WORKING OUT THE KINKS: New York’s Department of Health began transitioning more than 147,000 Medicaid and Medicare Savings Program enrollees to an upgraded case management system about a year ago.
Since then, state officials say only a third of them have been able to automatically renew their coverage without assistance.
The shift is part of a $1.1 billion contract aimed at creating an automated system for Medicaid enrollees to receive real-time determinations on their eligibility for the two programs. While the new system is intended to create a seamless enrollment process, for many consumers it’s been riddled with challenges.
The initiative is part of a broader effort to move the Medicaid program away from local social services departments that still rely on paper applications and an outdated system in desperate need of overhaul. The state wants to transition the program to one centralized system run through its public health insurance marketplace, New York State of Health, according to officials.
Lindsay Heckler, managing attorney for policy at the nonprofit Center for Elder Law & Justice, said her firm has seen a surge in inappropriate denials.
“I’m not saying the new system shouldn’t be in place,” Heckler said. “But the concern is that the training and processes that are in place are preventing people from becoming eligible. My concern is that in the coming year they are moving more people into a system that doesn’t have the kinks worked out for the people that are in the system right now.”
The state began rolling out the new Medicaid Eligibility and Client Management system in September 2025. A second wave of more complex cases is expected to migrate to the new system between November 2027 and February 2028. And while state officials say the system — which was created by Deloitte Consulting through a $1.1 billion contract — was thoroughly tested by both the Health Department and the company, they concede that problems remain and are being addressed as they’re flagged.
Advocates describe the situation in starker terms. They say errors have put health care coverage in jeopardy for people who are 65 years and older, blind or disabled. They also told POLITICO they’ve discovered inaccurate information being transferred, a flawed automated asset verification tool and state workers’ inability to manually override inappropriate denials.
Deloitte did not respond to a request for comment.
New York entered into a $177 million contract with Deloitte in August 2023. But that projected outlay has grown to $1.18 billion after the state quietly filed four amendments to the initial deal, which ended on March 31, 2025. The latest amendment included an $866 million extension along with a work plan modification, according to details of the contract listed in the Open Book New York database.
The Health Department said the contract extension will complete the migration of Medicaid enrollees to the new system, which includes more complex cases in the next wave, such as long-term care and nursing home patients. The contract also includes additional funding for Deloitte to conduct testing and ensure compliance with new federal requirements.
“This multi-year transition to a centrally administered model will replace the outdated, expensive, error-prone and inefficient paper-based system with a streamlined, user-friendly platform that better supports the health coverage needs of New Yorkers while reducing the potential for waste, fraud, and abuse,” Health Department spokesperson Cadence Acquaviva said in a statement. “At every step of the way, this transition and contract were subject to extensive federal review and approval by the Centers for Medicare and Medicaid Services.”
Read more in POLITICO Pro from Katelyn Cordero.
MARK YOUR CALENDAR: Join POLITICO’s New York Outlook: Affordability, Industry & The Economy on Oct. 14 for live conversations about the business and policy decisions being made today — from City Hall to the State Capitol — that will shape the city’s economic future. The lineup includes New York City Council Speaker Julie Menin, New York City Economic Development Corp. CEO Anthony Shorris, Partnership for NYC CEO Steven Fulop, Citizens Budget Commission President Andrew Rein, Charles H. Revson Foundation President Maria Torres-Springer, and more. Register now to attend in person or watch the livestream.
From the Capitol
JACOBS WINS: State Democratic Committee Chair Jay Jacobs handily won a new two-year term on the job, receiving 82 percent of the weighted vote at a party gathering in Westchester today.
Jacobs — who angered the left last year by declining to endorse then-Democratic mayoral nominee Zohran Mamdani in the general election — faced a challenge from Otsego County chair Caitlin Ogden. He preached unity as his victory message, inviting Ogden to join his leadership team in a “substantive” role.
“This party has got to come to an understanding that our first priority is electing Democrats in whatever districts they’re in, and speak the language of the people in those districts,” Jacobs said. “All sides of our party need to learn to listen, to understand, to respect each other. There should be no vitriol inside the Democratic Party tent.”
Party members have traditionally supported the governor’s choice for chair. Gov. Kathy Hochul never publicly wavered in her support for Jacobs, making clear in recent weeks he was still her pick.
