New Federal Rule for 2027 New York State Medicaid Coverage

Starting Jan. 1, 2027, a new federal rule (H.R.-1) means that some adults age 19 to 64 will need to renew their Medicaid every six months instead of once a year and meet work requirements.*

These Medicaid changes may impact you and your practice as more frequent coverage disruptions may occur. We ask that you encourage your patients to keep their contact information up to date and respond right away to renewal notices, so they don’t lose their coverage.

This also means some members must meet certain requirements to keep their New York state (NYS) Medicaid coverage. They must show they are doing at least one of the following: 

• Working.
• Attending school.
• Volunteering in the community.
• Participating in a job training program.

Some members may be exempt from the requirements and will need to show proof of their exemption when they renew their Medicaid coverage. More information on exemptions can be found on the NY State of Health website Stay Covered. Please check this website frequently as it is updated regularly. It includes a timeline of key changes, steps Medicaid enrollees can take to prepare, and frequently asked questions. The page also includes a short interactive questionnaire to help your patients learn if the new work requirements will apply to them. 

We’ve been educating members about the changes and what they should do to keep their Medicaid coverage and continue seeing you for their healthcare. Our member website contains the most up-to-date information we’re sharing with members.

Additional provider resources

Follow NY State of Health’s Stay Covered campaign to learn more about the work and community engagement requirements for NYS Medicaid coverage as well as other changes.

• The NY State of Health Communications Tool Kit will continue to post the latest news and available resources. Providers are encouraged to share these resources with their patients to help inform them about the upcoming changes.

*These changes do not apply to Essential Plan members.