Despite the extraordinary efforts of health advocates across the country, including CHCs in New York, the federal reconciliation bill passed and was signed into law by the President on July 4, 2025.
This legislation, which was opposed by community health centers, hospitals, nursing homes, providers, and patient advocates nationwide, makes sweeping and harmful changes to Medicaid, Medicare, the Essential Plan, and the insurance marketplace. It is projected to result in over 1.5 million New Yorkers losing health coverage and a $13.5 billion annual loss to New York State. It is the largest rollback of public benefits in decades.
Key provisions impacting health centers and their patients include:
- Medicaid Work Requirements: Beginning December 31, 2026, adults ages 16-64 in the Medicaid expansion population must work or participate in qualifying activities for at least 80 hours per month to maintain eligibility. Medically frail individuals and caregivers for children are exempt.
- Frequent Eligibility Redeterminations: Medicaid expansion adults will be subject to redeterminations at least every six months.
- Immigrant Eligibility Restrictions: Narrows the definition of qualified immigrants eligible for Medicaid and CHIP.
- Limits on Retroactive Medicaid Coverage: Reduces retroactive coverage to one month for the expansion population and two months for traditional enrollees.
- Defunding Planned Parenthood: Bars Planned Parenthood from receiving federal Medicaid funds.
- Medicaid Cost-Sharing: Requires copays for Medicaid services, however, provides an exemption for care provided at FQHCs.
- Rural Health Grants: Establishes a $50 billion rural health grant program that includes FQHCs as potentially eligible recipients, to be determined by the State.
- No Limits on Gender-Affirming Care: The final version does not restrict federal Medicaid funding for gender-affirming care.
- SNAP Program Changes: Introduces stricter work requirements, cost-sharing, and benefit limits in the Supplemental Nutrition Assistance Program (SNAP).
A comprehensive summary and comparison of the current bill’s provisions to earlier versions of the legislation is available from the Kaiser Family Foundation by clicking here.
Click here to view CHCANYS public statement on the passage of the bill.
We will continue to monitor next steps and share additional updates as the provisions in the bill are implemented.