Alliance Alert: The Alliance for Rights and Recovery remains deeply concerned about the impact that new federal Medicaid work requirements will have on New Yorkers who rely on Medicaid for lifesaving mental health, substance use, and physical healthcare services. While many individuals will qualify for exemptions or continue to meet the new requirements, hundreds of thousands of people could still lose coverage simply because of increased paperwork, reporting requirements, or administrative barriers rather than actual ineligibility. No one should lose healthcare because they were unable to navigate a complex bureaucratic process.
These new requirements also come with a significant cost to New York. As the state invests millions of dollars and hires additional staff to build new eligibility and verification systems, those are resources that cannot be used to address other pressing needs, including expanding the community-based mental health, substance use, housing, peer support, and recovery services that Medicaid often does not adequately fund. We should be investing more in helping people stay healthy and connected to their communities, not creating additional layers of administration.
As New York moves toward implementation, the Alliance will continue working with the Department of Health, Office of Mental Health, and other state partners to ensure the process is as streamlined and compassionate as possible. We will advocate for automatic verification whenever feasible, strong protections against unnecessary loss of coverage, and robust education for beneficiaries and providers. We will also continue pushing for expanded supported employment, education, volunteer, and peer workforce opportunities so that people have meaningful pathways to participate while improving their health, recovery, community integration, and overall quality of life.
Medicaid Work Requirements Will Raise NY’s Enrollment Admin Costs 20%
By Ethan Geringer-Sameth | Crain’s Healthcare | June 26, 2026
New York’s administrative costs for Medicaid enrollment are expected to increase roughly 20% due to changes laid out in President Donald Trump’s spending megabill last year.
State Medicaid Director Amir Bassiri discussed the need for increased spending at a House oversight hearing on Thursday in Washington, D.C. The state must implement new eligibility and enrollment systems to account for changes H.R. 1 made to Medicaid employment requirements, he said. New York’s Medicaid office is also spending more on marketing to keep residents informed of the changes and hiring additional county-level staff to implement them.
“The administrative cost associated with that implementation is significant,” Bassiri told members of a subcommittee of the House Committee on Energy and Commerce. “This is the largest administrative cost the state has incurred since the implementation of the (Affordable Care Act).”
Trump signed H.R. 1 in July 2025, creating new work requirements for Medicaid enrollment and shortening the period for redetermination to every six months. Those changes are set to go into effect Jan. 1.
The changes are expected to increase paperwork that could result in hundreds of thousands of residents losing coverage, even if they meet the new employment criteria. The state is taking steps to mitigate the impact on customers and preserve continuity of care, Bassiri said.
The Department of Health is hiring 200 employees to help administer the changes including 86 people assigned to determine enrollee eligibility, according to spokeswoman Danielle DeSouza. The cost to the state is projected to be roughly $8 million, with additional funding from the federal government, she said.
An estimated 594,000 to 1.2 million New Yorkers could lose coverage due to the new work requirements and six-month redeterminations, according to a March analysis from Urban Institute. In the Bronx, where the state’s Medicaid enrollment is the highest, 20,000 to 30,000 residents <https://www.crainsnewyork.com/health-care/cny-bronx-safety-net-medicaid-snap-cuts-20260619/> are expected to lose coverage, according to Urban Health Plan, a large health clinic network based in Longwood.
“The biggest challenge is communicating effectively and accurately with our members about the changes that are forthcoming and the very nature of those changes at different time periods,” Bassiri said.
The purpose of Thursday’s hearing was to examine fraud, waste and abuse in Medicaid programs in four Democrat-led states, including New York. The Trump administration and Republicans in Congress have held multiple hearings on Medicaid fraud during the president’s second term, part of a crusade that has targeted blue states like California and Minnesota.
“The question here is, should taxpayers continue to pay and be put on the line for this waste, fraud and abuse, or should the taxpayer say, ‘Okay, you fix it and then we’ll be glad to fund those who by law are allowed to use these programs,’” said Rep. Rick Allen, a Georgia Republican.
Bassiri managed to escape questioning on what is potentially the most bruising topic — the fraught overhaul of a popular home care program, known as Consumer Directed Personal Assistance, that is now the subject of a Department of Justice lawsuit. Federal prosecutors alleged that Bassiri, state Health Commissioner James McDonald, and a company administering the program rigged the bid for the lucrative contract.
“What safeguards currently exist to verify that services (in the Consumer Directed Personal Assistance Program) are billed actually and delivered?” asked Rep. John Joyce, a Pennsylvania Republican and chair of the Subcommittee on Oversight and Investigations. “My time has expired. I’m going to ask you to respond to that in writing.”