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New Medicaid Rules are Coming

Work rules and shorter renewal cycles start January 1, 2027. Don't lose your produce box. Most Project FoodBox members already qualify for an exemption - see where you stand.

Most members won't see any changes to their coverage.

You can still:
  • See your doctor
  • Get your medicine
  • Get checkups and vaccines
  • See a dentist
  • Access mental health care
  • Receive your FoodBox benefit

Key Dates Timeline

Nothing about your coverage changes today. Three dates matter over the next several months — when your notice arrives, when the work rule starts, and when your renewal cycle shifts. Watch your mail for each one.

  1. By SEP 30, 2026

    NY State of Health mails or emails your notice. Open it right away and follow whatever deadline it gives you.

  2. JAN 1, 2027

    The 80-hour work rule starts for adults 19–64 in the ACA expansion group. Most members — including kids, people 65+, and people with disabilities — aren't affected.

  3. After MAR 1, 2027

    Members renewing after this date move from yearly to twice-a-year eligibility checks. Update your contact info now so a renewal notice doesn't miss you.

Maintaining Coverage

Starting January 1, 2027, keeping Medicaid will depend on documenting work, school, training, or income — here's exactly what changes.

 

What to do now

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Update your contact information
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Check your exemption status
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Watch your mail
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Keep your Project FoodBox enrollment active

 

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Exemption Checklist

Qualifying isn't automatic, but for most PFB members it's already within reach.
Check the categories below to see where you stand. For the latest official guidance, visit NY State of Health - Stay Covered.

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Caregiving 

  • Pregnant, or were pregnant in the last 12 months
  • Caregiver of a child under 14
  • Caregiver of a disabled family member
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Health & Disability

  • Enrolled in Medicaid with a disability
  • Physical or mental health condition that makes it hard to work (see the NYSOH Stay Covered website for the latest definitions).
  • Active drug or alcohol treatment program
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Status-based

  • 18 or younger, or 65 or older
  • Enrolled in Medicare Part A or Part B
  • American Indian or Alaska Native
  • Veteran with a total disability rating
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Life Circumstances

  • Currently in jail or prison, or released in the last 3 months
  • In foster care, or aged out of foster care under 26
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Other Qualifications

  • In a SNAP household already meeting SNAP work requirements
  • Already meeting TANF work requirements
Hospital Care

Temporary Exemptions

  • Hospitalized
  • Traveling for medical care not available locally
  • In a federally declared disaster area
  • In a high-unemployment area

New York Medicaid Change FAQs

Common questions about what will change in Medicaid next year

H.R. 1 is a federal law passed in 2025 that changes Medicaid rules nationwide, including in New York. Most of its Medicaid changes take effect in 2027.

Not yet — the work requirement doesn't start until January 1, 2027. The most useful thing to do today is make sure NY State of Health (or your county LDSS) has your current address, phone number, and email.

Wages, self-employment and gig income (including platforms like Uber or DoorDash), tips, unemployment, Social Security and SSDI, retirement income, and some investment or rental income all count. SSI, child support, gifts, loans, veterans' disability payments, and workers' compensation do not.

You could lose your Medicaid coverage. New York gives you a 90-day window after a coverage loss to submit information and have your eligibility reviewed — act as soon as you get a notice.

New York is part of a multi-state legal challenge to part of the federal rule, and the state has said it's still finalizing which health conditions will qualify for a work-requirement exemption. A judge has allowed the January 1, 2027 start date to stand while the case continues. We'll update this page as the state finalizes details.

SNAP has its own separate work-requirement rules, and being in a SNAP household that already meets SNAP work rules can actually count as a Medicaid exemption.