NY Medicaid/Essential Plan Income Eligibility and one time large EOY capital gains reporting

I lost my self-employment at the end of 2023. For 2024 I only had NY Unemployment as income, and some capital gains. I've been on marketplace insurance for years, and in October 2024 I updated my income, and qualified for NY Medicaid (qualifying income about $10k I think as of October). I switched from my Marketplace plan to NY medicaid plan, both under MVP provider.

As of Dec 2024, i will be harvesting a large sum of capital gains for tax purposes, which will be reported on my 2024 taxes. The amount is somewhat flexible/planned, based on 0% LTCG rate, but still limited by ACA subsidy income limits being reduced. I might do a one time Traditional IRA -> Roth IRA conversion too, which will count as income also.

My questions are:

Do I need to report this somewhere for NY Medicaid eligibility, and how? I think I'd report on the marketplace, and just update my application there? Is it true there is a 12-month lock-in period on Medicaid I was approved for, or might I move from the basic Medicaid to the 200%-250% NY Essential Plan medicaid? The eligibility limit on income is $51100 for 2024 for my household of 2. I assume I need to be definitely below that for 2024 taxes or risk losing medicaid in 2025 and being booted back to standard ACA? If I report income change in January 2025, is that based on my 2024 tax filing or based on current ongoing 2025 income? Capital gains were a one time 2024 thing, and my unemployed income for 2025 going forward is still $0 right now. If 12 month lock-in is true, come Oct 2025, if I am still unemployed with $0 income, is my income still based on 2024 or is it back to the $0 monthly at that point. I am currently living off savings only.

TLDR. Basically I'm confused about how to handle this large, single time capital gain at the end of 2024, and how it affects 2025 eligibility. Monthly, and later in the year.

submitted by /u/ralphy112
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