Alliance Alert: As New York begins implementing the Medicaid eligibility changes required under H.R. 1, the focus must be on ensuring that every eligible person is able to keep the health coverage they rely on. While new work requirements and more frequent eligibility reviews will create significant administrative challenges, our response cannot simply be to notify people of the changes, we must actively support them through the process.
The Alliance for Rights and Recovery believes that state agencies, community providers, and local organizations must work together to ensure people receive individualized assistance. This means helping people determine whether they qualify for an exemption, connecting those who are able and interested with employment opportunities, supporting enrollment in education or training programs, and identifying meaningful volunteer opportunities that satisfy the new federal requirements. Success should not be measured by how many notices are mailed, but by how many people are able to maintain the healthcare coverage they need.
Simply sending letters, emails, text messages, or automated phone calls will not be enough. Many Medicaid recipients face housing instability, language barriers, disabilities, or other challenges that make navigating complex government systems difficult. We must invest in trusted messengers, including peer specialists, community health workers, family support providers, and community-based organizations, who can meet people where they are, answer questions, and walk alongside them throughout the process. These trusted relationships have repeatedly proven to be one of the most effective ways to connect people with services, and they will be just as essential during this transition.
The Alliance will continue working closely with New York State, providers, advocates, and our community partners to ensure implementation places the least possible burden on Medicaid members and that every effort is made to prevent eligible individuals from losing coverage because of paperwork, confusion, or administrative barriers.
These issues will be front and center at our 2026 Annual Conference, where attendees can participate in workshops examining the latest federal policy changes, including Medicaid and other system changes, and discuss practical strategies for how our community can respond. We’ll also feature a panel on New York’s Medicaid 1115 Waiver, highlighting the progress made through Health-Related Social Needs services and exploring the state’s upcoming waiver renewal and opportunities to further strengthen community-based support. We encourage everyone invested in protecting access to healthcare and advancing recovery-oriented services to join us for these important conversations.
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Op-ed: New York’s Medicaid Crisis Won’t be Solved by Better Text Messages
By Eric Eve | Crain’s Healthcare | July 30, 2026
The passage of H.R. 1 marks the biggest change to Medicaid eligibility in years, creating new hurdles that could disrupt coverage for millions of Americans.
Across New York, healthcare organizations are preparing for the changes. Much of the conversation has focused on better portals, AI-powered outreach and smarter reminder systems.
But that’s solving the wrong problem.
The greatest threat isn’t technology. It’s trust. We are not going to text, email or robocall our way out of this.
As federal regulators begin implementing the law, many Medicaid beneficiaries will have to complete more paperwork, respond to more eligibility reviews and, in some cases, meet new work requirements to keep their coverage. For many, the greatest risk won’t be that they no longer qualify. It will be that they miss a notice, fail to complete paperwork or simply don’t understand what is required.
Technology can help people navigate that process. But it cannot replace the community relationships that determine whether people open the envelope, answer the phone or ask for help before it’s too late. That’s especially true in communities where language barriers, unstable housing and longstanding distrust of institutions already make it harder to stay connected to care.
The organizations most successful at keeping people enrolled won’t necessarily be those with the most sophisticated technology. They’ll be the ones that combine digital tools with trusted community relationships.
That means partnering with pastors, imams, school counselors, pharmacists, neighborhood advocates, barbers, local business owners and community organizations that residents already know and trust. These are the people many families already turn to when they need help understanding complicated systems or making important decisions. They can explain what’s changing, answer questions and help people complete the steps needed to keep their coverage.
The stakes are high. Every avoidable coverage loss means more people delaying care until they’re sick enough to need the emergency room, leaving hospitals to absorb the cost. It also creates more disruption for health plans and more financial strain on the hospitals and community clinics that care for New York’s most vulnerable residents.
New York has seen this model work before.
During the pandemic, successful vaccination campaigns relied on far more than automated reminders. Public health leaders worked through churches, schools, community organizations and neighborhood leaders because they understood that trust — not simply information — drives action. Meeting people where they were proved far more effective than relying on mass communications alone.
The coming Medicaid transition demands that same mindset.
Healthcare leaders should spend less time asking how many messages they can send and more time asking how many trusted community partnerships they can activate. Technology should strengthen those relationships — not try to replace them.
The debate over H.R. 1 is largely over. The challenge now is implementation. The organizations that keep the most people covered will be those that recognize that relationships — not reminders — drive results.
New York’s Medicaid challenge won’t be solved from a call center. It will be solved through the people communities already rely on.
Eric Eve is the founder and CEO of Eve & Co. He previously served as a senior advisor to leaders across the public and private sectors in New York and nationally.