Yorkers can stay safe and cool during dangerously hot and humid weather. We thank Assemblymember Paulin and Senator Rivera for their leadership on this important issue,” said Laurie Wheelock, Executive Director and Counsel, Public Utility Law Project of New York.

Health Coverage for Reentry

People return to their communities from incarceration with disproportionately high rates of chronic illness, including HIV, diabetes, serious mental illness, and substance use disorder. Yet many are released without health insurance, and that gap in coverage has devastating consequences. In the first two weeks after release, formerly incarcerated people are thirteen times more likely to die than the general population and 130 times more likely to die from overdose.

A.269 directs state and local correctional facilities to provide Medicaid enrollment assistance to all people leaving incarceration and ensures that individuals can connect to that coverage immediately upon release, when the risk to their health is greatest.

“Leaving incarceration is hard enough, both economically and socially. On top of that, when people leave incarceration without health coverage, they often can’t afford to go to doctors’ appointments, fill prescriptions, or access the treatment they need to live productively, and even to stay alive,” said Assemblywoman Paulin. “Connecting people to care the moment they leave improves quality of life, reduces costly emergency visits, and helps people transition safely back to their communities.”

The legislation builds on work that many facilities have already done, though without any mandate. In recent years, the State’s Department of Corrections has enrolled about 90 percent of individuals leaving incarceration in Medicaid, and about half of the jails in New York State are already providing enrollment assistance. A.269 would establish a uniform requirement so that no one falls through the cracks, and directs facilities to determine eligibility for other coverage if the individual does not qualify for Medicaid.

“I’m grateful to the healthcare professionals, community service leaders, and advocates who have come together to help me pass this bill,” continued Paulin. “Helping people stay healthy after release is one of the most effective things we can do to support people being released and strengthen our communities.”

"Ensuring individuals have access to healthcare as they transition from incarceration back into the community not only improves health outcomes but also strengthens public safety by supporting successful reentry. I thank Assemblywoman Amy Paulin for championing this important legislation, which aligns with the Suffolk County Sheriff's Office's mission and helps connect individuals to the services they need to build stable, productive lives," said Suffolk County Sheriff Errol D. Toulon, Jr.

"The passage of the Transitional Reentry Health Act (TRHA) comes at a pivotal moment. As federal Medicaid changes threaten access to health coverage and care for millions, including those in the especially vulnerable reentry population, New York is taking critical action to ensure people leaving incarceration can connect to care when they need it most. This legislation is a lifesaving investment as people returning to the community from incarceration face an extraordinarily high risk of death in the weeks following release, including a dramatically elevated risk of fatal overdose. Moreover, because Black and brown New Yorkers are disproportionately impacted by incarceration and the barriers that follow, TRHA represents an important step towards advancing racial justice by closing health coverage gaps and ultimately reducing longstanding racialized health and economic disparities. Bottom line: by helping to ensure that New Yorkers returning home from jail and prison can access care from day one, this landmark legislation will not only improve their lives and those of their families, but it promises to strengthen communities statewide,” said Megan French-Marcelin, Sr. Director of NYS Policy, Legal Action Center.

"Friends of Recovery–New York proudly supports the passage of the Transitional Reentry Health Act (S.614-B Rivera/A.269-A Paulin). This legislation recognizes a simple but important truth: access to healthcare is a foundation for successful reentry. For individuals returning home from incarceration, particularly those living with substance use disorder and other chronic health conditions, the weeks immediately following release can be life or death. Access to Medicaid helps ensure people can connect to healthcare, treatment, recovery support services, and other essential supports without unnecessary delays. It also provides a critical lifeline for individuals at heightened risk of overdose following release. Healthcare is often the first step toward stability. When people are connected to care, they are better positioned to focus on recovery, secure housing, find employment, reconnect with their families, and successfully reintegrate into their communities. The Transitional Reentry Health Act helps remove unnecessary barriers during a critical transition period and ensures people have the support they need to move forward. We applaud Senator Rivera and Assemblymember Paulin for their leadership and commitment to ensuring that people returning home have the tools and support they need to thrive," said Dr. Angelia Smith-Wilson, Executive Director, Friends of Recovery - New York.

"Many people who enter incarceration arrive having already faced risk factors that make them more vulnerable to substance use disorder and mental illness, and the conditions of incarceration often worsen those harms. Our 2025 report with the Legal Action Center found that without ready access to substance use disorder and mental health support upon discharge, people face a real threat of jeopardizing recovery, broken ties with loved ones, unstable housing, and, in many cases, death. Assemblymember Paulin and Senator Rivera have taken a meaningful step to address one of the biggest obstacles to care by making sure people leaving incarceration have insurance coverage in place when they return home," said Jihoon Kim, LMSW, CRPA-P, President & CEO, InUnity Alliance.

“The passage of bill A.269 is a crucial step toward codifying access to health insurance for individuals leaving the state's correctional facilities,” said Jennifer Scaife, Executive Director at the Correctional Association of New York (CANY). “CANY strongly supports efforts to ensure continuity of healthcare during reentry, and we applaud Assemblymember Paulin’s leadership on this vital issue. We look forward to tracking the bill's implementation and working to ensure that the transition from custody back into the community is fully supported.”

