New York Medicaid Is Changing: What Families of Children with Autism Need to Know

If your child gets ABA therapy through Medicaid, you may have seen news about cuts and changes to health coverage in New York. Some of it is worrying, and some of it doesn't affect children at all. This guide explains what is changing, what it means for your family, and what you can do now.

Horizon Blue ABA still serves families with Medicaid

You may have heard that some ABA providers in New York are thinking about no longer seeing Medicaid patients. We understand how unsettling that is, especially if your child is making progress. Horizon Blue ABA continues to accept children covered by Medicaid, including Medicaid Managed Care, at our centers in the Bronx and Brooklyn and at home across New York City. Our Intake team will confirm whether your child's specific plan is one we work with.

What is changing, and when

1. Lower payments to ABA providers (in effect now)

Since October 2025, New York Medicaid has lowered what it pays providers for one-to-one ABA therapy three times. The most recent cut took effect on October 1, 2026, and brought the rate to about half of what it was in early 2025. In summer 2026 the State also paused the enrollment of new Medicaid providers, including ABA providers, for at least six months. Provider groups report that many practices are unsure whether they can keep serving Medicaid patients.

What it means for you: the ABA benefit itself has not changed; it remains a covered service for eligible children. But you may hear about providers closing waitlists or leaving Medicaid. If your provider is changing how it serves Medicaid families, contact us and we'll help you look at your options.

2. Children's coverage renews every 12 months again (since July 1, 2026)

Until this summer, children in New York Medicaid and Child Health Plus could keep continuous coverage from birth to age six. That ended on July 1, 2026. Children now go back to 12-month coverage periods, with a renewal each year. Twelve-month continuous coverage for adults on MAGI Medicaid also ended on the same date.

What it means for you: watch your mail for renewal notices and respond by the deadline, so your child's coverage, and therapy, isn't interrupted.

3. New work requirements for some adults (starting January 1, 2027)

Under the federal law passed in July 2025 (H.R.1, also called the One Big Beautiful Bill Act), some adults ages 19 to 64 who get Medicaid through the adult "expansion" group will need to show 80 hours a month of work, volunteering, job training or school, or a monthly income of at least $580 (80 hours at the federal minimum wage). These adults will also renew their coverage every six months instead of once a year.

Children are not subject to work requirements. Several groups of adults are exempt too, including parents and caregivers of a child 13 or younger or of a person with a disability, people who are pregnant or postpartum, and people who are medically frail.

What it means for you: if you are a parent or caregiver on Medicaid, you may qualify for an exemption. Make sure New York has your current address, phone number and email so you don't miss any requests for information.

4. Other changes that may affect parents' own coverage

• Essential Plan: since July 1, 2026, adults with incomes between 200% and 250% of the federal poverty level no longer qualify for New York's Essential Plan. About 450,000 New Yorkers were affected.
• Immigrant eligibility: on October 1, 2026, federal rules narrowed which lawfully present immigrants qualify for federally funded Medicaid. Many people affected may still qualify for state-funded coverage in New York, so check with NY State of Health before assuming your coverage has ended.

Five steps to protect your child's coverage and care

1. Update your contact information with NY State of Health or your local Medicaid office.
2. Open every letter about your coverage and respond by the deadline.
3. Keep your child's paperwork handy: the autism diagnosis and the ABA referral. Under New York's Medicaid policy, a referral is valid for up to two years.
4. Get free help if you need it. In New York City, call the NYC Health Department at 866-INSURED (866-467-8733) to speak with a counselor, or visit nyc.gov/medicaidhelp. Statewide, visit NY State of Health.
5. Ask your ABA provider whether they will keep serving Medicaid patients. If you need a new provider, start an intake with Horizon Blue ABA.

New to ABA? Read What Is ABA Therapy? A Parent's Guide, or see what in-home ABA looks like.

Frequently asked questions

This article is general information, not legal, medical or insurance advice. Rules and dates can change; check with NY State of Health or your health plan about your family's situation. Information current as of October 2026.