Alliance Alert: The Alliance for Rights and Recovery strongly opposes any federal effort to impose work requirements on Medicaid enrollees. As highlighted in the recent Poughkeepsie Journal article, between 500,000 and 750,000 New Yorkers could lose their health coverage under proposals currently being pushed by Republicans in Congress.
This is not about promoting employment—it’s about erecting bureaucratic barriers that deny people care. Most Medicaid beneficiaries who can work already do. But creating complicated reporting systems would cause many to lose coverage simply because of red tape, lack of internet access, or confusion—not because they don’t qualify. These are service cuts by another name.
The mental health and substance use systems rely heavily on Medicaid to fund voluntary, community-based services. If this proposal moves forward, the consequences will be devastating: fewer people accessing treatment, more crises, and greater pressure on emergency systems already stretched thin.
We must act now to protect Medicaid—and the people it serves.
The Alliance has launched a national action alert to help advocates, providers, and community members email their members of Congress and urge them to protect Medicaid from harmful cuts and work requirements.
Send your message today:
ACT TODAY
Let’s make it clear: Medicaid is a lifeline, not a privilege—and it must be preserved, strengthened, and expanded, not chipped away.
NY Health Officials: Half-Million Could Lose Medicaid Under GOP Cuts
By David Robinson | Poughkeepsie Journal | May 5, 2025
More than 500,000 New Yorkers could lose health insurance under Medicaid work requirement proposals being considered by Republicans in Congress, state officials said.
That estimate — which could rise to about 750,000 people losing health insurance, depending on the proposal details — came after the GOP-controlled Congress resurfaced an old idea: requiring many adults on Medicaid to get a job so they can keep their health insurance.
The work requirement was one of several ways Republicans are seeking to slash hundreds of billions of dollars from Medicaid, the government health program for low-income and disabled residents that covers one in five Americans. In New York, Medicaid has become even more entrenched in health care, covering about 7 million people, or 29% of the population.
How would Medicaid work requirements impact NY?
State health officials in New York provided a breakdown of the potential impact of a federal measure imposing work requirements for Medicaid. It noted:
- Of the roughly 7 million New Yorkers covered by Medicaid, there are 3.7 million working-age adults.
- Of those 3.7 million adults, about 2.2 million to 2.6 million would potentially be exempted from Medicaid work requirements through administrative renewal based on their status in other programs, including SNAP, which already requires meeting certain work requirements.
- The remaining 1.1 to 1.5 million adults may include populations that would be exempt — for example, pregnant adults and caretakers. And based on data from other states, at least 50% of these remaining adults are actively seeking or fully employed.
Put simply, anywhere from 500,000 to 750,000 adults who are eligible for and currently enrolled in Medicaid in New York would potentially lose coverage due to imposing work requirements.
At the same time, mandating work reporting requirements would introduce significant administrative burdens, state health officials noted in a statement, adding that has the potential to increase program costs to both enrollees and state Medicaid departments across the country.
Some outside health policy researchers have also estimated Medicaid work requirements could have an even more significant impact in New York, removing coverage for up to nearly 850,000, according to the Robert Wood Johnson Foundation.
The stakes are clear as New York’s handling of Medicaid has resulted in taxpayer-supported spending increases that far outpaced the national average, with New York’s program now spending $3,100 per resident compared to the $1,800 national average, according to the Empire Center, a fiscally conservative Albany think tank.
Do Medicaid work requirements work? What we know
Conservatives who support the idea say a Medicaid work requirement would motivate people to seek employment and potentially secure health insurance through the workplace, saving taxpayers money.
A Medicaid work requirement for healthy adults is about “empowering Americans” and would save more than $100 billion over a decade, said Rep Dan Crenshaw, a Texas Republican, who introduced federal legislation that would impose the requirement.
Opponents warn Medicaid work requirements, which surfaced during Trump’s first term, failed to achieve significant savings while adding administrative costs and stripping away coverage of people who qualified. They cited in part results from a program imposed in Arkansas, as well as similar policies implemented nationwide for people receiving SNAP benefits, according to a report by Commonwealth Fund, a health care research nonprofit.
Among the findings of potential impacts of Medicaid work requirements:
- Many of those losing benefits are actually employed, or should be exempt but lose their benefits anyway, owing to confusing paperwork requirements. Merely lacking internet access made people more susceptible to losing their benefits, one study found, noting meeting compliance reporting obligations is more difficult without reliable internet.
- Any gains in employment or income are minimal. That’s because work requirements fail to address the underlying reasons for unemployment, such as lack of proper job training, reliable transportation, or childcare support, or because too few jobs are available in their areas.
- The Congressional Budget Office in 2023 concluded that Medicaid work requirements would “have a negligible effect on employment status or hours worked by people who would be subject to the work requirements.”
Still, some states are already seeking to impose new state-level Medicaid work requirements prior to a federal mandate. That includes Iowa Gov. Kim Reynolds, a Republican, who announced April 15 that Iowa is submitting a waiver request to the federal government asking to implement work requirements for able-bodied adults on the Iowa Health and Wellness Plan, the state’s Medicaid expansion program.
Includes reporting by Ken Alltucker of USA TODAY.