The ACA has helped New York close the coverage gap by enrolling over 2.7 million New Yorkers into coverage. But some New Yorkers remain ineligible for these new options for affordable coverage because of immigration status limitations on affordability programs.
The Community Service Society, a HCFANY Steering Committee member, released a new report today that offers an in-depth analysis of costs, eligibility and coverage options related to providing affordable and high-quality health insurance to nearly a half million unauthorized immigrants living in New York who are uninsurable due to their immigration status.
The paper, “How New York Can Provide Health Coverage to its Uninsured Immigrant Residents,” describes three coverage options that would improve health coverage for a vulnerable segment of the state’s population while also closing the coverage gap left by the Affordable Care Act (ACA).
Despite the state’s expansive public insurance programs, there are as many as 457,000 unauthorized immigrants ineligible for coverage. Uninsured people are more likely to get sick and even die younger, and the cost of care can mean financial ruin for uninsured families. Treating uninsured patients also strains the budgets of community health care providers that treat them.
The policy paper investigates three coverage options that would extend health insurance to between 90,100 and 241,600 immigrants New Yorkers who are ineligible for Medicaid and Marketplace coverage due to their immigration status. Funding even the most ambitious of these proposals would result in a less than one percent increase in the state’s health budget of roughly $65 billion.
The report also points out a more modest policy fix that New York could enact this year, while the State considers the more comprehensive options outlined in the report. This option, the Essential Plan “Clean Up,” would extend Essential Plan coverage to about 5,500 lawful immigrants in New York with immigration statuses that would make them eligible for Medicaid in New York, but not for the federally-funded Essential Plan. These New Yorkers include young adults who qualify for Deferred Action for Childhood Arrivals status, also known as the Dreamers.
High rates of un-insurance among lesbian, gay, bisexual and transgender (LGBT) people have finally started to drop because of the affordable, nondiscriminatory health coverage options made possible by the Affordable Care Act (ACA). The LGBT uninsured rate fell from 24.2 percent to under 18 percent in the first year of operation of ACA health marketplaces, according to national Gallup surveys. But that was still significantly higher than the 13.2 percent un-insurance rate for the U.S. population as a whole.
That’s why Health Care for All New York is reaching out to uninsured LGBT New Yorkers as they participate in Pride celebrations in June and July. Raising Women’s Voices-NY, a HCFANY Steering Committee member, will be at every Pride Month celebration in the New York City area, handing out LGBT-specific information, and collecting contact information for uninsured people and connecting them to navigators who specialize in working with LGBT consumers for enrollment assistance.
Big selling points this year are the recent New York State policy announcements requiring health insurers to cover all medically-necessary transgender care. HCFANY’s LGBT Task Force is delighted to see that the New York Department of Financial Services responded to our concerns by issuing a guidance letter covering private health plans. HCFANY is also educating LGBT New Yorkers about the March 2015 partial lifting of transgender exclusions in state Medicaid coverage.
We’re letting LGBT New Yorkers know that if they are getting married, having a baby or experiencing one of a list of “qualifying life events,” they are eligible for a special enrollment period to apply for coverage through the NY State of Health marketplace. Low-income LGBT people can apply for Medicaid or Children’s Health Insurance Program coverage for themselves and their families year-round. The third open enrollment period for ACA health coverage starts on November 15.
RWV-NY Community Organizer Liza Lederer and summer intern Christianna Silva were at the Brooklyn Pride festivities on June 13, handing out materials and talking with uninsured LGBT people about how to get covered. More than 10,000 people attended Brooklyn Pride, which occupied six blocks in Park Slope Community. Many of the vendors at the festival were self-employed people interested in getting health insurance for the first time, reported Lederer. The following day, June 14, RWV-NY participated in Rockland Pride, which was held in the village of Nyack, and was attended by more than 2,000 people from the Rockland LGBT community.
