What is the change?

New Medicaid rules are scheduled to take effect on January 1, 2027, potentially affecting nearly 13,500 people in New Rochelle. There are two significant changes that will affect many Medicaid recipients:

•  People between the ages of 19 and 65 will have to prove that they are working, volunteering, going to school, or participating in a training program at least 80 hours per month to keep their coverage.
• All Medicaid recipients will need to re-enroll every six months instead of annually.

There are many exceptions, including people with young children, those who are ill or have disabilities, and those meeting work requirements for other programs like TANF or SNAP. See the fact sheet for a full list.

Why is this happening?

This change is due to the passage of a federal bill, H.R.1 in July 2025, referred to by the Trump Administration as the “Big Beautiful Bill” (and also known by other names).  

What should you do now?

The most important thing to do now is to make sure that NY State of Health or your Medicaid provider has your correct address, email and phone number. You may be enrolled in a Medicaid Managed Care Plan (MMC) through a commercial insurer like Healthfirst, MVP, Fidelis, Anthem, or others. People enrolled in these plans will also be subject to the new regulations.  Make sure you know your plan and your plan knows how to find you. 

Make sure you open all your mail or email related to your health insurance and read what the sender is asking you for. The rules about how to document your eligible activities have not been established yet, so it’s important to pay attention.

Where can you get help?

Your health plan and the NY State of Health say they will assist in every way they can. Your enrollment card has a customer service number on the back. Call them! 

How can you get involved in a program that will count toward your 80 hours?

If you are working and earning at least $580 per month, or enrolled in a half-time school or training program, you are covered. If not, you may need to find a volunteer position or enroll in an educational or training program for at least 20 hours per week. Many organizations are currently investigating ways to provide meaningful volunteer opportunities or eligible training for those who need it. Hospitals, childcare centers, libraries and other non-profit organizations are likely hosts.  New RoAR News will provide further information as it becomes available.

Where can you get care if you lose your coverage?

There are two sources of care for people who are uninsured. Community health centers (CHCs) provide primary care (care for acute and chronic conditions, prevention and screening ) for anyone who needs it, regardless of your insurance status, and have sliding fee scales based on income. These include Sun River Health in New Rochelle, Yonkers and White Plains, Open Door in Mamaroneck and Port Chester, and Westchester Community Health Center in Mount Vernon and Yonkers.  In a true emergency, hospital emergency rooms are required to care for you.  But some kinds of care may not be available without insurance if you cannot pay.

How is this going to affect the health care system?

Hospitals and health centers are already suffering from reduced funding as a result of the elimination of federal subsidies for the “Obamacare” plans.  Many people have already lost their insurance coverage as the plans became more expensive than they could afford. As these new Medicaid rules take effect, more people will no doubt lose coverage if they can’t document that they are meeting the work requirement.  Some may lose coverage even if they are eligible because of difficulties completing the paperwork to re-enroll.    

On the system-wide level, health care facilities are likely to lose revenue and may cut services or staff.  People without insurance may delay seeking care until they are seriously ill, and emergency rooms are likely to become more crowded.  So everyone, even those who still have insurance, may have more difficulty accessing health care when they need it.  

The Good News

New York State’s Attorney General, Letitia James, along with a coalition of attorneys general and governors from 25 other Democratic states, has sued the Trump administration and the Centers for Medicare & Medicaid Services (CMS) challenging the new federal Medicaid work requirements and eligibility verification checks. The lawsuit argues that the new work requirements deviate from the congressional intent of the Medicaid program. To date, efforts to obtain an emergency pause in the implementation plan have not succeeded, but the litigation challenging the policy continues.