“The Drug Policy Alliance applauds Assemblymember Paulin and Senator Rivera for championing the Transitional Reentry Health Act - legislation that expands access to health insurance. This critical bill ensures a continuity of care for treatment and recovery for incarcerated individuals during one of the most destabilizing times: community reintegration. In 2022, NYS passed a law prioritizing the health of people who use drugs by introducing a comprehensive medication for addiction treatment programs. However, without access to healthcare on the outside, that critical life-saving program is met with immediate destabilization that can lead to death. Data reveals that people recently released from prison account for nearly a quarter of all fatal overdoses in the nation. This corrective will address the needs of our most underserved and lead to better health and wellness outcomes," said Toni Smith, NY State Director, Drug Policy Alliance.

"When health care access for those incarcerated and re-entering society disappears, the consequences extend well beyond individual health,” said Lieutenant Diane Goldstein (Ret.), Executive Director, Law Enforcement Action Partnership. “People leaving incarceration without health care are more likely to experience relapse, untreated mental health crises, and housing instability – all of which increase the likelihood of reoffending. The ensuing harms undermine overall public safety, increase costs to all taxpayers, and place us all at greater risk. Law Enforcement Action Partnership celebrates the passage of Assembly Bill 269, because we know that ensuring continuity of care is one of the most effective ways to support successful reentry, reduce recidivism, and bolster our shared safety."

"People leaving prison need immediate access to mental health and healthcare services. Yet all too often, our clients must navigate a byzantine re-enrollment process in the weeks after their release before they have access to these vital services, a system that would only get worse with Medicaid eligibility changes. The Transitional Reentry Health Act will fix this problem by requiring Medicaid enrollment assistance and simplifying the eligibility determination. We applaud the Legislature for passing this bill, and Assemblywoman Paulin and Senator Rivera for their leadership. We urge Governor Hochul to sign the bill into law," said Nadia Chait, Senior Director of Policy & Advocacy, CASES.

"The Community Service Society of New York (CSS) has spent nearly two centuries working toward a more equitable New York, and A.269/S.614 helps advance that mission. By ensuring people can enroll in coverage before they leave custody, this bill closes a dangerous gap and gives New Yorkers a real chance to succeed in their reentry,” said David R. Jones, President and CEO, Community Service Society of New York.

Creating a Rare Disease Council

There are more than 7,000 known rare diseases. While an estimated 1-in-10 New Yorkers live with one, about 95 percent of rare diseases have no FDA approved treatment. For patients, the road to an accurate diagnosis is often long, specialists who understand their condition can be hard to find, and fair insurance coverage can be a constant fight.

A.1296 establishes a permanent Rare Disease Advisory Council within the New York State Department of Health to identify best practices, raise awareness about rare diseases, evaluate barriers to care, and make recommendations to the Legislature and the Governor. New York first created such a council in 2019 through earlier legislation Assemblywoman Paulin sponsored, but it was enacted only as a temporary working group. A.1296 makes the Council permanent and allows the prior working group to be reconvened, which reduces the time and administrative burden required to get the new Council running. The Council will be made of healthcare professionals, rare disease researchers, patients and caregivers, and other key stakeholders.

"For years, families across the state have navigated rare diseases largely on their own," said Assemblywoman Paulin. "A permanent Rare Disease Advisory Council gives them a seat at the table and gives our state the expertise it needs to make the best decisions possible for this community."

Senator Roxanne J. Persaud, Senate bill sponsor, said, "A permanent Rare Disease Advisory Council in New York State will provide the expertise and guidance we need as legislators to create programs and policies that truly address the needs of the rare disease community. By bringing together patients, caregivers, healthcare providers, researchers, and advocates, we can ensure the voices of this community are heard and reflected in the policymaking process. This Council will help ensure that New York remains a leader in advancing equitable, patient-centered policies for those living with rare diseases."

"Assemblymember Paulin has championed this work since 2019, through every iteration and extension. Her dedication has brought us to this moment and today, we celebrate with the entire rare disease community – the dedicated coalition of advocates, our member organizations, and our broad stakeholder network who have worked tirelessly these past years to make this possible. With the passage of this bill, the legislature has secured a permanent pathway for rare disease patients to participate in their state government, to advise on the very decisions that govern their care – from Medicaid coverage to how we respond in emergencies. NORD is profoundly grateful for the Assemblymember's persistence and vision in seeing this through," said Carolyn Sheridan, Associate Director of State Policy, National Organization for Rare Disorders (NORD).

"NewYorkBIO celebrates this milestone in recognition of the rare disease community, underscoring the importance of patients having a meaningful seat at the table,” said Jennifer Hawks Bland, CEO, NewYorkBIO, the leading advocate for New York’s life sciences community. "We remain steadfast in our commitment to accelerating the innovation and development of transformative treatments, cures, and technologies in New York to deliver hope to rare disease patients and families across the globe."

"For families facing ALS and other rare diseases, every day matters. Too often, patients and caregivers feel unseen as they navigate a healthcare system that does not fully meet their unique needs. The ALS Association was proud to work alongside Assemblymember Amy Paulin and a broad coalition of advocates to advance A.1296. By creating a permanent Rare Disease Advisory Council, New York is ensuring that the voices of patients and families help shape the policies that affect their lives for years to come," said Lindsay Jack, Managing Director of Advocacy, ALS Association.

"The MSUD Family Support Group is proud to support a permanent Rare Disease Advisory Council in New York. The families we represent face daily challenges, from accessing specialized medical care and dietary formula to navigating a healthcare system that often doesn't understand their condition. A permanent council gives our community a unified voice and ensures that the people who live with rare diseases help shape the policies that affect them," said Sandy Bulcher, MSUD Board President.