On February 3, thousands of New Yorkers gathered outside New York University (NYU) Langone’s Tisch Hospital in Manhattan to protest the hospital system’s decision to stop providing gender-affirming care for transgender youth — a decision that New York attorney general Tish James warned violates state antidiscrimination law. That same day, Crain’s reported that NYU Langone had warned staff not to protect undocumented patients from Immigration and Customs Enforcement (ICE), suggesting that it will require New York health care workers to collaborate with the Trump administration’s plans for mass deportations.

NYU Langone’s rapid capitulation to Donald Trump should be disturbing: it means a critical part of New York City’s health care infrastructure will be hostile to trans and immigrant New Yorkers at the very moment when the federal government is coming after them. The system is gigantic, employing over 50,000 workers across six inpatient hospitals and three hundred outpatient facilities; its decisions on which patients deserve care and protection are a matter of enormous public concern. The health care workers who staff NYU’s facilities are dedicated professionals who want to keep their patients safe — but management is telling them they’re not allowed to.

It wouldn’t be the first time health care workers at NYU faced off against management over patient care. Just a year ago, an arbitrator sustained union nurses’ charge that the hospital system had violated the law by understaffing its Brooklyn campus.

No doubt NYU will plead poverty, arguing that the Trump administration’s threat to withdraw federal grants leaves it with little choice but to comply. That argument doesn’t hold water.

The hospital system reported $431 million in net income on $14.2 billion in revenue in 2024; its CEO, Robert Grossman, earned nearly $23 million in 2023 alone. Those figures are expected, given what NYU charges for care. The labor union 32BJ SEIU found that NYU Langone bills $40,568 for a C-Section — $10,000 more than Mount Sinai and more than twice as much as NYC Health + Hospitals charges for the same procedure. If any health system in the country can afford to stand up for its patients, NYU can. But it is choosing not to.

That’s not surprising: the chair of the hospital’s board, after all, is Republican billionaire megadonor Ken Langone, who once compared Obama-era efforts to tax the rich to Adolf Hitler’s tactics in Nazi Germany. Langone has donated hundreds of millions of dollars to NYU over the years, including a $200 million gift in 2023. NYU Langone management may think they’d better stay on their biggest donor’s good side.

They should think twice, though, because Ken Langone isn’t the biggest donor to NYU. That title goes to the taxpayers of New York City.

A 2022 report by the Lown Institute estimated that NYU Langone gets $261.1 million in tax breaks every year, much of it in the form of exemptions from NYC property and sales taxes. The Center for New York City Affairs has calculated that NYU as a whole receives $219 million a year in property tax exemptions alone.

Let’s be clear: these tax exemptions are taxpayer money. When institutions with tens of thousands of employees and billions of dollars in real estate don’t pay the taxes that fund our schools, roads, police, and firefighters, that means the rest of us need to chip in and pay their share. I have long been concerned about the injustice of asking New Yorkers to pick up the tab for institutions with billions of dollars in endowments and real estate holdings; that’s why in the State Assembly I introduced the REPAIR Act, which would tax Columbia and NYU to fund the City University of New York.

Of course, NYU Langone receives these subsidies because it is supposed to be a nonprofit, offering community benefits like free care. But a recent report from the Lown Institute showed that NYU Langone receives far more in subsidies than it provides in community benefits — $222 million more. That was the third-largest gap in the entire country. (The largest, at $274 million, was another New York hospital, New York–Presbyterian, a Columbia University affiliate recently in the news for cracking down on nurses fighting for safe staffing.)

Tax breaks are far from the only way New York City subsidizes NYU Langone. The New York Times has reported that NYU discriminates in its emergency room policies by routinely shifting the burden of caring for poor and homeless patients to publicly funded hospitals like Bellevue, while offering special treatment to wealthy donors. New York City’s public employee health plan, which covers nearly a million people, routinely pays exorbitant prices for care to NYU. More broadly, private hospitals like NYU Langone rely for their revenue on insurance, Medicare and Medicaid funding ultimately paid for by working-class people — not billionaire megadonors like Ken Langone.

That’s why New York City needs to reconsider its relationship to wealthy private hospital systems like NYU Langone. As mayor, I will demand that NYU Langone pay its fair share of city taxes, and I will use that funding to strengthen New York City’s public hospital system. I will end private hospitals’ practice of shunting poor New Yorkers into the public system to make way for wealthier patients. I will reexamine the exorbitant prices the New York City public employee health plan pays to private hospitals, ensuring that New York’s civil servants get high-quality care without spiralling costs or privatization schemes. And I will ensure that every New Yorker, regardless of gender identity and regardless of immigration status, gets the care they need at every New York hospital.