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New York Medicaid and the new work rules
New York Medicaid is run by New York State Department of Health, Office of Health Insurance Programs — with NY State of Health, the state marketplace, running eligibility for most enrollees. New York expanded Medicaid on January 1, 2014, which is why the new federal work requirement reaches this state — and why what you do before January 1, 2027 matters.
From January 1, 2027, most adults have to show 80 hours a month
The requirement applies to adults aged 19 to 64 covered through Medicaid expansion — around 1,989,558 people in New York. It is not only about paid work: study, job training, volunteering and a mix of them all count , and earning at least $580 a month satisfies it on its own.
New York will try to confirm compliance from records it already holds — federal and state tax records, and Truv, the income verification tool it already uses at application and renewal. Most people should not have to send anything. If the state cannot confirm it, you get a notice that says what is missing and gives a deadline, and you have 30 days to respond. Replying by that deadline is what protects your coverage, even if you were eligible all along.
If your hours swing from month to month, say so. The rule is written per month, which is the wrong shape for farm and fishing work, construction, tourism and seasonal retail — a good month and a dead month average out to a living, but the dead month is the one that fails. Federal law has a provision for exactly this: a seasonal worker can satisfy the requirement using their average monthly income over the previous six months instead of hours worked in the month being checked. It is at 42 CFR 435.552(a)(7), and the law defines who counts as seasonal by pointing at the tax code rather than listing jobs, so do not decide for yourself that it misses you. If your work is seasonal or your hours are irregular, tell the state that when you report, and ask for the six-month average to be used.
That is the state's own estimate of how many will lose coverage.
Up to 1.2 million New Yorkers losing coverage from the work requirement and six-month renewals combined is the figure two independent analysts attribute to the Department of Health; the state's November 2025 mid-year budget update is reported as putting the range at 750,000 to 1.5 million. The Fiscal Policy Institute's own estimate is lower, at about 800,000. New York's own earlier projection, published before the law passed, was over a million a year once work requirements begin. Against all of that, about 63% of New York Medicaid adults potentially in scope already work 80 hours a month or attend school, which is why most of the expected loss is administrative rather than a real change in who qualifies.
Most of that is expected to be paperwork rather than people becoming ineligible. Which is the whole reason to sort out your address and your proof now rather than at the last minute.
You do not have to prove anything if any of these describe you
Exemptions are meant to be applied by the state automatically from records it already holds, but records are imperfect. If one of these fits you and you still get asked to report hours, say so and ask them to check — don't assume the notice is right.
What you can earn and still qualify
Monthly income, before tax, for the whole household. These are the state's own published figures, which is what its caseworkers actually apply. If you are close to a line, apply anyway — some income does not count, and only the agency can run the calculation for your situation.
Adults 19 to 64138% of the poverty line
- 1 person
- $1,836
- 2 people
- $2,489
- 3 people
- $3,142
- 4 people
- $3,795
- 5 people
- $4,449
- 6 people
- $5,102
- 7 people
- $5,755
- 8 people
- $6,408
Parents and caretakers138% of the poverty line
- 1 person
- $1,836
- 2 people
- $2,489
- 3 people
- $3,142
- 4 people
- $3,795
- 5 people
- $4,449
- 6 people
- $5,102
- 7 people
- $5,755
- 8 people
- $6,408
Pregnant223% of the poverty line
- 2 people
- $4,022
- 3 people
- $5,077
- 4 people
- $6,133
- 5 people
- $7,189
- 6 people
- $8,244
- 7 people
- $9,300
- 8 people
- $10,355
Source: GIS 26 MA/05, '2026 Federal Poverty Levels', and its attachment 'New York State Income Standards for MAGI Population' — effective January 1, 2026, revision stamp 02.05.2026. Cross-checked against NY State of Health's 'Medicaid At a Glance' card (2026) and '2026 Income Levels for Medicaid, Child Health Plus and Essential Plan'. A note on precision: Adults 19–64 and parents or caretaker relatives are held to the same 138% standard in New York, so the two tables are identical — having children at home does not raise or lower your limit. We publish the state figure.
Two other changes land on the same day
Renewals get more frequent, and back-dated coverage gets shorter.
P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.
