Advocates for immigrants are urging state lawmakers to pass a bill that would extend New York’s Essential Plan health care coverage to immigrants whose status currently leaves them ineligible for federal support.
In all, an estimated 1 million New Yorkers are uninsured. About 245,000 are currently ineligible for public health insurance due to their immigration status, and among that group, about 154,000 are uninsured.
Proposed legislation known as Coverage for All would create a $500 million fund to support health coverage for poor, uninsured New Yorkers, especially immigrants, regardless of status.
“There's not many places where they can receive care,” said Cara Stratton at Justice for Migrant Families, a Buffalo-based agency which provides legal assistance to immigrants. “This would ensure that you can like go through their immigration proceedings, eventually find jobs, be part of the community. I've worked in situations where people were actually like, the best thing to happen for this person is that he gets re-incarcerated, because there was just no services that would be willing to cover him. And that's really bleak.”
Located on Buffalo’s West Side is the HOPE Refugee Drop-In Center, operated by Jericho Road Community Health Center. It is there where personnel assist clients - refugees and immigrants, specifically - with case management.
They do not ask the client for their immigration status. Dr. Anna Ireland Mongo, chief program officer for Jericho Road, explains that as a federally qualified health center, they’re not allowed to ask a client about status. Nor, she says, would they want to.
“We really see the repercussions of people coming in not having proper health care coverage. We run the Vive shelter for asylum seekers, and lots of times asylum seekers do not have immediate access to Medicaid or other supports to the extent that incoming refugees do,” Mongo said. “And pretty much they're only eligible for emergency services only, which I'm thankful for. And they didn't always even use to be eligible for that.”
Mustafa Ali is HOPE’s program director. He was once a refugee who knows firsthand the difficulty of navigating the healthcare system. He says clients especially need help with mental health coverage, in light of the traumas they’ve suffered along their journey.
He credits living in both urban and rural settings during his own years as a refugee with learning how to navigate the healthcare process. And he points out that such navigation with clients is not limited to simply helping them fill out applications.
The state ultimately decides who is eligible for Medicaid, and Ali says he and his personnel help clients work through any needed appeals.
“If we feel like the eligibility or the determination is not correct, we do call the New York State Department of Health and explain the situation and say, I don't feel this is correct, can you please double check,” he said. “So it's just not about helping and doing the application and you know, you're done for the day. It's more of advocacy, more of, you know, explaining to the family, making sure every document, everything is in place to ensure that the family has health insurance.”
Among those supporting passage of the bill are organizations representing health insurance providers. Leanne Politi, with the New York State Conference of Blue Cross and Blue Shield Plans, says that organization has always supported universal coverage for all New Yorkers.
“New York has dramatically reduced its uninsured rate over the last several years. And we know that the state is on the verge of universal coverage. We also know that within the uninsured rate, which is under five percent, and even lower in upstate New York, especially in the Western New York-Buffalo region, that about half of the uninsured population is currently eligible for some sort of coverage, largely Medicaid, and they can get coverage at any time. The other half of the uninsured population are not currently eligible for coverage. And those are undocumented New Yorkers.”
Immigrants are credited with reversing a longtime population decline in Buffalo and Erie County, and migrant workers are the backbone of many New York State farms. Eric Linzer, president and CEO of the New York Health Plan Association, notes many of those who would finally receive health coverage under the bill served on the front lines of the pandemic as essential workers. He says passage of Coverage for All would provide relief not only for uncovered poor immigrants but also to the hospitals and care providers who serve poorer New Yorkers.
“We've certainly been communicating our support for this to legislators and their staff as well as to the administration. The conversations have gone well,” Linzer said. “They all have been willing to listen and engage on this issue. And we're hopeful that when the budget passes at the end of March that it will include a state-funded insurance coverage option for low income uninsured immigrants who are unable to access coverage because of their immigration status.”
But passage of Coverage for All on time to be included in the new state budget is not guaranteed. Nor is passage at all. Currently, the bill sits in the State Senate’s Finance Committee. Sen. George Borrello, who represents the 57th District, sits on the Finance Committee and predicts it will be a very close vote.
He noted that the bill did pass the State Senate’s Health Committee, but by the slimmest of margins, at seven to six. The Health Committee is made up of ten Democrats and five Republicans. Borrello predicts similar bipartisan resistance in the Finance Committee, suggesting the topic is controversial in Albany.
“When you start talking about things like health care, and caring for vulnerable people, which I understand... you know, our nursing homes are suffering badly. Not only do they suffer because of COVID, but they have had their reimbursement rates for Medicaid cut year after year after year,” Borrello said. “Certainly, Governor Hochul put a very, very modest increase in this year. But under her predecessor, Andrew Cuomo, they're still getting reimbursed at rates from 10 or 15 years ago. So to look at spending $500 million on something like this, when our senior citizens and those on Medicaid in nursing homes are really not getting the funding that they deserve, it’s really very concerning.”
