8 Apr, 2026
The Budget Reconciliation law known as HR1 enacted the One Big Beautiful Bill Act, signed into law July 4, 2025. The law imposes massive cuts in Medicaid, Medicare, SNAP, and immigrant eligibilty for these and other public programs. The strategically delayed implementation of many of the worst cuts until after the mid-term elections that will be held in November 2026. But some changes are happening sooner. This article provides links to some of the many explanations of the law and its impact by national organizations, and gathers information about implementation in NYS.
NYS ACTION ALERT! CALL YOUR STATE REP TO PROTECT Health Care for 480,000 New Yorkers!
National Summaries and Analyses of HR1 Medicaid cuts
Impact of HR 1 in New York State
WHAT ARE NEXT STEPS OF IMPLEMENTING H.R.1?
March 1, 2026 - SNAP (Food Stamp) Work or Volunteer Requirements Began for Able-Bodied Adults Ages 18-64 Without Dependents (ABAWD)
October 1, 2026 - Restrictions on immigrant eligibility for federally subsidized Medicaid take effect.
- The federal government reimburses NYS for about 50% of the cost of Medicaid services for citizens and certain legal immigrants. The definition of who is a "legal immigrant" for piurposes of qualifying for federal reimbursement for Medicaid costs will be retricted on Oct. 1. 2026. After that date, the only immigrants whose Medicaid qualifies for federal reimbursement are:
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people with Lawful Permanent Residence status (Green Card holders) for more than five years;
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Cuban and Haitian entrants; and
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people from the Compacts of Free Association States (citizens of Micronesia, Palau, and the Marshall Islands).
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Many lawful immigrants who previously qualified for federally funded Medicaid will no longer qualify for FEDERAL Medicaid but they should still qualify for STATE-funded Medicaid. This is thanks to a NYS Court of Appeals decision Aliessa v. Novello, 730 N.Y.S.2d 1 (2001). Aliessa held that the NYS Constitution provision requiring care for the needy required coverage of Medicaid for legal immigrants, including those permanently residing under color of law (PRUCOL). See this article about PRUCOL eligibility New York State Medicaid should still cover lawful immigrants who, until Oct. 1, 2026 have been covered by Federal medicaid including:
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Refugees and Asylees
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Victims of domestic violence (Violence against Women's Act) and trafficking
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other legal statuses listed in this Public Benefits Chart as eligible for Federal Medicaid. This chart does NOT reflect the changes coming on Oct. 1, 2026. (Chart by NY Immigration Coaltion, Empire Justice Center & Legal Aid Society).
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See CSS recommendations for how NYS can cover many of the immigrants who no longer qualify for the Essential Plan coverage - and whose income is too high for Medicaid.
January 1, 2027 - Work, School or "Community Engagement" Requirements Start for Some Medicaid Recipients
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NYS Dept. of Health Webpage announcing work requirements - with information about WHO must comply, WHAT activities comply, and more.
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The new requirements do NOT apply to people age 65+, who have been determined disabled, who are under 18 or taking care of a child under age 14, and see webpage for other exceptions.
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Most people who must comply with these new requirements have Medicaid administered on the NYSofHealth website, not with the local county Medicaid office or HRA. It is not yet known whether anyone with Medicaid administered by the local Medicaid office will have to comply.
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ADVOCACY on Work Requirements: See Mitigating the Harms of Medicaid Work Requirements for Older Adults: Tools for State Advocates (Justice in Aging - March 2026)
Check back on this webpage for more information.