Coming up on Saturday, June 27, will be Harlem Pride, where RWV-NY staff will do outreach to uninsured LGBT people in the neighborhood. Then, on Sunday, June 28, is the big Pride Festival in Manhattan, which draws more than 200,000 people from around the country. RWV-NY staff and volunteers will be leafleting and collecting names of uninsured people along the parade route and in the exhibit and vendor area that stretches over five blocks in the West Village. Pride activities in the New York City area will conclude on July 17, when RWV-NY will have a table at Bronx Pride, which will be held from noon to 8 p.m. in Crotona Park.
Guest post: Lois Uttley, Director, Raising Women’s Voices – NY
All this week, HCFANY’s LGBT Task Force has been sponsoring events to reach uninsured LGBT New Yorkers with information about how to get enrolled in an affordable health insurance plan before the Feb. 15 deadline of open enrollment through the NY State of Health Marketplace.
An event on Tuesday in Jackson Heights, Queens, highlighted the fact that this is also national Latino outreach and enrollment week, and underscored the particular challenges facing LGBT New Yorkers who are also immigrants. The event was held at Voces Latinas, a NYS-certified Navigator agency that partners with the LGBT Community Center to serve the many Spanish-speaking LGBT people who live in Queens.
“Within New York City, LGBT individuals are disproportionately uninsured. These numbers increase when we factor immigration status and language barriers,” explained Nathaly Rubio-Torio, Executive Director of Voces Latinas. “Our navigators are bilingual, bicultural and fully culturally competent.”
Rubio-Torio (at left in photo) was joined at the event by (left to right in photo) NYC Council Member Danny Dromm, who represents Jackson Heights and is a member of the Council’s LGBT Caucus; Luis Scaccabarrozzi, Director of Health Policy and Advocacy for the Latino Commission on AIDS; Alexander Cortes, an enrollment specialist with Voces Latinas; and Lois Uttley, Co-Chair of HCFANY’s LGBT Task Force (not pictured).
Another of the organizations participating in this week’s events also has a special mission of serving LGBT immigrants. Make the Road NY is sponsoring an LGBT information and enrollment event this Friday night, January 16, from 6 to 8 p.m. at its 301 Grove St. Brooklyn office.
Guest Post: Kari Siddiqui, Policy Analyst, Schuyler Center for Analysis and Advocacy
Everyone cheered when the Affordable Care Act (ACA) included a provision allowing young adults to stay on their parents’ health insurance until they turned 26. An equally important and lesser-known provision extends health insurance coverage to young adults formerly in foster care, who are unlikely to have the option of receiving health coverage through family. The ACA extends Medicaid access to these youth, with no income restrictions, until they turn 26.
The Medicaid to 26 provision went into effect in January 2014 and offers health insurance coverage to the more than 20,000 youth who age out of foster care across the country each year. In New York State alone 1,283 youth aged out of foster care in 2012. These young adults particularly need health coverage as they transition from foster care into their independent adult lives.
The Schuyler Center for Analysis and Advocacy, a member of the HCFANY steering committee, is working to ensure that young adults can take advantage of this benefit. With input from our State partners, the New York State Department of Health and the Office of Children and Family Services, Schuyler Center developed materials to help youth understand and access this benefit. Young adults with ties to foster care – those still in care and those who have aged out – are helping us to shape the message, target outreach, and design materials. Their input helps us understand how to reach youth where they are and communicate effectively.
Drawing on this input, Schuyler Center developed outreach and education materials, including a brochure with an application checklist, newsletter articles, videos (like the one above featuring Shanice), a youth-targeted Everything You Need to Know guide to the Medicaid to 26 benefit, as well as a toolkit for providers. Please join us in these outreach efforts, and use the materials we’ve created to reach youth and providers in New York State and in your communities across the country. Follow Schuyler Center on Twitter at @SchuylerCenter using the hashtag #Medicaidto26 and find all materials on our website: www.scaany.org/scaa-resources/medicaid-to-26