Gizmo Warehouseby Joe Eichenbaum | 17A

Medicaid work requirements · New York

Medicaid work requirements in New York: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

New York expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 1,861,116 of them (15.5% of an expansion pool of 1,989,558) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 406,888 people in New York lose coverage by 2034: 351,055 of them still eligible but lost to paperwork and reporting failures, and 55,833 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. New York scores 62 of 100 on this model's ex parte capability index, a mid band; its eligibility system is NYSoH / WMS.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureNew York
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)1,989,558
Adults subject, strict definition1,861,116
Adults subject, permissive definition1,823,893
Share of expansion pool subject15.5%
Projected coverage loss by 2034406,888
Hardship exception statusAdopting
Early implementerNo
Ex parte capability score (0 to 100)62 (mid)

Who is subject in New York

Of the 1,861,115 subject adults, 34% already work 80 or more hours a month and 58% are not working. 30% have a child under 14 at home. Among those not working, 42% report a disability and 15% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2414%
Age 25-3420%
Age 35-4420%
Age 45-5419%
Age 55-6426%
Not working58%
1 to 19 hours a month1%
20 to 79 hours a month7%
80 or more hours a month (meets the bar)34%
Not working: Disabled42%
Not working: Caregiver15%
Not working: Postpartum1%
Not working: Student5%
Not working: Other37%

Why eligible people lose coverage

Of the 406,888 projected to lose coverage in New York, 351,055 meet the requirement or qualify for an exemption but fail to document it. 161,722 of those are working people who cannot prove their hours through data the state can see, and 189,333 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Multiple part-time jobs (aggregation failure)50,699
Variable shifts / on-call work33,690
Self-employed (other)30,491
Full-time students not auto-verified14,643
Gig / courier (DoorDash, Uber, Lyft, Instacart)9,963
Volunteering / job training9,060
Seasonal: agriculture, hospitality, food service6,973
Cash-paid construction & trades6,203
Medically frail without auto-match77,958
Caregivers of a disabled adult53,689
Parent caregivers of children ≤13 without auto-match16,520
SUD treatment not flagged in claims data14,534
Kinship caregivers (non-parent) of children ≤1310,348
American Indian / Alaska Native (tribal exemption)9,186
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)4,805
Recent incarceration (data-match gap)1,611
Pregnancy / postpartum data lag681

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (55% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. New York's composite score is 62 (mid band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite62
Observed ex parte55
Core capability100
Data sources76
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four751,60140.4%
Working ≥ qualifying hours / income348,95718.8%
Medically frail255,86213.8%
Working ≥ qualifying hours / income + Parent caregiver of child ≤13216,26611.6%
Full-time student105,3015.7%
Parent caregiver of child ≤1393,3425.0%
Working ≥ qualifying hours / income + Full-time student41,7162.2%
Working ≥ qualifying hours / income + Medically frail14,2730.8%

Counties in New York

Subject adults concentrate: Kings County (214,811), Queens County (203,971), and Suffolk County (146,465) account for 30% of the state's subject population.

All 62 counties in New York with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Kings County214,81113.3%46,96319.0%1,615,318
Queens County203,97114.2%44,59312.0%1,433,407
Suffolk County146,46515.9%32,0216.0%918,596
Nassau County139,58217.1%30,5165.0%815,106
New York County135,69512.5%29,66616.0%1,089,422
Bronx County118,68814.1%25,94827.0%841,440
Westchester County96,16516.2%21,0249.0%592,857
Erie County93,21016.5%20,37814.0%563,461
Monroe County74,88916.8%16,37313.0%447,158
Onondaga County46,94817.0%10,26414.0%276,546
Richmond County46,85715.8%10,24410.0%297,298
Orange County39,18516.6%8,56713.0%236,502
Albany County33,47117.1%7,31813.0%195,864
Rockland County33,34418.3%7,29015.0%182,090
Dutchess County30,40016.7%6,6469.0%181,615
Saratoga County23,89316.8%5,2247.0%142,580
Oneida County22,52917.1%4,92514.0%131,544
Broome County22,31119.4%4,87819.0%115,275
Niagara County21,22917.3%4,64113.0%122,868
Ulster County18,51216.8%4,04715.0%110,016
Rensselaer County16,65017.1%3,64011.0%97,664
Schenectady County15,60816.4%3,41212.0%95,025
Tompkins County13,67020.5%2,98916.0%66,542
Chautauqua County13,05618.4%2,85418.0%71,012
Oswego County12,46317.8%2,72517.0%69,985
St. Lawrence County12,08919.2%2,64317.0%62,908
Ontario County11,93518.5%2,6099.0%64,526
Putnam County10,32917.4%2,2586.0%59,180
Jefferson County9,84814.3%2,15313.0%68,654
Steuben County9,35117.8%2,04413.0%52,504
Wayne County9,29317.8%2,03211.0%52,102
Chemung County8,09717.1%1,77015.0%47,320
Cattaraugus County8,03418.9%1,75617.0%42,614
Clinton County8,03016.7%1,75613.0%48,018
Sullivan County8,02017.3%1,75315.0%46,287
Cayuga County7,56317.3%1,65413.0%43,775
Madison County7,50319.0%1,64010.0%39,568
Otsego County7,16919.9%1,56713.0%35,950
Warren County6,98018.6%1,5269.0%37,544
Livingston County6,79618.5%1,48612.0%36,693
Columbia County6,69519.2%1,46410.0%34,876
Herkimer County6,32418.9%1,38312.0%33,554
Allegany County5,91622.1%1,29317.0%26,744
Washington County5,88016.4%1,28611.0%35,743
Genesee County5,60016.6%1,22410.0%33,694
Cortland County5,32018.8%1,16313.0%28,242
Fulton County5,19217.0%1,13514.0%30,540
Tioga County5,04318.5%1,10310.0%27,234
Delaware County5,04120.4%1,10215.0%24,714
Chenango County4,84718.7%1,06012.0%25,960
Montgomery County4,84017.3%1,05815.0%27,896
Greene County4,76917.1%1,04310.0%27,917
Franklin County4,35215.7%95218.0%27,754
Wyoming County3,97816.6%87011.0%23,962
Orleans County3,95716.5%86513.0%23,918
Essex County3,91718.5%85610.0%21,214
Schoharie County3,43420.2%75110.0%17,044
Seneca County3,33717.8%73013.0%18,801
Lewis County2,81318.9%61513.0%14,854
Yates County2,65920.1%58114.0%13,206
Schuyler County1,91519.1%41916.0%10,044
Hamilton County64623.8%14111.0%2,706

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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