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Bronx residents will be exempt from new Medicaid work rule, state officials say
By
Caroline Lewis
Published Oct 8, 2026
Modified Oct 9, 2026
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By
Caroline Lewis
Published Oct 8, 2026
Modified Oct 9, 2026
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Because of high unemployment in the borough, Bronx residents will be exempt from Medicaid work requirements when new federal rules take effect in January, the New York state's health department confirmed on Thursday.
State health officials told a meeting of hospital leaders this week that Bronx residents qualify for a federal hardship exemption that gives a pass to people living in areas with high rates of unemployment, Politico first reported.
Without that exemption, many Bronx residents would have to prove they are working, in school or otherwise, complying with the new federal Medicaid requirements in order to maintain their health coverage.
About 60% of the Bronx’s 1.4 million residents are covered by the public insurance program for people with low incomes, compared with about 40% of New Yorkers citywide, according to state data.
We want to hear from you
Are you a New York City resident who may be affected by Medicaid work requirements? We want to hear from you! Email health reporter Caroline Lewis at [email protected].
New federal eligibility requirements for Medicaid were included in the H.R. 1 domestic policy bill passed by President Donald Trump and Congressional Republicans last year. It’s up to health officials in each state to implement the changes.
“New York State is committed to protecting New Yorkers from the harmful impacts of the reckless cuts enacted under H.R. 1 and is taking all necessary steps to secure a county-wide, short-term hardship exception for Medicaid community engagement requirements in the Bronx due to the high rate of unemployment,” said Cadence Acquaviva, a spokesperson for the state health department.
The Trump administration has carved out a “short-term hardship exception” from Medicaid work requirements for residents of counties with unemployment rates that are either over 8% or at least 1.5 times the national average.
The Bronx is the only county in New York state that would qualify, Acquaviva said. The Bronx's unemployment rate was 7.1% in August, compared with a national rate of 4.3%.
According to the U.S. Centers for Medicare and Medicaid Services, New York has not submitted a formal request to implement the hardship exemption.
Acquaviva said New York has notified CMS that the state is taking advantage of the hardship exemption for the Bronx, but there is no formal approval process.
Meanwhile, many New Yorkers across the five boroughs will be exempt from the new Medicaid rules for other reasons.
The new rules require adults under 65 to prove they are working, doing community service or participating in an employment program for at least 80 hours a month, or that they are enrolled in an educational program at least half-time. Healthcare consumers can also show they are engaged in some combination of these activities.
People who are exempt include those who have a child under 14, are pregnant or postpartum, have a disability, are enrolled in a drug or alcohol treatment program, or are on SNAP, among several other conditions.
The state Department of Health has posted information about the new rules online and said it would notify Medicaid enrollees by Sept. 30 if they are subject to the work requirements. The health department will be able to verify eligibility for some Medicaid enrollees using existing records and data, but others will be asked for proof that they still qualify when it’s time to renew coverage.
The city health department has estimated that about 900,000 residents in the five boroughs will be at risk of losing Medicaid coverage because of the new requirements.
Chantal Gomez, a spokesperson for the city health department, praised the state’s move to protect the Bronx, stating that “a borough-wide exemption would mean that thousands of New Yorkers will face less of a burden to get or keep life-saving coverage.”
But she added that the city is still doing outreach to help thousands of other New Yorkers on how to maintain coverage.
Find out more about new Medicaid work requirements and possible exemptions from the state Department of Health.
This story was updated with comment from U.S. Centers for Medicare and Medicaid Services.
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Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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