New York’s Medicaid program began doing something in January 2025 it had never done at scale: paying for food, rent and rides. The shift came as the state launched nine regional Social Care Networks on Jan. 1, 2025, the operational core of a federally approved Medicaid waiver that treats unmet social needs as a reimbursable part of health care.

The networks operate under New York’s 1115 New York Health Equity Reform (NYHER) waiver, a roughly $7.5 billion, three-year investment that the federal Centers for Medicare and Medicaid Services approved on Jan. 9, 2024, and that runs through March 2027. The premise is “food as medicine” writ broadly: that addressing hunger, housing instability and lack of transportation can improve health outcomes and ultimately reduce costlier medical care.

What the waiver now pays for

Under the waiver, Medicaid can reimburse a defined menu of “health-related social needs,” or HRSN, services. Those include:

  • Nutrition — nutrition counseling, home-delivered meals, and pantry and cooking supplies.
  • Housing — rent assistance, temporary housing, and utility setup.
  • Social care management — outreach, referrals and navigation.
  • Transportation — non-medical rides connected to social-needs services.

New York State began reimbursing the Social Care Networks and their partners for these services in January 2025, marking the point at which the policy moved from approval to payment.

How the networks are built

Each of the nine regions has a lead entity responsible for assembling and contracting a network of community-based organizations — food pantries, meal providers, housing groups and others — that actually deliver the services. The lead entities will collectively receive $500 million over three years for the infrastructure and coordination work of standing up those networks. Separately, the state has allocated more than $3 billion to fund the enhanced HRSN services themselves.

The design deliberately routes Medicaid dollars to community organizations that have long done this work on thin grants and donations, giving them, for the first time, a billable relationship with the health-care system. State officials and policy groups have framed that as a way to make community-based organizations more financially sustainable while plugging them into Medicaid’s data and referral plumbing.

Who gets screened

The program’s reach is broad on paper. All Medicaid members — both fee-for-service and managed-care enrollees — can be screened for health-related social needs. The state’s intent is for every member to receive an HRSN screening annually, or sooner after a major self-reported life event such as a job loss, eviction or new diagnosis. Members who screen positive and meet eligibility criteria can then be connected to the enhanced services.

That scale matters in New York City, where a large share of residents are covered by Medicaid and where housing and food insecurity are concentrated. The Social Care Networks effectively give the city’s Medicaid population a new pathway to social services that are billed through, and coordinated by, the health system rather than navigated piecemeal.

A bet still being measured

The waiver is a bet — that spending Medicaid money upstream on meals and rent will pay off downstream in fewer emergency visits and hospitalizations. Whether it delivers those savings is the question the demonstration is designed to answer over its three-year run. The structure builds in screening, referral and outcome tracking, and the program’s fate after March 2027 will hinge on what that data shows.

For now, the practical change is concrete: as of January 2025, a New Yorker on Medicaid who can’t afford rent, lacks transportation to care, or needs medically tailored meals has, in principle, a covered benefit to turn to — coordinated through one of nine regional networks the state stood up to make it happen.

Verification

Frequently Asked Questions

What are Social Care Networks?
Regional networks of contracted community organizations that screen Medicaid members for unmet social needs and connect them to — and now pay for — services like home-delivered meals, rent and utility help, and transportation. New York launched nine of them on Jan. 1, 2025.
What does the program pay for?
Enhanced 'health-related social needs' services reimbursable under the waiver include nutrition (counseling, home-delivered meals, pantry and cooking supplies), housing (rent assistance, temporary housing, utility setup), social care management, and transportation.
How big is the waiver?
New York's 1115 New York Health Equity Reform (NYHER) waiver is a roughly $7.5 billion investment over three years, approved by CMS on Jan. 9, 2024 and running through March 2027.
Who can be screened?
All Medicaid members — both fee-for-service and managed care — can be screened for health-related social needs, intended annually or after a major self-reported life event.