Waiver Amendment Ensures Children Under Six Have Uninterrupted Coverage in Child Health Plus and Medicaid

Continuous Eligibility Waiver Will Promote Health Equity Throughout the State

Governor Kathy Hochul on Nov 22nd, announced that the state is now able to offer children under the age of six continuous eligibility in Child Health Plus and Medicaid. This change simplifies enrollment in these programs by reducing administrative burdens and ensures the youngest New Yorkers have consistent access to coverage through the age of six. Under Governor Hochul’s leadership, the New York State Department of Health submitted a 1115 Medicaid Redesign Team waiver amendment that has been approved by the Centers for Medicare and Medicaid Services. This approval follows through on the Governor’s commitment to enhance New York’s health care system, advance health equity and expand health care coverage.

“By expanding health coverage for 800,000 children across our state, we’re ensuring they have the uninterrupted coverage they need to lead full and healthy lives,” Governor Hochul said. “This waiver allows us to give families options when it comes to their children’s health care, and we will always go the extra mile to create a healthy future for our youngest New Yorkers.”

Governor Hochul’s dedication to ensuring quality health care across the state solidifies New York’s position in the growing list of states that provide continuous health insurance eligibility for children under six years old.

There are more than 800,000 children under the age of six enrolled in Medicaid and Child Health Plus who could benefit from this change.

As of September 2024, more than 2.5 million children under 18 years of age have been enrolled in Medicaid and Child Health Plus, making New York's one of the most expansive public health insurance programs in the country. Medicaid and Child Health Plus are available for enrollment throughout the year and provide comprehensive health benefits for the most vulnerable New Yorkers, including low-income families with children, seniors, children in foster care, pregnant women and people with disabilities.

New York State Health Commissioner Dr. James McDonald said, “This is a very important and timely announcement. Children are so vulnerable, and at risk for serious adverse health outcomes, if they do not have access to quality healthcare. The approval of this waiver from CMS represents great work from the department, and demonstrates our strong partnership with the federal government in achieving our common goals of optimal health outcomes for our children and achieving health equity.”

New York State Medicaid Program Director Amir Bassiri said, “Children who are unable to access necessary health services are more likely to suffer negative long-term repercussions for their mental, physical and social development. By providing uninterrupted access to health insurance for young children, this waiver will help safeguard their ability to thrive from the beginning, fostering better health outcomes for vulnerable New Yorkers and reducing systemic health disparities throughout the state."

Senate Majority Leader Charles Schumer said, “Medicaid is the bedrock of healthcare for countless New Yorkers, and this federal approval of New York’s Medicaid waiver will ensure that more young children can access care. Now, families across NY will have more health care options for their children. I am pleased to work side-by-side with Gov. Hochul to make health care more affordable and accessible to our youngest New Yorkers.”

Senator Kirsten Gillibrand said, “Access to high-quality health care is essential to make sure that New York’s children can thrive physically, mentally, and academically, and I’m proud to see our state taking action to increase this access. This waiver will expand health care coverage for our most vulnerable populations, helping to improve long-term health outcomes for the next generation. I applaud CMS for approving this waiver, and I will continue advocating relentlessly at the federal level to make sure that New Yorkers get the care they need.”

Representative Jerrold Nadler said, “It is critical for New York’s children to have access to high quality and uninterrupted health care coverage. I am pleased that CMS approved New York’s 1115 MRT waiver amendment to offer continuous eligibility for children under age six in Child Health Plus and Medicaid.”

Representative Nydia M. Velázquez said, “This coverage expansion will help ensure that all children, regardless of background, have access to the health care they need to thrive. By prioritizing continuous health coverage for children under six, New York is setting a powerful example for states partnering with the federal government to improve health equity. I commend Governor Hochul and her administration for their dedication to protecting the well-being of vulnerable children across the state.”

Democratic Leader Hakeem Jeffries said, “I am grateful for Governor Hochul’s leadership to ensure that nearly one million of our youngest New Yorkers will be able to access comprehensive health insurance coverage through Medicaid to set them on a healthy path forward. Down in Washington, House Democrats will work to build upon our historic efforts to lower prescription drug costs and expand the Affordable Care Act through the Inflation Reduction Act and protect Medicaid from extremists who want to take a blowtorch to our care.”

Representative Adriano Espaillat said, “Governor Hochul is delivering lifesaving healthcare coverage to over 800,000 children under the age of six, fulfilling her promise to improve New York’s healthcare system and ensure equitable access to healthcare for all New Yorkers. By ensuring children will remain enrolled in Medicaid and Child Health Plus without disruption, the New York State Department of Health is preventing the lifelong physical, mental, and social repercussions. I look forward to continuing to work with the Governor to ensure the health of New York families.”

Representative Joe Morelle said, “Far too many children in our communities are being underserved and unable to access the care they need due to the high cost of healthcare. On Nov 22nd’s announcement moves us closer to solving this urgent issue in New York State. Expanding eligibility for Child Health Plus and Medicaid to children under six will make a real difference for families, giving them the security and peace of mind that comes from knowing their children’s health and safety are a priority. I’m grateful to Governor Hochul for her dedication to supporting families, and I look forward to continuing our work together to invest in their well-being.”

Representative Dan Goldman said, “Arbitrary Medicaid eligibility requirements should never come between a young child and the doctor’s office. I applaud Governor Hochul for working to implement the 1115 waiver, which will ensure uninterrupted health care coverage for 800,000 children across New York. Good health and access to regular health care in a child's early years increase the likelihood that they will live long, healthy lives. It is imperative that we do everything possible to ensure children across our country have access to the comprehensive, dependable health care coverage they deserve.”

Representative Tim Kennedy said, “Every child deserves access to a healthy start in life. This health coverage expansion gives thousands of children across New York a solid foundation from which to build lifelong wellness and opportunities to thrive.”

The waiver amendment revises the state’s current MRT 1115 waiver by modifying existing eligibility criteria for children in Medicaid and Child Health Plus, to allow them continuous enrollment even if the child’s family circumstances change. Gaps in coverage for young children can be detrimental to their long-term health and well-being. These experiences can have negative long-term implications for children's mental and physical health, educational attainment, and financial security.

In receiving this approval, Governor Hochul has secured uninterrupted access to health insurance that will ensure children are connected to coverage and essential health care during their formative years, including important preventive and primary care services. This furthers the Governor’s strong commitment to putting New York at the forefront of progressive, compassionate health care.

More information about the MRT 1115 Continuous Eligibility waiver amendment can be found here.

More information and public comments for the MRT 1115 Continuous Eligibility waiver amendment can be found here.