Solid Progress in Reaching Diverse Immigrant Communities, but Additional Work Remains

By Claudia Calhoon, MPH, Director of Health Advocacy, New York Immigration Coalition; Laura F. Redman, Director, Health Justice Program, New York Lawyers for the Public Interest; and Sarika Saxena, Staff Attorney, Health Justice Program, New York Lawyers for the Public Interest


The release of the 2015 Open Enrollment report from the New York State of Health (NYSOH) demonstrates that NYSOH made important progress in reaching New York’s culturally diverse immigrant communities this year. The New York Immigration Coalition (NYIC) and New York Lawyers for the Public Interest (NYLPI) supported a number of strategies for effective outreach, such as a Spanish-language version of the web portal and outreach materials in 17 different additional languages. HCFANY is excited to see that New York has made concrete progress toward making the Marketplace friendly and accessible for all immigrant communities.

Other important accomplishments in the report include:

  • 13% of enrollees selected Spanish as their primary language (as opposed to 10% in 2014)
  • 25% of Marketplace enrollees describe themselves as Hispanic, a population that is disproportionately likely to be uninsured (an increase from 21% in 2014)
  • Help from the NYSOH call center was given in 92 different languages, suggesting that information on coverage is reaching a wide array of diverse communities.
  • Availability of an interactive calendar of events, navigation tools, and new “How to” videos in English and Spanish.

These successes point to the Affordable Care Act’s approach of working with in-person assistors, NYSOH Navigators and certified application counselors. Many Navigators and CACs work at strong culturally competent and language proficient immigrant-serving organizations, offering enrollment assistance in a total of 48 different languages.

The report also highlights important areas for improvement for open enrollment 2016 and beyond. Enrollment for French, French Creole, Italian, Korean, and Russian speakers does not appear to have increased. Consumers who speak languages other than English and Spanish would benefit from a calendar, navigation tools, and videos in other languages. immigrant health 2And improved data on racial and ethnic minority and language groups will be essential to help inform targeted and innovative outreach and engagement strategies to make sure all immigrant communities can benefit fully from the ACA. While it is evident that information may be getting to diverse communities, information on enrollment outcomes is not available. Unfortunately, 31% of enrollees chose not to report their race, and 12% chose not to report their ethnicity, which represents a large gap in our knowledge. HCFANY members like the NYIC and NYLPI will continue to work with NYSOH to identify strategies to improve data collection and to educate health consumers about why sharing racial and ethnic identity information is safe and important.

This is the fourth in a series of blog posts about the NYSOH 2015 Open Enrollment Report.

On July 10, 2015 the 5th Circuit Court began weighing the merits of the court case Texas v. the United States. This lawsuit was filed in order to block President Obama’s executive order of November 2014. The President’s order included the expansion of Deferred Action for Childhood Arrivals (DACA)* for young people who came here as children, and created a new program called Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) to allow parents of children born in the United States to apply for administrative relief.

If the program is allowed to move forward, “DACAmented” or “DAPAmented” individuals would be allowed to apply for a social security number and work authorization.   Immigration and health advocates in New York State were jubilant when the President first announced his executive order. Not only do these programs offer undocumented immigrants the opportunity to live without fear of deportation, obtain a driver’s license, and work with the protections of the Labor Department, but individuals who have applied for these programs will be eligible for Medicaid in New York State if they meet income requirements.

It’s estimated that as many as 350,000 New York State residents could potentially be eligible for administrative relief, and as many as half of them could qualify for Medicaid once the programs are in operation.

The timeline following the July 10 hearings is hard to predict. Depending on the outcome of the 5th Circuit decision, either side could ask the Supreme Court to review the case, which would very likely extend into 2016. In the meantime, HCFANY members like the New York Immigration Coalition and Make the Road – New York are working to prepare immigrant communities for administrative relief and taking advantage of the time to get the word out to service providers about Medicaid eligibility. Immigrants continue to wait for relief with high hopes.


* The court case and injunction leaves the original 2012 Deferred Action program unchanged.


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.

This post is part of a two-part blog series on unaccompanied minors in New York. View the first post here. Last month, the Children’s Defense Fund – New York and the Health Care for All NY coalition presented two webinars on unaccompanied minors and access to health services.  The full recordings and materials for Unaccompanied Minors and Health Care Access and Unaccompanied Minors and Behavioral Health Services are available at the HCFANY website.




Guest Post: Lorraine Gonzalez-Camastra, Director of Health Policy,
Children’s Defense Fund – NY

The United States is making steady progress in reducing the number of uninsured Hispanic children, even as the total population of Hispanic children grows, according to a report recently released by Georgetown Center for Children and Families. Since 2009, the number of Hispanic children who are uninsured has dropped by more than half a million, while the total number of Hispanic children grew by more than a million. New York is one of three states nationally that has rates of uninsured Hispanic children that are well below the national average. While this is a huge accomplishment, it is important to consider how the recent surge in unaccompanied children nationally, and in New York State, might impact uninsurance rates. These children will need to be connected to a means for health insurance coverage to avoid an uptick in the uninsurance rate for Hispanics nationally and in New York State, specifically.

In response to the latest surge of unaccompanied children who have arrived in New York State, mainly populating the downstate region, the New York City Council, in partnership with the Robin Hood Foundation and New York Community Trust, has secured resources for legal services to represent these children at immigration and deportation proceedings. Additionally, the Council and Mayor’s Office of Immigrant Affairs have also begun to organize an accessible pathway to social service supports for these children/youth on-site at the federal immigration court in New York City. Most concretely, Mayor de Blasio’s administration has created a resource directory for the unaccompanied minor population so that front-line workers can direct children and families to appropriate support services.

New York State reflects a very diverse demographic.  It can be daunting for newly immigrated families to become acculturated to Americanized social service systems that offer health care, education, and other supports. For children who arrive unaccompanied, the experience can be all the more intimidating.

It is essential that city and state officials employ social service policies that are user-friendly by children and families, especially new immigrants. In New York City and State, we have worked to gain some successes in this area. Moving ahead, we must continue to keep pace with the rising demand of Hispanic and other ethnicities entering our local communities.

Want to learn more? Visit the HCFANY webinars available here and here.