What's happening
This bill guarantees all children in New York free health insurance regardless of family income.
Why it matters
Impacts all children under age 19 statewide, regardless of immigration status or household income, by making health coverage truly universal and removing all premium payments and income-based eligibility requirements. This is a major expansion from previous thresholds that limited free or subsidized care to families under certain income levels.
Streamlines and simplifies the enrollment process, introducing “presumptive eligibility” and temporary enrollment for children so they can access care immediately while their eligibility is determined, reducing gaps in coverage and administrative burdens for families. This is especially important for children in families experiencing sudden changes in income or circumstances.
Requires state agencies to seek federal waivers and funding to support the program, potentially increasing federal dollars flowing into New York’s health system and signaling a significant policy shift that could serve as a model for other states considering universal child health coverage.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Children and Families in New York
Families with children under 19 will be directly affected, as the bill eliminates income as a barrier to eligibility and removes premium payments, expanding access to universal health coverage for all children regardless of household income.
Healthcare Providers and Insurers
Hospitals, clinics, pediatricians, and managed care organizations will see changes in patient eligibility, increased enrollment, and potentially higher demand for services from children who previously lacked insurance.
State and Local Government Agencies
The New York State Department of Health and local social services departments will be responsible for implementing new eligibility rules, managing expanded enrollment, processing waivers, and ensuring compliance with federal requirements.
- Watching
Advocacy and Child Welfare Organizations
Groups focused on child health, poverty reduction, and healthcare equity will have a vested interest in supporting, monitoring, and publicizing the impacts of universal child health coverage, as well as ensuring effective outreach and enrollment.
Headline styles
Free Health Care for Children
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Print number 10698a
- Amend and recommit to rules
- Referred to rules
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
10698--A
IN SENATE
September 11, 2026
Introduced by Sen. COONEY -- read twice and ordered printed, and when printed to be committed to the Committee on Rules -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the public health law, in relation to universal health care for children; and to repeal certain provisions of such law relating thereto
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraphs (a), (b) and (c) of subdivision 6 of section 2510 of the public health law, as added by section 69 of part B of chapter 58 of the laws of 2005, are amended to read as follows:
(a) the period of eligibility for a child who ceases to be eligible because [he or she] they no longer [resides] reside in New York state or [has access to or] obtained other health insurance coverage, as defined by the commissioner in consultation with the superintendent pursuant to paragraph (c) of subdivision two of section twenty-five hundred eleven of this article, shall end the last day of the month in which the child ceases to be an eligible child; and
(b) the period of eligibility for a child who becomes eligible for medical assistance shall end the last day of the [third] sixth month after the child becomes eligible for medical assistance[; and
(c) the period of eligibility for a child for whom an applicable premium payment has not been paid shall end in accordance with time frames and procedures determined by the commissioner].
§ 2. Subdivision 9 of section 2510 of the public health law is amended by adding a new paragraph (f) to read as follows:
(f) for periods on or after January first, two thousand twenty-eight, no payments are required for eligible children.
§ 3. Subparagraphs (ii) and (iii) of paragraph (a) of subdivision 2 of section 2511 of the public health law, subparagraph (ii) as amended by section 28 of part A of chapter 58 of the laws of 2007, and subparagraph (iii) as amended by section 30 of part D of chapter 56 of the laws
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD16345-03-6
of 2013, are amended and a new subparagraph (iv) is added to read as follows:
(ii) effective July first, two thousand, resides in a household having a gross household income at or below two hundred fifty percent of the non-farm federal poverty level (as defined and updated by the United States department of health and human services); [and]
(iii) effective September first, two thousand eight, resides in a household having a household income at or below four hundred percent of the non-farm federal poverty level (as defined and updated by the United States department of health and human services); and
(iv) effective January first, two thousand twenty-eight, household income is removed as a factor for determining eligibility;
§ 4. Paragraph (b) of subdivision 2 of section 2511 of the public health law, as amended by chapter 639 of the laws of 1996, is amended to read as follows:
(b) is not eligible for medical assistance, except that a child who becomes eligible for medical assistance after becoming an eligible child under this title, may be eligible for a subsidy payment pursuant to subdivision three of this section as medical assistance for a period up to [three] six months after becoming eligible for medical assistance; and
§ 5. Paragraph (f) of subdivision 2 of section 2511 of the public health law is REPEALED and a new paragraph (f) is added to read as follows:
(f) Notwithstanding any inconsistent provision of law to the contrary and subject to the availability of federal financial participation under title XIX of the federal social security act, a child under the age of nineteen shall be presumed to be eligible for subsidy payments and temporarily enrolled for coverage under this title, once during a twelve-month period, beginning on the first day of the enrollment period. The temporary enrollment period shall continue until an eligibility determination is made pursuant to title eleven of article five of the social services law, or two months after the date temporary enrollment begins; provided however, a temporary enrollment period may be extended in the event an eligibility determination under title eleven of article five of the social services law is not made within such two-month period through no fault of the applicant for insurance for medical assistance. The commissioner shall assure that children who are enrolled pursuant to this paragraph receive the appropriate follow-up for a determination of eligibility for benefits under title eleven of article five of the social services law prior to the termination of the temporary enrollment period. The commissioner shall ensure that children and their families are informed of all available enrollment sites in accordance with subdivision nine of this section.
