As of Oct. 1, 2026, federally funded Medicaid has been limited to U.S. citizens, green card holders, and a few other groups. This excludes many lawfully present immigrants, including refugees and asylees without a green card. The change comes from the “One Big, Beautiful Bill.”
More changes are coming in 2027. In New York City alone, up to 900,000 Medicaid enrollees may be at risk of losing their coverage under the new requirements, according to the NYC Health Department.
What should you do if you lose Medicaid eligibility? What other options can you consider? Read on to learn the latest updates on Medicaid for New York residents.
Who currently qualifies for Medicaid?
Medicaid is jointly funded by federal and state governments. For the immigrant groups no longer covered by federal funding, New York will pay the full cost itself or move them to the Essential Plan. Many children and pregnant individuals will keep the same coverage options.
If you are:
- A New York State resident, and
- A U.S. citizen or someone with an eligible immigration status, such as green card holders who have had their card for at least five years (or are exempt from the wait), Cuban-Haitian entrants, or individuals residing under the Compacts of Free Association (COFA migrants)
You may qualify for Medicaid if you meet income limits for your age group and household size.
There are different income limits for different groups in 2026:
- Pregnant people and infants
- Children age 1-18
- People age 19-20 living with parents
- Adults age 19-64 who are caretakers or parents
- People ages 65 and older, people living with a disability, and people with a visual impairment will further need to pass a resource test.
For a family of three applying under the parent or caretaker category, income must not exceed $37,702 a year ($3,142 a month or $725 a week).
Undocumented immigrants are not eligible for federally funded Medicaid and other federally funded health programs, including Medicare and the Affordable Care Act (ACA) Marketplaces.
Most adult lawful permanent residents (green card holders) must wait five years after obtaining their green card before they can get federally funded Medicaid. This isn’t a new rule. However, people granted asylum and refugees don’t have to wait five years once they get their green card.
What changed for immigrants in October 2026?
Starting Oct. 1, 2026, the federal government stopped fully paying for Medicaid for many lawfully present immigrants. In New York, the groups affected are:
- Refugees
- Asylees
- Parolees (people allowed into the U.S. for temporary reasons)
- Survivors of domestic violence or human trafficking
If you are currently enrolled in Medicaid and belong to one of the affected groups above, you will likely be able to keep your coverage. Your health plan may switch to state-funded Medicaid or the Essential Plan. The NY State of Health, New York’s official health insurance marketplace, sent affected enrollees a letter, text or WhatsApp message between Sept. 1 and Sept. 4 to explain these changes.
According to NY State of Health, “If you get tax credits to help pay for your insurance, the state will review your account in the fall. Any changes to your costs will start in 2027. Health coverage for children, pregnant people and those who recently gave birth will not change.”
What are the work requirements starting in 2027?
Starting Jan. 1, 2027, some Medicaid enrollees ages 19 to 64 will need to show proof of work to keep their coverage. For people already enrolled, it starts with renewal on or after March 1, 2027. The rules are similar to the new SNAP work requirements and come from the same law. However, if you already meet the SNAP work requirement, you are exempt from the Medicaid one.
You can meet the requirements by meeting one or more of these:
- Earn a household income of at least $580 per month
- Complete at least a total 80 hours per month of work, school (at least part-time), job training, or volunteering in your community (or any combination of these)
NY State of Health gives an example: if you earn $380 per month, that equals 52 hours when using the federal minimum wage of $7.25 ($380 ÷ $7.25 = 52). To reach 80 hours, you would need to do 28 more hours of any of the activities above.
You can also take this interactive questionnaire from the Mayor’s office to see if the work requirements apply to you.
If the work requirements do apply to you, New York State will first try to check your income when you apply for or renew Medicaid next year. This may include information from your tax records. Nancy Cai, a health insurance enrollment navigator at Charles B. Wang Community Health Center, said at a recent public workshop at Queens Public Library that you must meet the requirements in the month before your Medicaid renewal date.
Not all people are subject to the requirement. Here are the exempted groups:
- 18 years old or younger
- 65 years old or older
- Pregnant, or were pregnant in the last 12 months
- Enrolled in Medicaid with a disability
- Diagnosed with a physical or mental health condition that makes it hard to work
- Entitled to, or enrolled in Medicare Part A or enrolled in Part B
- American Indian or Alaska Native
- A parent, guardian, caretaker relative, or family caregiver to a disabled person
- A parent, guardian, caretaker relative, or family caregiver to a child under 14
- In a SNAP household, and subject to SNAP work requirements
- Receiving TANF (cash assistance) and meeting TANF work requirements
- In a drug or alcohol treatment program
- Currently in jail or prison, or released in the last 3 months
- Currently in foster care
- Under 26 and aged out of foster care
- A veteran with a total disability
You may need to meet certain conditions or show proof that you fit one of these exceptions when you renew your Medicaid coverage.
There are four temporary exceptions:
- You were in a hospital or a nursing facility
- You or a dependent had to travel for serious medical care not offered in your community
- You live in an area where the federal government declared an emergency or disaster
- You live in an area with very high unemployment
For the first two temporary exceptions, you will need to provide information on your Medicaid application. For the latter two, NY State of Health will inform you whether they apply to you.
How the six month renewals work
Starting Jan. 1, 2027, most adults ages 19 to 64 must renew their Medicaid every six months instead of once a year, according to the NY State of Health. For current enrollees, the six-months renewal cycle starts on or after March 1, 2027.
American Indian and Alaska Native adults are exempt from this change and will still renew once a year, as will some other groups, like children and people with disabilities. If you apply before Jan. 1, 2027, or renew before March 1, 2027, you will get 12 months of coverage first, then switch to six-month renewals.
Does the change apply to Emergency Medicaid?
Regardless of immigration status, low-income New Yorkers who meet Medicaid’s other eligibility rules, such as income limits, can still apply for Emergency Medicaid to cover emergency medical care.
Lost Medicaid? Here are other options and free help
NY State of Health sent enrollees affected by the new changes a letter, text or WhatsApp message between Sept. 1 and Sept. 4. Your health plan may switch to state-funded Medicaid or the Essential Plan.
Immigrant New Yorkers may also qualify for other health insurance options. Learn more about who is eligible for each plan from the NYC Office of Citywide Health Insurance Access.
According to the NYC Health Department, if you lose coverage, you can get low or no-cost health care services at NYC Health + Hospitals facilities, regardless of immigration status.
To get free help enrolling in a new plan, you can:
- Call 311 and ask for “help with health coverage,” or call directly at 347-665-0214
- Text “CoveredNYC” to 55676
- Walk in to a nearby enrollment center
- Submit a Health Insurance Inquiry Form at nyc.gov/healthcoverage
NYC Care continues to offer low and no-cost care for New Yorkers who don’t qualify for or can’t afford insurance.
