This is Part 2 of a two-part series on Medicaid work requirements and East New York. Read Part 1 here.

In Part 1, we explained what the new federal Medicaid work rules are and who is affected. The picture was serious: starting January 1, 2027, many low-income adults on Medicaid must prove they are working, in school, volunteering, or qualify for an exemption — or risk losing coverage.

This week, we have better news to share. New York State is actively preparing to protect as many residents as possible. But protection only works if you know about it. Here's where things stand and what East New York families should do right now.

New York Got More Time

When the federal government released the official rules for implementing Medicaid work requirements on June 1, 2026, it included an important concession for states like New York that need more time to build the systems to verify compliance.

For 2027, New Yorkers who need an exemption — because of a health condition, caregiving responsibility, or other qualifying reason — will largely be able to self-declare that they qualify. You will not have to submit full documentation in 2027. That requirement kicks in later, in 2028.

New York State Medicaid Director Amir Bassiri had flagged the original timeline as his primary concern. The state is now purchasing new software to manage verification alongside the existing New York State of Health system — the online marketplace where most people in this situation manage their Medicaid.

A Critical Immigrant Deadline: October 1, 2026

Urgent — Before January 2027

Starting October 1, 2026, federal reimbursement rules for immigrant Medicaid eligibility will tighten. Only certain immigrants will qualify for federally-funded Medicaid: Green Card holders for more than 5 years, Cuban and Haitian entrants, and citizens of Micronesia, Palau, and the Marshall Islands. If you or a family member is an immigrant on Medicaid, contact NYC HRA or a local immigration legal services provider now — before October 1.

Exemptions Are Broad — If You Claim Them

Here is the key detail that can protect families in our neighborhood: the exemptions are broad if you know about them and claim them. New York City's Health Department is actively working to help residents get exemptions through two main pathways:

1. Medical Frailty / Health Condition Exemption: If you have a chronic illness, mental health condition, substance use disorder, physical disability, or other serious health issue, you may qualify as "medically frail" and be fully exempt. For 2027, self-declaration is allowed — but get documentation from your doctor now while there is time.

2. Caregiver Exemption: If you are caring for a child under 14, a disabled family member, or another dependent, you are exempt. This covers a very large share of East New York families — but only if the system knows you are a caregiver.

Other exemptions include pregnancy and postpartum status (up to 12 months), participation in drug or alcohol treatment programs, veterans with total disability ratings, and former foster youth under 26.

East New York May Qualify for the High Unemployment Exception

Federal rules allow counties with high unemployment rates — at or above 8% or 1.5 times the national average — to be exempt from work requirements entirely. Research from KFF found that nine in ten Medicaid enrollees who could qualify for this exception live in five states — and New York is one of them. East New York has historically had unemployment rates above citywide and national averages. If our community qualifies, residents could be exempt with no paperwork needed. The East New York Times will track this closely as the state makes its determinations.

What To Do Right Now — The 2026 Checklist

Your Action Checklist

  • Update your address with HRA/Medicaid — Every notice will go to the address on file. Update at nyc.gov/accesshra or call 718-557-1399.
  • Talk to your doctor about your health — Ask them to document any chronic condition in your medical records now. This becomes your exemption paperwork if needed.
  • Document your caregiving — School enrollment records, birth certificates, or a letter from a social worker can establish your exempt status as a caregiver.
  • Watch your mail starting now — When a letter arrives about Medicaid, open it immediately. You have 30 days to respond if there is an issue with your coverage.

Where to Get Free Help in East New York

Local Resources

The Bottom Line

New York is fighting to protect its residents and has more time than originally feared. But protection is not automatic — it requires residents to claim their exemptions, keep their information current, and respond to notices. In East New York, where residents already carry enormous burdens, that paperwork gap is the real risk.

The East New York Times will continue reporting on this story as New York releases more details on implementation, which zip codes qualify for the unemployment exemption, and what local organizations are doing to help.

Have a question about Medicaid or know someone who needs help? Contact Deric Johnson at info@eastnewyorktimes.com.

Sources: CMS Interim Final Rule (June 1, 2026) · Medicaid Matters New York · Alliance for Rights and Recovery · KFF Health Policy Research · Georgetown Center for Children and Families · NY Health Access