NEW YORK (PIX11) — If you are a New Yorker on Medicaid, changes may be coming your way.
Starting Jan. 1, 2027, some New Yorkers on Medicaid will need to show they are working at least 80 hours per month, attending school, volunteering in their community, or receiving job training to maintain their healthcare coverage.
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States will have until the beginning of next year to implement these changes, according to the Centers for Medicare & Medicaid Services.
“As required by law, on June 1, 2026, CMS issued an interim final rule implementing a new statutory requirement for certain adults in Medicaid to meet an 80 hours per month work requirement (sometimes referred to as Medicaid community engagement) as a condition of eligibility,” reads the website.
Will the work requirements for Medicaid affect me?
This rule generally applies to adults ages 19 to 64 with Medicaid coverage who can work and do not qualify for an exemption.
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Who will be excluded from this rule?
Exemptions apply to New Yorkers under 18 or over 65, pregnant women or those who were pregnant in the past year, disabled veterans, and Medicaid recipients with disabilities.
Other exemptions include individuals with physical or mental health conditions, Native Americans, parents, guardians, or caregivers of disabled people, and caregivers to children under 14 or those in foster care.
Households receiving SNAP or TANF benefits that face work requirements are also exempt.
Individuals enrolled in programs for substance abuse, currently incarcerated, or set to be released within 90 days are exempt.
Additionally, those New Yorkers discharged from foster care between ages 18 and 21 are exempt until age 26.
When will I be notified if these changes apply to me?
If work requirements for Medicaid coverage apply to you, NY State will send you a notice by mail or email about the upcoming changes by September first, according to the New York State of Health.
When will these changes go into effect?
The rules are set to go into effect on January 1, 2027, in New York, or states have chosen earlier start dates, according to CMS.
Where can I get more information on these upcoming changes?
If you are a New Yorker on Medicaid and want to know about upcoming changes, click here.
Matthew Euzarraga is a multimedia journalist from El Paso, Texas. He has covered local news and LGBTQIA topics in the New York City Metro area since 2021. He joined the PIX11 Digital team in 2023. You can see more of his work here.