New York 2026 State of the State Address – January 13, 2026

January 15, 2026

Overview

On January 13th, Governor Kathy Hochul delivered her annual State of the State speech, which outlines her policy agenda for the 2026 New York State (NYS) Legislative Session. The accompanying State of the State Book describes the Governor’s proposed agenda across 11 sections.
Some of the notable health-related proposals in the 2026 State of the State include: 

  • Extending the Safety Net Transformation Program;
  • Developing extensive youth mental health initiatives;
  • Strengthening oversight of healthcare transactions; and
  • Increasing transparency of prior authorization policies.

Further details, including legislative language for proposals that require funding appropriations, will be included in the Governor’s upcoming Executive Budget and Financial Plan, which are expected to be released later next week.

A full summary of proposals relevant to health care providers and stakeholders in the State of the State is provided below. The 2026 State of the State book is available here.

Safety Net Transformation Program

The Governor proposes to allocate additional resources to the Safety Net Transformation Program to support new projects under the program and reach an increasing number of struggling safety-net hospitals. Furthermore, additional funding will allow support for innovative projects, such as including partnerships that focus on regional planning to improve coordination of care and reduce duplication of healthcare services, and partnerships that utilize AI to improve efficiency and quality of care.

Artificial Intelligence Technology

Governor Hochul plans to direct the Department of Health (DOH) to establish a consortium consisting of experts in healthcare and AI, with the goal of sharing data and best practices, and strengthen cross-sector collaboration around building, testing, and deploying safe and effective AI tools. To ensure equitable access, Governor Hochul will incentivize partnerships between safety-net hospitals and other healthcare partners to implement AI solutions that improve quality of care and strengthen operations. In addition, the State will develop systems to evaluate and launch best-in-class AI tools within DOH, the Medicaid program, and New York’s Office of the Medicaid Inspector General (OMIG) to strengthen program integrity.

Oversight of Healthcare Transactions

Since 2023, the New York Material Transactions Law requires healthcare entities to report transactions that increase revenues by $25 million or more. To strengthen oversight of these entities, Governor Hochul will expand this law to require ongoing reporting on the actual impact of closed material transactions, along with external reviews for high cost, high impact transactions.

Certificates of Need

In order to streamline the Certificate of Need (CON) process, the Governor intends to direct DOH to make the process more efficient and targeted.

Healthcare Workforce

The Governor proposes several pathways to improve access to healthcare through workforce investments, including the following: 

  • Extending the scope of practice for critical workers, including allowing certified nursing assistants (CNAs) to administer medication in nursing homes, physician assistants to practice independently, and medical assistants to administer vaccinations. The state law will also be amended to allow DOH to verse and make additional changes to licensed professionals’ scope of practice.
  • Introducing legislation to reduce reliance on temporary healthcare staff.
  • Maintaining funding for the Career Pathways Training (CPT) Program and the Health Care Access Loan Repayment Program (HEALR).

Health Insurance

The Governor reiterated her decision to apply to the Centers for Medicare and Medicaid Services (CMS) to return the Essential Plan to a Basic Health Program. The Governor also intends to direct DOH to negotiate with the federal government to develop affordable coverage options for the nearly half a million New Yorkers who will lose their current Essential Plan coverage in the transition.

Prescription Drugs

Governor Hochul plans to direct DOH to identify and target specific classes of high-cost drugs for direct negotiations with manufacturers to achieve better discounts for the State and drive savings for the Medicaid program.

Prior Authorization

The Governor intends to create transparency around prior authorization, specifically: 

  • Requiring drug formularies to be posted publicly and in a standard, accessible format.
  • Extending length of coverage for prior authorizations for designated chronic conditions.
  • Expanding “continuity of care” (the period insurers must cover out-of-network treatment for new patients) from 60 days for life-threatening conditions to 90 days for all conditions and the full post-partum period.
  • Increasing requirements for the data that health insurance companies report on claims processing, including the frequency and denial rate of prior authorization requests.
  • Launching a public education campaign highlighting resources available to consumers and providers to navigate insurance challenges.

Workers’ Compensation

New York requires special authorization for healthcare providers who treat workers’ compensation claimants. The governor plans to eliminate this authorization process and allow any eligible licensed medical provider in good standing to treat workers’ compensation claimants.

Older Adults

The Governor proposes to promote the safety and well-being of older adults by: 

  • Increasing investments in Naturally Occurring Retirement Communities, which are housing developments or neighborhoods with large populations of older adults where community providers offer supportive services for residents.
  • Renew the $35 million investment made in state fiscal year (SFY) 2026 to reduce waitlists for nonmedical in-home services such as personal care, case management, home delivered and congregate meals, and transportation.
  • Launch the Community Aging in Place – Advancing Better Living for Elders (CAPABLE) program, to give 2,600 older adults in-home visits for nursing, occupational therapy, and other services.
  • Launch an educational awareness initiative to inform clinical providers and staff about options for community-based palliative care, hospice care, and the importance of advanced care planning.
  • The creation of free, virtual, and accessible training modules on elder abuse prevention and response by the New York State Office for the Aging (NYSOFA).
  • The creation of a short term, multi-agency council to create a list of all benefits relevant to older adults and present recommendations to the Governor on options for a “one-stop shop,” which would allow New Yorkers to identify benefits they might be eligible to apply for. The council will also explore the option of a universal benefits application.

Immunization

The Governor proposes to advance legislation to ensure that New York can set its own immunization standards. The proposal will authorize the Commissioner of Health, in consultation with recognized medical organizations, to establish immunization requirements that will guide school eligibility, clinical practice, and insurance coverage.

