New Rule Changes For Medicaid Recipients In New York

Medicaid recipients in New York State are in for a rude awakening. Trump and Republicans' 'Big Beautiful Bill' will implement many changes that will force them to lose coverage. Others will have to meet stricter requirements to keep their coverage.

What Is Medicaid Vs. Medicare?

Sometimes people get Medicaid and Medicare confused. While they both provide healthcare coverage to New Yorkers, there are some big differences. Medicare is for New Yorkers aged 65 and older, as well as some people who are younger and have certain disabilities. Medicaid offers coverage to a wider range of New Yorkers,

Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to over 77.9 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States.

In New York, there are 6,912,571 people enrolled in Medicaid as of February 2025. Massive changes to the federal-state health care program will impact these New Yorkers soon.

KEEP READING: Big Beautiful Bill: The Good And Bad For New Yorkers

Massive Changes Coming To Medicaid In New York

As Republicans cheer about the 'Big Beautiful Bill,' it means some New Yorkers will lose their coverage. Beginning in 2027, as the federal government slashes Medicaid funding, it will also implement stricter rules. Medicaid recipients will be subject to mandatory, twice-yearly eligibility checks. There will also be new work requirements for New Yorkers on Medicaid. Per Health Management, "These requirements cannot be waived."

There will also be new cost-sharing requirements,

"Starting in 2028, states must apply cost-sharing requirements to Medicaid expansion adults with incomes greater than 100 percent of the federal poverty level."

KEEP READING: Bad News For Student Loan Borrowers In New York

While the cuts that Republicans are making will affect many New Yorkers, rural areas may get hit harder than cities. The areas of the state that heavily vote Republican rely on Medicaid more than urban areas. Per KFF.org,

"Approximately 66 million people – about 20% of the U.S. population – live in rural areas, where Medicaid covers 1 in 4 adults (a higher share than in urban areas) and plays large part in financing health care services. In rural communities, Medicaid covers nearly half of all births and one fifth of inpatient discharges. Overall, federal Medicaid spending in rural areas could decrease by 15% ($119 billion), which is far more than the $15 billion that has been suggested for the rural health fund."

KEEP READING: Changes To Student Loan Repayment Spark Concern Across New York

Per the Community Service Society,  45 percent of rural hospitals around New York State are at risk of closing in the next two to three years. Over the next six to seven years, 57 percent of rural hospitals are at risk of closing. These numbers were based on a study from 2024.

Here's How Many Medicaid Recipients Are In Each County In New York:

ALBANY - 71,547
ALLEGANY - 12,598
BRONX - 927,035
BROOME - 6,474
CATTARAUGUS - 21,449
CAYUGA - 19,945
CHAUTAUQUA - 38,945
CHEMUNG - 29,352
CHENANGO - 14,241
CLINTON - 19,811
COLUMBIA - 14,546
CORTLAND - 12,075
DELAWARE - 10,263
DUTCHESS - 62,888
ERIE - 254,835
ESSEX - 8,081
FRANKLIN - 14,516
FULTON - 14,711
GENESEE - 13,019
GREENE - 12,256
HAMILTON - 698
HERKIMER - 16,419
JEFFERSON - 29,028
KINGS (BROOKLYN) - 1,299,235
LEWIS - 5,218
LIVINGSTON - 11,824
MADISON - 15,673
MONROE - 200,898
MONTGOMERY - 18,610
NASSAU - 309,776
NEW YORK (MANHATTAN) - 484,266
NIAGARA - 54,080
ONEIDA - 70,840
ONONDAGA - 119,472
ONTARIO - 22,685
ORANGE - 127,261
ORLEANS - 10,997
OSWEGO - 33,410
OTSEGO - 13,227
PUTNAM - 17,859
QUEENS - 1,115,064
RENSSELAER - 35,750
RICHMOND (STATEN ISLAND) - 182,234
ROCKLAND - 151,610
SAINT LAWRENCE - 28,473
SARATOGA - 36,750
SCHENECTADY - 47,690
SCHOHARIE - 7,117
SCHUYLER - 3,534
SENECA - 7,690
STEUBEN - 26,276
SUFFOLK - 368,517
SULLIVAN - 28,496
TIOGA - 11,977
TOMPKINS - 16,540
ULSTER - 48,838
WARREN - 15,676
WASHINGTON - 16,440
WAYNE - 21,492
WESTCHESTER - 241,075
WYOMING - 8,898
YATES - 4,946

Get our free mobile app