Do this now
Update your address and phone number first. Everything about the new rules arrives by mail, and a stale address is the most common reason people lose coverage they are still entitled to. Then check whether an exemption applies to you.
About the phone numbers: Which number you need depends on how you enrolled. Most New Yorkers enrolled through NY State of Health and should call 1-855-355-5777 to change an address or do a renewal; the Medicaid Helpline on 1-800-541-2831 answers questions about what Medicaid covers. People who enrolled through a county Local Department of Social Services — generally those over 65, on Medicare, or needing long-term care — have to contact that county office instead, and the state cannot update their address for them.
Deaf, hard of hearing or speech-impaired: 711 (relay) for the Medicaid Helpline; 1-800-662-1220 for NY State of Health.
NY State of Health publishes the Medicaid change materials in 26 languages besides English, including Karen, Tigrinya, Twi and Yiddish — one of the widest ranges of any state. Help is available in your language by phone and in person, free, on 1-855-355-5777. The printed Medicaid application for people who apply through a county office comes in 11 languages.
Most people who lose coverage lose it over paperwork, not eligibility
62.5% of the coverage losses recorded in New York were procedural — a form, a deadline, or an address, rather than a real change in whether someone qualified. From January 1, 2027 that matters more, not less.
NOTICE OF ELIGIBILITY DETERMINATION
Case number: ███████
Date of this notice: 1January 12, 2027
Our records do not show that you met the community engagement requirement for the reporting period.
2If you believe this is incorrect, or if an exemption applies to you, contact us on or before February 11, 2027.
3Coverage for other members of your household is not affected by this notice.
What the federal data says about coverage here
Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what those numbers mean if you are the person enrolled.
Of people who lost coverage here, this share lost it over paperwork rather than eligibility.
Open every letter. Keep your address current with the agency.
Records here are relatively accurate, so treat a notice as real rather than assuming a mistake.
Quintile 1 of 5.
Provider supply here is around the national middle.
Book an appointment before you need one, not when you do.
The requirement also reaches a separate waiver group here
New York is one of eight states CMS named for an extra 1115 waiver population.
Who that is. Adults who have Medicaid through New York's Medicaid Redesign Team waiver because they receive Temporary Assistance for Needy Families cash assistance — what the waiver calls Demonstration Population 2, TANF Adult.
The work requirement normally reaches only the ACA expansion group. CMS also went through every state's section 1115 waivers looking for groups that are covered the same way but through a waiver rather than the state plan, and named eight states and thirteen such groups. New York's is the TANF adult group: people on cash assistance whose Medicaid is paid for under the waiver's spending authority and who never go through the ordinary income test. If you are on public assistance and have Medicaid through your county, this is probably you. In most cases it will not change what you have to do, because meeting the TANF work requirements is itself one of the exemptions, and anyone caring for a child under 14 is exempt too. But the exemption only protects you if the state can see it, so read anything that arrives and answer it. New York has separately asked CMS to retire this waiver group and move everyone in it onto regular state-plan Medicaid instead, with the transition aimed at January 1, 2027 — the same day the work rules start. Expect a letter, and open it.
If you are covered one of these ways rather than through the ordinary expansion group, the rules above still reach you. Don't assume otherwise because your coverage has a different name.
CMS interim final rule CMS-2454-IFC, 91 Fed. Reg. 33353–33354 (June 3, 2026), and the CMS overview slide deck posted July 27, 2026 at medicaid.gov/resources-for-states/working-families-tax-cut-legislation/community-engagement; reported by Georgetown CCF on July 16, 2026 and KFF on July 24, 2026.
Questions people ask about this
Do the new Medicaid work rules apply to me in New York?
How many hours a month do I have to work?
Who is exempt from the work requirement in New York?
When do the New York work rules start?
What is the income limit for New York Medicaid?
How do I apply for New York Medicaid?
How often do I have to renew New York Medicaid?
Guides for neighboring states
The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.
New York finished mailing its work-rule notices on September 30, so if nothing has reached you, log into your NY State of Health account and check rather than assuming you are exempt.
The state has also said that anyone who loses Medicaid purely for missing the work rules is shut out of the tax credits that make a marketplace plan affordable, which makes answering a notice on time the single most valuable thing you can do.
Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.
Go to NY State of Health (nystateofhealth.ny.gov) →