New York advances a $2.245 billion takeover of Maimonides Medical Center by NYC Health + Hospitals, prompting lawsuits and protest from Brooklyn's Orthodox Jewish community ahead of a September 17 state vote.
New York state regulators are advancing a $2.245 billion deal for Maimonides Medical Center, one of Brooklyn's largest hospitals. It would transfer the hospital from independent nonprofit control to NYC Health + Hospitals (H+H), the city's public hospital system. Four Hasidic congregations, Maimonides trustees and a 34,000-signature petition drive are fighting it ahead of a September 17, 2026 state vote.
What Is Actually Being Transferred?
The transaction transfers Maimonides' assets, operations and governance to entities controlled by H+H. It is not a management contract or a funding partnership.
A May 2026 ruling from Albany County Supreme Court Justice Denise Hartman describes the underlying agreement. Maimonides and H+H signed the Affiliation and Asset Transfer Agreement in December 2025. It calls for the transfer of "substantially all" of Maimonides' assets, liabilities and operations to H+H. It also creates new entities controlled by H+H to run the hospital, restructures Maimonides' governance, and transfers operational oversight and hospital licensure to H+H.
The New York City Comptroller's office reached a parallel conclusion in its independent analysis. The deal converts Maimonides and its affiliate, Midwood Hospital, into subsidiaries of H+H. H+H holds reserved powers over the subsidiaries' budgets, policies and procedures.
Why Did a Judge Already Block This Deal Once?
Justice Hartman ruled in May 2026 that the state Health Commissioner tried to approve the deal without full council review. She called that attempt "arbitrary and capricious and affected by error of law."
The ruling came in Matter of Refuah Helpline v. McDonald, an Article 78 proceeding filed in Albany County Supreme Court. The petitioners were Refuah Helpline and Borough Park residents Pessie Schlafrig, Chaim Beigel and Israel Minkoff. Four Hasidic congregations joined them: Congregation Khal Shaarei Zion Bobov Inc., Congregation Kehilas Belz USA, Congregation Yetev Lev D'Satmar, and Khal Bobov 45 Inc. The court agreed that state law required full review by the Public Health and Health Planning Council (PHHPC). That review must happen under Public Health Law Section 2801-a before a deal this size can proceed. It annulled the Commissioner's November 2025 determination that had tried to bypass that process.
That ruling is separate from a second lawsuit filed by members of Maimonides' own Board of Trustees. The trustees sued Maimonides, CEO Kenneth Gibbs and board chair Eugene Keilin in November 2025, later adding H+H as a defendant. They argued the board pursued the deal without proper board process. They also argued Maimonides could become subject to the political preferences of whoever holds the New York City mayoralty.
What Happens to Kosher Food and Religious Accommodations?
H+H CEO Dr. Mitchell Katz has stated in court documents that the merger agreement requires preserving Maimonides' religious and cultural practices for at least 30 years. That includes its kosher kitchen and Shabbat accommodations. Katz repeated that commitment at the August 27, 2026 PHHPC hearing. He told reporters "we're not here to change Maimonides, we're here to support Maimonides," according to Jewish News Syndicate.
Maimonides currently operates Shabbat elevators that stop on every floor. It employs Yiddish-speaking staff and hosts daily prayer in an on-site synagogue. It also accommodates Jewish end-of-life practices.
The 30-year figure answers part of the community's objection but does not resolve it. Rabbi Yeruchim Silber directs New York government relations for Agudath Israel of America. He told JNS that current assurances do not address what happens under a future administration. "Administrations come and go," Silber said, questioning whether a future H+H leadership might decide to run the hospital differently once the 30-year term expires.
Who Is Paying for This, and Why?
New York State's Safety Net Transformation Program approved approximately $2.245 billion over five years to stabilize Maimonides' finances.
| Funding Component | Amount | Source |
|---|---|---|
| Total Safety Net Transformation Program allocation | Approximately $2.245 billion over five years | New York State |
| Operating funding | Up to $1.5 billion | New York City Comptroller's office analysis |
| Capital funding, including the Epic electronic medical records rollout | Roughly $500 million | New York City Comptroller's office analysis |
The Comptroller's office also reports that the state has committed to covering Maimonides' operating deficit for five years. H+H is expected to assume full financial responsibility by 2031.
Maimonides carries a large Medicaid patient population. That has historically meant lower reimbursement rates than commercial insurance pays. Joining H+H would let Maimonides access the State Directed Payment program, which increases Medicaid reimbursement for public hospital system members. The New York Post reported that industry sources say other private hospital systems declined to take over Maimonides. The sources cited the scale of its accumulated operating losses.
Who Is Fighting the Deal, and What Do They Want?
Opposition to the deal includes four major Hasidic congregations, a coalition of Maimonides trustees, two Orthodox patient advocacy groups, and a petition drive. That petition collected more than 34,000 signatures.
Congregation Khal Shaarei Zion Bobov, Congregation Kehilas Belz, Congregation Yetev Lev D'Satmar and Khal Bobov 45 Inc. joined the Refuah Helpline lawsuit in March 2026. They argue their congregants depend on Maimonides for care that respects their religious practices. The Coalition to Preserve Maimonides says it collected more than 34,000 signatures. The petition opposes approval of the deal without an independent review of alternatives, according to VIN News reporting from the August 27 hearing.
State Assembly Member Simcha Eichenstein said in an October 2025 video address that the city's proposal was "being shoved down our throats." He said this despite years of working with hospital leadership on alternative solutions. Trustees opposing the deal have pointed to Touro University and Westchester Medical Center as potential affiliation partners. They say these were never seriously considered before Maimonides moved forward with H+H.
What Happens Next?
The full Public Health and Health Planning Council is scheduled to vote on the transaction on September 17, 2026. State Health Department staff have recommended contingent approval, according to VIN News.
Even if the council approves the deal, the litigation is not resolved. The Article 78 proceeding decided in May 2026 sent the matter back to the Department of Health for additional proceedings. The trustees' separate lawsuit remains active. Any nonprofit asset transfer this size also requires sign-off from the state Attorney General's Charities Bureau or a state Supreme Court justice. That process has already forced at least one missed target date earlier in 2026.
Few participants dispute that Maimonides faces serious financial challenges. The fight is over who controls the hospital after the rescue, and what protections Borough Park's Jewish community keeps once it does. H+H has answered that question for the next 30 years. Nobody has answered it for year 31.
For more Olam coverage of American Jewish institutional governance, see American Jewish Institutional.
