New York State Department of Health Announces Submission of 1115 Waiver Amendment That Will Provide Continuous Eligibility for Medicaid and Child Health Plus to Children Under Age Six
1115 Waiver Amendment Would Allow Young Children to Have Uninterrupted Coverage in Child Health Plus and Medicaid Starting January 2025
Continuous Eligibility will Prevent Gaps in Coverage, Improve Continuity of Care, and Promote Health Equity Throughout the State
Waiver Previously Announced by Governor Hochul to Enhance New York's Health Care System
ALBANY, N.Y. (July 11, 2024) – The New York State Department of Health today announced the recent submission of an 1115 Medicaid Redesign Team (MRT) waiver amendment to the Centers for Medicare and Medicaid Services (CMS), which, when approved, will allow the State to offer children under age six continuous eligibility in Child Health Plus and Medicaid, effective January 2025. The waiver amendment would make New York the fourth state to offer continuous eligibility for health insurance to children under six, along with Oregon, Washington, and New Mexico.
"This waiver amendment, once approved, represents a significant change, and will ensure that children, age six and under, are provided continued eligibility to the health services they need through Child Health Plus and Medicaid," said State Health Commissioner Dr. James McDonald. "Uninterrupted coverage for all young children results in better health outcomes, makes life simpler and less stressful for parents, and reduces systemic health disparities throughout the state."
"As we have seen nationally through the Medicaid Unwinding process, eligible children throughout the country are inappropriately losing access to health insurance which increases the likelihood of negative long-term repercussions for their mental, physical and social development," said New York State Medicaid Program Director Amir Bassiri. "By providing continuous coverage for young children, New York will build on its nationally leading coverage rate for children to ensure that all children have the access to comprehensive coverage from birth, which will foster better health outcomes and reduce systemic health disparities throughout the state."
The waiver amendment will revise the state's current MRT 1115 waiver by preventing children in Medicaid and Child Health Plus from losing health insurance coverage due to fluctuations in family income. Uninterrupted access to health insurance will keep children connected to coverage and essential care during their formative years, including important preventive and primary care services that are detrimental if missed. The loss of health coverage is particularly problematic for young children, since events in the early years of a child's life can significantly impact future health and social outcomes.
New York's MRT 1115 waiver gives New York the flexibility to advance incentives that will enhance the delivery and continuity of care, expand health coverage, and access to services, and improve health outcomes across the state. The 1115 waiver came into effect in 1997 and has been extended since then. The waiver is currently approved through March 31, 2027.
The amendment application is currently posted for a 30-day federal public comment period. Comments will be accepted June 27 through July 26 on CMS's website here.
The MRT 1115 Continuous Eligibility waiver amendment submitted to CMS can be found here.
More information on the MRT 1115 Continuous Eligibility waiver amendment can be found here.
As of May 2024, there were over 6.7 million Medicaid enrollees and over 1.9 million enrollees in Child Heath Plus and the Essential Plan, making New York one of the largest and most extensive public health insurance programs in the country. These programs are available for enrollment all year, and provide comprehensive health benefits for the most vulnerable New Yorkers, including low-income families with children, seniors, foster care, pregnant women, and persons with disabilities.
