New York state officials have acknowledged that only approximately one-third of more than 147,000 Medicaid and Medicare Savings Program enrollees have successfully used an automated system to renew their coverage without assistance. The transition, which began in September 2025, is part of a broader effort to replace local paper-based processes with a centralized digital platform managed by the New York State of Health marketplace.
The initiative relies on a contract with Deloitte Consulting that has grown from an initial $177 million to $1.18 billion following four amendments filed by the state. While the Department of Health states the new Medicaid Eligibility and Client Management system is intended to reduce waste and improve user experience, advocates report that technical errors and procedural hurdles are jeopardizing healthcare access for vulnerable populations, including seniors and individuals with disabilities.
What the Right Is Saying
State officials defend the transition as a necessary modernization of an outdated infrastructure. The Department of Health maintains that the previous system, reliant on local social services departments and paper applications, was inefficient and prone to error.
Cadence Acquaviva, a spokesperson for the Health Department, stated that the multi-year transition will replace the "outdated, expensive, error-prone and inefficient paper-based system with a streamlined, user-friendly platform."
Officials emphasize that the contract and system design were subject to extensive federal review and approval by the Centers for Medicare and Medicaid Services (CMS). The Department noted that problems are being addressed as they are flagged and that the system was thoroughly tested by both the state and Deloitte Consulting before deployment.
What the Left Is Saying
Advocates and legal aid organizations argue that the rapid implementation of the new system has outpaced the necessary support structures for enrollees. Lindsay Heckler, managing attorney for policy at the Center for Elder Law & Justice, noted a surge in inappropriate denials of coverage.
"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."
Advocates describe the current situation as critical for individuals aged 65 and older, as well as those who are blind or disabled. They cite specific technical failures, including inaccurate data transfers, a flawed automated asset verification tool, and the inability of state workers to manually override inappropriate denials in real time.
What the Numbers Show
The contract with Deloitte Consulting has expanded significantly since its inception in August 2023. Initially valued at $177 million, the total cost has risen to $1.18 billion. The increase stems from four amendments to the original deal, with the latest amendment adding an $866 million extension and modifying the work plan, according to the Open Book New York database.
Since the rollout began in September 2025, more than 147,000 enrollees have been targeted for migration to the new system. State data indicates that only about one-third of these individuals have been able to automatically renew their coverage without assistance.
The migration is proceeding in waves. The current phase involves standard cases, while a second wave comprising more complex cases, such as long-term care and nursing home patients, is scheduled to migrate between November 2027 and February 2028. Deloitte did not respond to requests for comment regarding the contract expansion or operational issues.
The Bottom Line
The New York Medicaid system is undergoing a high-stakes digital transformation funded by a $1.18 billion contract. While the state aims to centralize eligibility determinations to reduce fraud and improve efficiency, the current rollout has resulted in significant service gaps for a majority of initial enrollees.
The state plans to extend the Deloitte contract to complete the migration of complex cases and ensure compliance with new federal requirements. The success of the program will likely depend on the state's ability to resolve the reported technical errors and staffing limitations before the more difficult long-term care population is integrated into the system in late 2027.