New York Home Care Workers Rally for Medicaid Reform

Advocates push to remove Medicaid long-term care from private insurers, save state $3 billion annually

Published on Mar. 9, 2026

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Home care workers and Democratic State Senator Gustavo Rivera rallied at the New York State Capitol in Albany to advocate for the Home Care Savings and Reinvestment Act. The proposed legislation would remove Medicaid long-term care from private insurers, replacing the current managed care system with a direct fee-for-service model that supporters say would save the state $3 billion per year.

Why it matters

The current privatized Medicaid long-term care system has been criticized for prioritizing profits over quality of care. Home care workers argue the proposed reforms would improve working conditions, increase training, and provide better services for patients who want to remain in their homes.

The details

The Home Care Savings and Reinvestment Act (S2332A/A2018A) would have the state government directly reimburse healthcare providers to manage home care, sidestepping payments to private insurance companies. The bill would also establish care coordination entities, centralize patient transportation services, and create an advisory group to support the transition and monitor quality of care.

  • The rally took place on Monday, March 9, 2026 at the New York State Capitol in Albany.
  • If passed, the new Medicaid payment model would not be implemented until 2028.

The players

Gustavo Rivera

Democratic State Senator and chair of the Senate Standing Committee on Health, who sponsored the Home Care Savings and Reinvestment Act.

Lilieth Clacken

A Long Island home health aide with 30 years of experience, who pointed out that many workers in the sector live in poverty and can't afford health care themselves.

Adria Powell

President of Cooperative Homecare Associates, who argued that direct funding would let agencies properly train their staff and that the current model is too focused on profit.

Eric Linzer

President of the New York Health Plan Association, who has opposed the legislation, arguing it would fail to generate savings and reduce the quality of care.

1199SEIU

The union representing New York's home healthcare workforce, whose members and leaders participated in the rally.

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What they’re saying

“How can we take care of our patients if we cannot take care of ourselves and our families?”

— Lilieth Clacken, Home health aide (mytwintiers.com)

“The proposal's financial assumptions are seriously flawed as it will fail to generate any savings and reduce the quality of care. It would take away the care that more than 300,000 low-income individuals who want to be in their home have come to depend on, while increasing costs for the State.”

— Eric Linzer, President, New York Health Plan Association (mytwintiers.com)

What’s next

If passed, the new Medicaid payment model would not be implemented until 2028, giving time for the state to establish the necessary care coordination entities and advisory group.

The takeaway

This rally highlights the ongoing tensions between home care workers, patient advocates, and the insurance industry over the future of New York's Medicaid long-term care system. Reformers argue that removing private insurers will improve working conditions, training, and quality of care, while opponents warn of disruptions and increased costs.