NYS DOH Announced Submission of 1115 Waiver Amendment for Continuous Eligibility for Medicaid and Child Health Plus to Children Under Age Six

The New York State Department of Health announced on July 11th 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.

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 30-day federal public comment period on the waiver is now open. The deadline to submit comments is July 26 on CMS's website here. More information on the MRT 1115 Continuous Eligibility waiver amendment can be found here.

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