Vital Records

Governor Hochul proposes the following improvements to the vital records system: 

  • Digitize archival records for genealogical requests, including converting historical birth, death and marriage certificates into searchable formats.
  • Reduce the living records request backlog and improve operational efficiency.

Cardiac Emergency Readiness

Governor Hochul proposes a multi-faceted approach to improve cardiac emergency readiness: 

  • Strengthen cardiac emergency readiness statewide by building on a successful model pioneered at the University at Buffalo to establish regional training hubs and ensure communities know how to use Automated External Defibrillators (AEDs) and support new, scalable approaches to hands-only CPR education.
  • Dispense with outdated red tape restrictions on the installation of fully automated AEDs and create New York’s first statewide AED registry.

Pain Management

Governor Hochul proposes the development of a comprehensive Pain Management and Drug Control Strategy focused on preventing opioid misuse and treatment, strengthening prescription oversight, and promoting best practices in pain management across the healthcare continuum.

Child Care

The Governor proposes a major expansion of New York State’s child care and early education system. The proposal commits an additional $1.7 billion in new funding to expand access to care for nearly 100,000 additional children statewide. Key elements of the proposal include: 

  • Pilot and scale a 2-Care initiative in NYC to provide free child care for two-year-olds, beginning with high-need areas and expanding citywide to serve over 30,000 children within four years.
  • Strengthen and better align NYC’s 3K program with family demand.
  • Invest $1.2 billion, a 40% increase from the SFY 2026 Enacted Budget, in the State’s Child Care Assistance Program (CCAP) to support low-income families access child care statewide.
  • Uncouple New York’s Child and Dependent Care Tax Credit from the federal tax code, simplifying access and increasing benefits by an average of $575 for approximately 230,000 families statewide.
  • Direct State and local agencies to review and streamline child care regulations to reduce barriers to opening and operating programs while maintaining safety standards and fiscal oversight.
  • Strengthen the early childhood education workforce by expanding scholarships and tuition aid and embedding key credentials into SUNY and CUNY programs.

Youth Mental Health

The Governor proposes numerous initiatives to support youth mental health, including the following: 

  • Make Teen Mental Health First Aid training available to 10th graders.
  • Create partnership between the Office of Mental Health (OMH) and a national crisis center to provide LGBTQ+ youth with access to trained crisis counselors.
  • Develop a hotline and resource website for the LGBTQ+ community.
  • Establish a new “Schools of Distinction in Supporting Strong Mental Health” designation to recognize and financially reward schools that provide effective mental health supports.
  • Publish a 10-year training roadmap for the implementation of evidence-based practices.
  • Direct OASAS to open up 15 new Youth Clubhouses, co-located with existing Recovery Community and Outreach Centers.
  • Direct OASAS to establish the state’s first Young Adult Recovery Residence for up to 35 young adults with substance use disorder and opioid addiction.
  • Partner with Tribal Nations to support Indigenous students’ mental health.
  • Create safe online environments for young people, including:
    • Restrict the use of integrated AI chatbot features on social media by children.
    • Limit direct messages from non-connections to minor accounts.
    • Default children to the highest privacy settings on covered platforms.
    • Stop young people from interacting with betting apps.
    • Develop resources for students, teachers, and parents to support responsible technology use.

Suicide Prevention

Governor Hochul proposes that OMH and key agencies will participate in a three-year suicide prevention action plan to raise awareness of risk factors including housing instability, financial insecurity, and limited access to culturally responsive care.

Behavioral Health Supportive Housing

The Governor proposes to invest $71 million to increase rates for community-based housing for those in recovery. The goal is to ensure that these programs, overseen by OMH and OASAS, have sufficient resources to maintain housing capacity for more than 23,000 individuals in recovery.

Cannabis Care and Health Equity

Governor Hochul proposes the establishment of a Center of Excellence for Medical Cannabis and Health Equity. The Center will train clinicians on cannabis pharmacology, evidence-based care, and patient counseling.

Substance Use

The Governor seeks to address substance use issues in the following ways: 

  • The establishment of GRACE (Guided Recovery Action through Congregational Engagement), an initiative to engage faith leaders serving communities of color in New York’s comprehensive approach to addressing the overdose crisis statewide.
  • Allowing clinics to provide mental health and substance use services under a single, jointly issued license.
  • Introducing a new Co-Occurring Capable (CoC) designation for qualifying OMH and OASAS-certified providers.

Food Benefits

Governor Hochul proposes to require schools participating in the State’s universal free meals program to provide links from their websites to the Office of Temporary and Disability Assistance (OTDA’s) MyBenefits portal, streamlining SNAP access for families.

Individuals with Disabilities

To support individuals with disabilities, the Governor proposes numerous initiatives, including: 

  • Direct the Empire State Development (ESD) to create a new Assistive Technology Innovation Center that will foster public-private collaborative efforts to support the research, development, and access of assistive technologies for individuals with disabilities and older adults aging in place.
  • Invest in the Bolstering Biotech Initiative that will accelerate the commercialization of life-changing therapeutics, with a focus on neurodegenerative disease, through the establishment of a Statewide Clinical Trial Consortium, venture capital investments, fellowships and skills-training programs, and a new Commercialization Grant Program.
  • Issue guidance to improve access to ASL and other sign language interpretation across state agencies.
  • Direct the State’s Early Intervention (EI) and Early Hearing Detection and Intervention (EHDI) programs to investigate and address the gaps in follow-up screenings for infants.
  • Expand income eligibility limits for certain rent freeze programs for New Yorkers with disabilities living in regulated housing.