Bills affecting Medicaid / public insurance in New York — 2026 session

Requires Medicaid to cover gender-affirming care regardless of federal funding; prohibits discriminatory practices by health care entities including hospitals, certain professionals, and insurers; requires insurance coverage for services or treatments for gender dysphoria or gender incongruence.

Defines "mental health clubhouse"; provides that the department of health, in consultation with the office of mental health, shall authorize Medicaid reimbursement for services provided by mental health clubhouses.

Requires all insurance policies and health maintenance organization contracts to provide coverage for maternity patients and their newborns for hospital stays of at least 48 hours following childbirth by natural delivery and 96 hours following childbirth by caesarean section; provides such coverage for patients who are recipients of medicaid.

Requires the commissioner of health to annually make the system of episodic payments, including all pricing mechanisms, available to all Medicaid managed care plans, all child health insurance plans and all essential plans, and to notify all such managed care plans of their responsibilities for ensuring that their enrolled members have access to certified home health agency services.

Requires fiscal notes to be included on any bill which imposes a new mandated insurance benefit or service; expands an existing mandated insurance benefit or service, or adds, expands or requires coverage of any benefit or service under the Medicaid fee-for-service program; requires such fiscal notes to include an actuarial analysis of the potential impact on insurance premiums as a result of such new or expanded mandated insurance benefit or service.

Requires medicaid and insurers to include coverage for testing of PFAS levels in blood; defines PFAS.

Requires health insurance policies and Medicaid to cover patient navigation services.

Requires the Medicaid inspector general to comply with standards relating to the audit and review of medical assistance program funds.

Establishes a program for specific individuals to become complex care assistants and provide private duty nursing services to certain Medicaid enrollees.

Relates to coverage and billing procedures in the Medicaid program for complex rehabilitation technology for patients with complex medical needs.

Removes certain restrictions on eligibility for personal and home care services under medicaid.

Provides that the submission of claims for services provided by home care agencies shall be done on forms approved by the centers for Medicare and Medicaid services.

Authorizes a prenatal and postpartum informational mobile application for individuals who are eligible for Medicaid.

Repeals the state Medicaid spending cap and related processes.

Requires Medicaid to provide comprehensive coverage for the treatment of obesity including coverage for intensive behavioral therapy, bariatric surgery, and FDA-approved anti-obesity medication.

Expands Medicaid coverage to include neuropsychological exams for dyslexia.

Requires a valid government issued photo identification card be presented when casting a ballot; provides for persons eligible for Medicaid to receive identification cards.

Relates to automatic Medicaid eligibility for striking workers.

Ensures that temporary protected status beneficiaries continue to receive Medicaid benefits if the federal government ends the program.

Establishes a 14 member doula Medicaid reimbursement work group within the department of health to set reimbursement rates for doulas in the state Medicaid program and address other criteria related to their practice; requires the work group to conduct a study and evaluate the costs, benefits and issues that may be associated with Medicaid reimbursement for doulas and for providing doula care to Medicaid recipients; makes related provisions.