What's happening
This bill directs the health commissioner to seek federal approval to require able-bodied adults on Medicaid to participate in work or community engagement activities.
Why it matters
This bill could significantly change Medicaid eligibility for able-bodied, working-age adults in New York. by tying continued coverage to participation in work or community engagement activities, potentially impacting thousands who rely on Medicaid but are currently not required to meet such conditions.
The proposal sets a structured, escalating schedule for participation. starting at 5 hours per week after three months and rising to 20 hours per week after a year—meaning recipients will need to steadily increase their engagement in approved activities to maintain benefits.
A broad range of activities would satisfy the requirement. , including job training, education, caregiving for nondependents with health conditions, and community service, offering some flexibility but also adding complexity to compliance and tracking.
The bill mandates ongoing assessment and reporting to state leadership. , which could influence future Medicaid policy decisions and shape the debate over work requirements by providing data on their impact on health outcomes and recipients' movement toward self-sufficiency.
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
Headline styles
Require Work for Medicaid
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1499
2025-2026 Regular Sessions
IN SENATE
January 10, 2025
Introduced by Sen. O'MARA -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT directing the commissioner of health to apply for a waiver to implement a work requirement for able-bodied adult recipients of Medicaid
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The commissioner of health shall prepare and submit to the Centers for Medicare and Medicaid Services an application for a waiver, pursuant to section 1115 of the Social Security Act, 42 USC 1315, to allow the state to implement a program incentivizing community engagement and employment among able-bodied, working-age adults with the goal of empowering program participants and providing them with the necessary tools to seek and obtain employment and transition to self-sufficiency. Such waiver shall include the following:
1. A requirement that every able-bodied, working-age adult enrolled in the Medicaid program participate in community engagement or employment activities. The following Medicaid program participants shall not be subject to the requirement for participation in community engagement or employment activities:
a. children under the age of 18 or individuals under the age of 19 who are participating in secondary education;
b. individuals age 65 years and older; individuals who qualify for medical assistance services due to blindness or disability, including individuals who receive services pursuant to a waiver under federal law;
c. individuals residing in institutions; individuals determined to be medically frail;
d. pregnant and postpartum individuals;
e. former foster children under the age of 26; and
f. individuals who are the primary caregiver for a dependent, including a dependent child or adult dependent with a disability.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04387-01-5
2. Requirements for gradually escalating participation in community engagement and employment activities, as follows:
a. three months after enrollment, at least five hours per week;
b. six months after enrollment, at least ten hours per week;
c. nine months after enrollment, at least fifteen hours per week; and
d. twelve months after enrollment, at least twenty hours per week.
3. Provisions for satisfaction of the requirement for participation in community engagement and employment activities through:
a. participation in job skills training;
b. job search activities; education related to employment;
c. general education, including participation in a program of preparation for the General Education Development (GED) certification examination, Test Assessing Secondary Completion (TASC) or community college courses;
d. vocational education and training;
e. subsidized or unsubsidized employment;
f. community work experience; community service or public service; or
g. caregiving services for a nondependent relative or other person with a chronic, disabling health condition.
4. Provisions for monitoring, evaluating, and assessing the effectiveness of the demonstration program in improving the health and wellness of program participants and furthering the objectives of the Medicaid program.
§ 2. The commissioner of health shall report to the governor, the speaker of the assembly and the temporary president of the senate on the status of the waiver application required pursuant to this act by January 1, 2026.
§ 3. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act directing the commissioner of health to apply for a waiver to implement a work requirement for able-bodied adult recipients of Medi- caid
Purpose or general idea of bill
To request that the Commissioner of Health submit an application to permit New York State to implement a community engagement and employment program among the able-bodied Medicaid recipients.
Summary of specific provisions
Section 1 of the bill directs the Commissioner of Health to apply for a waiver to permit the state of New York to implement work requirements to eligible Medicaid recipients.
Section 2 states that the Commissioner of health shall provide an update regarding the waiver application on January 1, 2024.
Section 3 establishes the effective data.
Justification
On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a State Medicaid Director Letter providing new guidance for Section 1115 waiver proposals that would impose work requirements (referred to as community engagement) in Medicaid as a condition of eligibility.
These provisions would promote program objectives by helping states improve enrollee health and well-being through incentivizing community engagement.
Prior legislative history
2017: S7959 2019: S933
2021: S5446
2023: S2182
Fiscal implications
To be determined.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.