New York enacts delayed 2025–26 budget after late-night negotiations; Medicaid, MTA, Nassau University Medical Center and mental-health provisions draw focus

The New York State Senate approved the 2025–26 budget late on May 7 after a months‑long negotiation and a final, compressed floor session that drew repeated complaints from both parties about the use of messages of necessity and the short review time for lawmakers and the public.

Lawmakers approved multiple budget bills that together set overall spending for the coming year, enacting measures that include a roughly $1.4 billion package of health investments routed through an insurer (MCO) assessment, about $6 billion of combined state and city commitments to the Metropolitan Transportation Authority capital plan, and a $50 million state readiness and repair commitment tied to a takeover-style intervention at Nassau University Medical Center (NUMC). The two contested floor votes reported on the record closed about 40–42 senators in the affirmative and around 20–22 in the negative, as recorded in the official roll calls.

The Senate’s finance chair, Senator Liz Krueger, framed the bills as a package that stabilizes health care, transit and other services while bargaining teams continued to work on items that remained unresolved. Opponents said the process — dozens of pages of final bills distributed hours before floor debate — denied lawmakers and the public a real chance to examine the text.

Most consequential policy and spending changes in floor debate

Medicaid and the MCO assessment: The bills accept an expanded MCO (managed‑care organization) assessment and use the proceeds for targeted investments in provider funding, nursing and other priorities. Senate floor exchanges identify about $925 million placed into hospitals, nursing homes and clinics plus a larger transfer (described on the floor as roughly $500 million) that officials said will be used to address outstanding federal/state unemployment‑insurance obligations and other budgetary pressures. Sponsor remarks and floor debate put the combined fiscal package for health at roughly $1.4 billion tied to…