New York — Medicaid Coverage Retention
Applies Last updated 2026-06-03 · confidence: high
New York is subject to federal Medicaid community-engagement/work-requirement implementation beginning January 1, 2027, unless modified by future federal or state guidance.
None identified
No public RFP for work-requirement communications/outreach identified as of 2026-06-03.
Procurement portal: New York State Contract Reporter (nyscr.ny.gov) is the statutory state procurement portal; NY DOH also posts grants/RFPs at health.ny.gov/funding. IT/eligibility work flows through ITS Integrated Eligibility System (IES) master service agreements. SAM.gov / BidNet Direct (Empire State Purchasing Group) are secondary. · Implementation funding: FY2027 NYS Executive Budget includes ~$722M for NY State of Health (NYSOH) operations, described as including funding for H.R.1 Medicaid Community Engagement implementation and eligibility changes. Federal support: ~$200M national grant pool for 2026 implementation activities plus enhanced federal IT match (90/10 design/build, 75/25 operations). No discrete state appropriation line specifically earmarked for a work-requirement member-communications campaign was identified. NEW (Jul 2026): NYC's adopted budget adds $3M for DOHMH community health workers to help enrollees navigate the requirements and identify exemptions; city agencies are also discussing city-government volunteer opportunities that would satisfy the 80-hour standard.
Latest detail
New York is implementing H.R.1/OBBBA community-engagement (80 hrs/month) requirements via its existing Medicaid eligibility modernization (the MECM/Integrated Eligibility System, with Deloitte as the incumbent IES delivery vendor; the modern system went live for limited populations on 2025-09-30) rather than through a newly published standalone work-requirement RFP. CMS issued its interim final rule on 2026-06-01, requiring states to conduct member outreach between 2026-06-30 and 2026-08-31 and to be operational by 2027-01-01; NY DOH has launched a public webpage explaining the rules but has not posted an identifiable procurement for the mandated member-communications campaign. The state estimates the work requirement and related provisions could increase the uninsured by ~500,000 by 2029 and over 1 million annually thereafter, and advocates/legislature are pressing for additional DOH FTEs and retention-focused implementation. Adjacent outreach activity exists (NYC Health Department launched a ~$500K coverage-enrollment campaign on 2026-05-19, and the Community Service Society's "Keep New York Covered" navigator RFP continues), but these are coverage-retention efforts, not a DOH work-requirement communications solicitation. UPDATE Jul 6, 2026 (Gothamist): NYS DOH will send notices by Sept 1 to enrollees subject to the requirements. NY and 24 other states are suing over the June 2026 federal rules, which require individuals to prove a serious condition prevents meeting the work requirement and bar states from auto-verifying medical frailty via claims data — raising the ex parte burden. NYC budget adds $3M for community health worker navigation support. Community health centers (via CHCANYS) are seeking state renewal-date data access to reach patients before deadlines — an active FQHC/PCA coordination channel.
Key exemption categories to monitor
- 80 hours/month of work, job training, education, or community service — or qualifying monthly income.
- Targets many ACA Medicaid expansion adults (19–64); non-expansion states largely have no such group.
- Federal enforcement: January 1, 2027 (states implement; some earlier).
- New: expansion adults redetermine every 6 months (not annually).
- Commonly-defined exemptions: pregnancy/postpartum; medically frail; primary caregiver; disability; SUD treatment; certain students; tribe (AIAN); short-term hardship. Exact definitions set by CMS rule and each state.
Short-term hardship exemptions to track
Short-term hardship exemptions — adoption pending state guidance.
Member communication risk
Risk detail pending.
What MCOs & state partners should do now
- Segment affected members
- Identify likely exemptions
- Send plain-language multilingual notices
- Deploy SMS/email/IVR reminders
- Track retention outcomes
Operating in New York?
The member-notice window is open now and closes August 31, 2026. Complete a Coverage Retention Readiness Audit while there is still time to act — we build CMS-compliant, plain-language, multilingual outreach to keep eligible New York members enrolled.
Request a Coverage Retention AuditFrequently asked
Who is subject to Medicaid work requirements in New York?
Many ACA Medicaid expansion adults ages 19–64 who do not qualify for an exemption. Final scope is set by CMS rule and state implementation.
When do New York Medicaid work requirements start?
Federal enforcement begins January 1, 2027 (some states may implement earlier). Member notices are expected in the federally-required window of June 30–August 31, 2026.
What exemptions are available?
Federal baseline categories include parent/caretaker of a child under 14, pregnant/postpartum, disabled/medically frail, American Indian/Alaska Native, and those already meeting SNAP/TANF work rules. Short-term hardship exemptions and exact definitions are set by CMS rule and state implementation.
Sources
- https://www.kff.org/medicaid/medicaid-work-requirements-tracker-overview/
- https://info.nystateofhealth.ny.gov/stay-covered
- https://www.healthinsurance.org/medicaid/new-york/
- https://nyhealthaccess.org/news/100/
- https://www.budget.ny.gov/pubs/archive/fy27/ex/agencies/appropdata/HealthDepartmentof.html
- https://www.health.ny.gov/health_care/medicaid/program/medicaid_modernization/
- https://ccf.georgetown.edu/feature/tracking-new-york-implementation-of-hr-1-medicaid-work-reporting-requirements/
- https://www.cms.gov/newsroom/fact-sheets/medicaid-community-engagement-requirement-certain-individuals-interim-final-rule-comment-period-cms
- https://gothamist.com/news/yes-this-does-suck-nyc-health-officials-brace-for-new-medicaid-work-rules
This page tracks publicly available implementation information and is updated as New York publishes guidance. State-specific rules are evolving. Not legal or eligibility advice.