§ 6. Subdivision 4 of section 2511 of the public health law, as amended by section 21 of part D of chapter 56 of the laws of 2013, is amended to read as follows:
4. Households shall report to the approved organization or state enrollment center, whichever is applicable, within thirty days, any changes in New York state residency or health care coverage under insurance that may make a child ineligible for subsidy payments pursuant to this section. Any individual who, with the intent to obtain benefits, willfully misstates [income or] residence to establish eligibility pursuant to subdivision two of this section or willfully fails to notify an approved organization or state enrollment center of a change in residence or health care coverage pursuant to this subdivision shall repay such subsidy to the commissioner. Individuals seeking to enroll children for coverage shall be informed that such willful misstatement or failure to notify shall result in such liability.
§ 7. Paragraph (i) of subdivision 8 of section 2511 of the public health law is amended by adding a new subparagraph (iii) to read as follows:
(iii) Effective January first, two thousand twenty-eight, reimbursement for covered health care services provided shall be at rates negotiated between the insurer and the providers of such health care services, provided that such rates are not less than the rates that would be paid for such services pursuant to the corresponding Medicare rate. In the instance that a covered health service under this section does not have a corresponding billing code in Medicare, the rate of reimbursement to the providers of the covered health care services shall be no less than 100% of the Medicaid fee for-service rate.
§ 8. The commissioner of health shall, expeditiously and as necessary, submit the appropriate waivers, including, but not limited to, those authorized under section 1115, title XIX, or title XXI of the federal social security act, or successor provisions, and any other waivers and state plan amendments necessary to secure federal financial participation under this act.
§ 9. This act shall take effect on the first of January next succeeding the date on which it shall have become a law. Effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to universal health care for children; and to repeal certain provisions of such law relating thereto
Summary of provisions
Section 1: Amends paragraphs (a), (b), and (c) of subdivision 6 of section 2510 of the public health law to remove access to other health insurance as a factor for eligibility, to extend the period of eligibil- ity for child health plus for a child who becomes eligible for medical assistance, and to remove an unpaid premium payment as a cause for inel- igibility.
Section 2: Amends subdivision 9 of section 2510 of the public health law by adding a new paragraph, (f), that removes payments for eligible chil- dren.
Read the full memo (777 words)
Section 3: Amends subparagraphs (ii) and (iii) of subdivision 2 of section 2511 of the public health law to remove outdated language, and adds a new subparagraph, (iv), that removes household income as a factor for determining eligibility.
Section 4: Amends paragraph (b) of subdivision 2 of section 2511 of public health law to extend the amount of time a child who becomes eligible for medical assistance may also be covered by child health plus
Section 5: Repeals paragraph (f) of subdivision 2 of section 2511 of the public health law, and adds a new paragraph (f) which establishes presumptive temporary eligibility for child health plus for children under the age of 19 while an eligibility determination is completed.
Section 6: Amends subdivision 4 of section 2511 of the public health law to remove misstating income for the purposes of obtaining benefits as a reason to have to repay subsidy payments to the commissioner.
Section 7: Amends paragraph (i) of subdivision 8 of section 2511 of the public health law by adding subparagraph (iii) to set the reimbursement rate to providers of covered health services under this title.
Section 8: Directs the commissioner of health to submit appropriate waivers and state plan amendments to the appropriate federal agencies to execute this legislation.
Section 9: Sets the effective date as the first day of the new year after it shall become a law, however, effective immediately the commis- sioner of health is authorized and directed to add, amend, and/or repeal any rule or regulation and to take other actions reasonably necessary to implement this act on such effective date.
Justification
In the United States, approximately one in five children lack adequate health insurance, with one third of commercially insured youth facing high costs or limited benefits, and those on public plans facing chal- lenging coverage gaps and delayed care. New York has been a leader in addressing these challenges for decades, and now can show a low rate of only 2.7% of children in the state without insurance. But one child uninsured, or with insurance that costs too much to utilize, is one child too many. The American Pediatric Association has continuously advocated for the benefits that proper, accessible health care has for children and the community at large, advocating for policies that create universal access. There is substantial research which confirms early interventions and preventative care for manageable conditions prevent escalation of the conditions into lifelong chronic illnesses requiring expensive and time-intensive care. Simply put, healthy kids grow into healthy, productive adults. In addition to the individual health bene- fits for the children receiving universal health coverage, implementing universal health coverage in New York State will help all New York fami- lies already struggling with high prices. Rising medical costs outpace inflation, and insurance carriers have been asking for 20%-plus premium increases, raising the cost of family health insurance by over $2,000 a year. By implementing universal children's health coverage, all fami- lies, regardless of income, will see savings and have the peace of mind to know whatever their children need, they will have it covered.
This legislation will create universal health care coverage for New York children by working with the existing federal medicaid programs, and opening New York's Child Health Plus access with premium-free plans for any child at any income level above the threshold for children's Medi- caid. This legislation will also create higher reimbursement rates for pediatricians helping to create sustainable practices and quality access for all New York children.
Legislative history
New Bill
Fiscal implications
To be determined.
Effective date
This act shall take effect on the first day of the new year after it shall have become a law. Effective immediately, the commissioner of health is authorized and directed to add, amend, and/or repeal any rule or regulation and to take other actions reasonably necessary to imple- ment this act on such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.