Medicaid eligibility changes threaten coverage for thousands in US

New federal Medicaid regulations are set to impact hundreds of thousands of residents in the United States. Starting in January 2027, new rules will require participants aged 19 to 64 to complete at least 80 hours per month of work, training, volunteering, or schooling, or meet specific monthly income thresholds, to maintain eligibility.

In New York City, health officials estimate that up to 900,000 of the city’s 3.6 million Medicaid enrollees could face coverage termination. The NYC Department of Health and Mental Hygiene has launched an outreach campaign to assist citizens, including providing resources in 13 languages and training community health workers to help navigate the new requirements.

Additionally, changes to federal funding are affecting legal immigrants. Following the 2025 tax and spending act, federal support for certain groups, including refugees and some asylum seekers, has been curtailed. While New York State has committed to using state funds to continue coverage for these individuals, the specific insurance plans may change. Nationally, data suggests over 281,000 legal immigrants across several states and D.C. may lose Medicaid coverage due to these shifting eligibility conditions.