Medicaid Changes
Major Medicaid changes take effect Jan. 1, 2027, including work requirements, six-month renewals and shorter retroactive coverage. Several changes have already taken effect in 2026.
This page is updated regularly as new information becomes available. It is not a comprehensive list of all changes or resources. Please check back for updates and consult official sources for the most current guidance.
Last updated: 10/28/26, 5:00 p.m.
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Remind service recipients to:
Update their contact information.
Read and respond to notices promptly. Notices will indicate whether work requirements apply.
Know their renewal dates.
Complete the work requirements questionnaire to check in advance.
Contact a Medicaid Assistor for help if resources are not available in-house.
Seek no-cost healthcare legal assistance to address enrollment challenges.
Printable fact sheets and posters, videos, and social media posts are available here.
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Document accurate diagnoses, including all co-occurring conditions, to support exemptions.
Monitor financial impacts using tools like this Provider Financial Forecasting Tool.
Estimate your expansion population using proxy measures. We expect DOH to share this data with managed care plans by early December and are advocating for it to be shared with providers.
Train staff to become certified Assistors (17-hour training), build relationships with local Assistors, and review the Assistor Tool Kit.
Request an online or in-person H.R.1 training (NYC only).
Connect with colleagues through IUA's Leading Together peer-to-peer series and other member meetings.
Prepare for uncertainty using IUA's toolkit for community-based SUD and MH services.
Take advantage of the National Council's HR.1 implementation resources.
Consider partnering with local non-traditional groups to keep community members informed.
Join advocacy efforts with IUA and our partners. Watch for opportunities through member briefings and other action alerts.
Learn more about membership here.
Summary of Key Changes (Jan. ‘27)
Work Requirements
Certain adults ages 19–64 must show they are working, in school, in job training or volunteering when they apply or renew. People in substance use disorder (SUD) treatment are exempt. People with an SUD or a disabling mental health condition may qualify as medically frail, unless they have been in recovery five or more years. Exemptions can be self-attested through 2027; starting in 2028, documentation is required after one self-attestation. New York has not yet released details or definitions.
6-month renewals
Certain adults ages 19–64 must renew every 6 months instead of every year. Those who apply before Jan. 1, 2027 or renew before March 1, 2027 keep 12 months of coverage, then move to 6-month renewals.
Retroactive coverage
Medicaid will cover medical bills from the 1 month before applying (certain adults 19–64) or the 2 months before applying (everyone else), down from 3 months.
July 1: Continuous coverage ended for children from birth to age 6; they now renew every year.
Oct. 1: Coverage ended for people with certain immigration statuses.
July 1: Essential Plan coverage ended for people earning between 200 and 250% of the Federal Poverty Level.