“I want to thank him for accepting the weight, the responsibilities,” she told party officials today. “Not the easiest job in the state. But he has done it in a way that has brought us together.”
Jacobs, who also heads the Nassau County Democratic Committee, has chaired the state party under the past three governors, serving from 2009-2012 and since 2019. If he completes his new two-year stint, he’d be just one term away from surpassing FDR kingmaker James Farley as the longest-tenured chair in the history of the New York Democrats. — Bill Mahoney
FROM THE CAMPAIGN TRAIL
POLL POSITION: Republican Rep. Mike Lawler and Democratic challenger Cait Conley are locked in a tight race, per a new Emerson College/PIX11 poll.
Conley earned 48% of support to Lawler’s 46%, with 7% of respondents undecided.
Lawler has more crossover support than Conley does, and independents break for him. But the pollsters note the percentage of Democratic backing for him fell from an Emerson survey in October 2024, while Conley’s GOP support increased compared to Lawler’s 2024 opponent, former Rep. Mondaire Jones.
Hochul’s favorability is underwater in the district — 40% of respondents approve and 49% disapprove — though the pollsters acknowledge she’s on better footing than she was in 2024. President Donald Trump is also unpopular, with 43% approving his performance and 53% disapproving. The poll did not ask about Mamdani, a favorite foil of Lawler’s on the trail.
The survey was conducted among 400 likely voters from Sept. 27-29. It has a margin of error of plus-or-minus 4.9 percentage points. — Madison Fernandez
TRUMP TO CNY: Trump is considering a trip to upstate New York on Oct. 9 to appear alongside Republican gubernatorial candidate Bruce Blakeman, according to three people with knowledge of the discussions.
The event is being considered for central New York, but has not been finalized, said a fourth person. The people were granted anonymity to disclose the private conversations about the potential trip.
Blakeman’s campaign did not comment and the White House did not immediately return messages seeking comment.
Trump previously appeared on Long Island this summer to rally with Blakeman and Republican House candidates.
Read more from POLITICO’s Nick Reisman.
FROM CITY HALL
BILLIONAIRE’S ZO: Mamdani hosted fifteen business leaders — several of them billionaires — at Gracie Mansion yesterday for the inaugural meeting of his Business Advisory Council.
The council brings together business executives across industries to help guide the city’s economic policy and shepherd growth and innovation. Despite decrying the ultra wealthy, Mamdani welcomed input from billionaires such as Chobani founder and CEO Hamdi Ulukaya and Jefferson River Capital Chairman Tony James on how to address the affordability crisis, which has inhibited their ability to recruit top talent.
The council also discussed potential plans to convert unused office space across the city into arts and research hubs, according to a spokesperson for the mayor.
While he was welcoming other business execs to his home, one of the mayor’s biggest billionaire foes, Ken Griffin, was announcing his $3 billion donation to Carnegie Mellon University, the largest single donation in the history of American higher education.
Most of that money is earmarked to build the university a new campus in Miami — months after Griffin said the mayor’s rhetoric prompted him to “double down” on investments in Florida, rather than New York.
The Mamdani-Griffin beef swelled this spring when the mayor posed in front of Griffin’s $238 million penthouse in a social media video promoting his pied-à-terre tax. In the post, Mamdani framed the billionaire as a prime target of his tax-the-rich agenda.
Griffin responded by calling the video “creepy and weird,” saying his plans to further invest outside of New York were “an immediate and direct consequence of the mayor’s poor decision.”
“We will welcome anyone’s support, anyone’s involvement, and we will always do so because this is a city that belongs to all who live here,” Mamdani said when asked about Griffin’s historic donation. — Molly Reinmann
IN OTHER NEWS
— RETREAT: NYC first lady Rama Duwaji reportedly sojourned at an Islamic wellness retreat with a history of calling for the destruction of Israel, as her husband was rolling out his blueprint to combat antisemitism. (Washington Free Beacon)
— CHATBOT GOVERNANCE: The Mamdani administration is planning to unroll new AI safeguards, including cracking down on chatbots used in customer service and launching a formal study of AI assistants. (POLITICO Pro)
— SPEEDING THINGS UP: Mamdani’s administration unveiled 12 districts where housing will be fast-tracked. (POLITICO Pro)
Missed this morning’s New York Playbook? We forgive you. Read it here.
