Dear Director Cooper:

Pursuant to the terms of the New York State Medicaid Section 1115 Demonstration Medicaid Redesign Team (MRT) Waiver (11-W-00114/2), New York State (NYS or the State) is pleased to submit the enclosed waiver amendment proposal to the Centers for Medicare and Medicaid Services (CMS) for its approval.

New York State is requesting approval from CMS for an amendment to its MRT 1115 Demonstration that would keep children enrolled in health coverage, improve continuity of care, and promote health equity. The amendment would authorize continuous enrollment for Medicaid and Child Health Plus (NYS’s Children’s Health Insurance Program) coverage for children during the first six years of their lives and federal Medicaid and Children’s Health Insurance Program matching funds without regard to whether a child’s family income exceeds eligibility limits. As of March 2024, there were a total of 2.2 million children enrolled in Medicaid and 493,206 enrolled in Child Health Plus (CHP), while only 2.6% of children were uninsured.

Through this amendment, NYS is seeking to ensure continuous Medicaid and CHP coverage for children during the first six years of their lives. This proposal is aimed at ending churn for young children and will not change eligibility limits for Medicaid or CHP. New York State estimates that an average of 66,177 young children will receive continuous enrollment on an annual basis as a result of this proposal. We estimate the total State and federal funds to implement continuous enrollment will be $60 million annually.

New York State has fully complied with federal transparency requirements in preparation for formally submitting this waiver amendment proposal. New York State transmitted tribal and public notices referencing the preliminary proposal draft (January 17, 2024), conducted virtual public hearings (February 21, 2024, and February 28, 2024), and received 34 verbal and written comments. The State’s engagement with stakeholders informed the structure and substance of this submission and have been addressed in the attached waiver amendment application.

The partnership between CMS and NYS continues to be important to the success of the underlying 1115 Demonstration MRT Waiver and will also be critical to this amendment’s success. We look forward to continuing to work with you and your colleagues. If you have any questions, please contact me at or .

Sincerely,

Amir Bassiri Medicaid Director
Office of Health Insurance Programs

cc: Jonathan Morancy, CMS
 &nsbp; &nsbp;Nicole McKnight, CMS
 &nsbp; &nsbp;Francis McCullough, CMS
 &nsbp; &nsbp;Juliana Sharp, CMS
 &nsbp; &nsbp;Melvina Harrison, CMS
 &nsbp; &nsbp;Selena Hajiani, NYS DOH
 &nsbp; &nsbp;Simone Milos, NYS DOH