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.
Today the New York State of Health Marketplace announced which health insurance carriers will be offering plans on the Marketplace for 2016. This encompasses Qualified Health Plans for both individuals and small businesses, the new Essential Plan, and stand-alone dental plans.
The 200,000 individuals who hold policies with Health Republic will have to go shopping for new plans when Open Enrollment begins on November 1st. The CO-OP is winding down operations and no longer issuing renewals. The good news is that sixteen carriers will offer individual QHPs in 2016, and eight for the Small Business Marketplace (SHOP). The definition of a small business is new for 2016: firms with 100 or fewer full time equivalent employees can use SHOP – up from 50 employees in 2015.
While insurers and consumers alike are new to the Essential Plan, there is a strong show of support with 13 carriers offering plans for 2016. Consumers can use this interactive map to see which plans are offered in their county. Some counties, like the Bronx, have eight plans on offer, while New Yorkers in other counties, like Putnam and Schoharie, will only have one plan option if they qualify for the Essential Plan.
The stand-alone dental market is largely the same as 2015, with 11 carriers offering plans, 3 of which offer plans in every county in the state. The maps for dental, individual, and small business plans are available here.
A report released this week by Kaiser Family Foundation shows that 58% of uninsured New Yorkers are eligible for free or subsidized health coverage. The majority of them – 548,000 people – are eligible but not enrolled in Medicaid. There are several reasons why people who are eligible for Medicaid have not enrolled: some do not know they’re now eligible under the Affordable Care Act’s Medicaid expansion, some avoid Medicaid because of the stigma of poverty attached to the program, and some have had their income drop since they last applied for coverage.
The 317,000 New Yorkers who are uninsured but would qualify for financial assistance (such as Cost Sharing Reductions and Advance Premium Tax Credits) on the Marketplace includes consumers who are newly-eligible for the Essential Plan, New York’s forthcoming Basic Health Program. Consumers enrolled in the Essential Plan will have monthly premiums of $0 or $20 a month, no deductible, and very low copays; this combination should assuage the fears of people who believe health coverage is too expensive. The New York State of Health hopes to draw consumers back during the third Open Enrollment period, which begins on November 1, by highlighting these new levels of affordability. They’ll be targeting these 317,000 New Yorkers with videos, social media campaigns, and catchy new graphics (stay tuned for more!).
Nearly a third of uninsured New Yorkers – 457,000 people – are unauthorized immigrants. New York City Mayor Bill de Blasio’s recent announcement on connecting immigrants to care through a “Direct Access” program was a crucial first step for those immigrants living in the City, and Health Care for All New York will continue to advocate for comprehensive health insurance coverage for our undocumented neighbors. New York State has done a fabulous job in the first two Open Enrollment periods in connecting people to coverage, and the rollout of the Essential Plan will be another step in the right direction. A critical next step for closing the coverage gap in New York will be expanding affordable coverage to New Yorkers who are excluded from coverage options because of immigration status.
New York City Mayor Bill de Blasio announced a new plan yesterday to connect the City’s undocumented immigrants with a soon-to-be launched “Direct Access” health care program. The Direct Access program is not insurance coverage, but a network of health care providers with the cultural competency and linguistic diversity to serve New York’s many immigrant communities.
The Direct Access program is outlined in a newly released report from the Mayor’s Task Force on Immigrant Health Care Access, available here. HCFANY Steering Committee members Becca Telzak (Make the Road New York), Claudia Calhoon (New York Immigration Coalition), Sheelah Feinberg (Coalition for Asian American Children and Families), and Elisabeth Benjamin (Community Service Society of New York) served on the Task Force that wrote the report. The report underscores that coverage is the gold standard for care and recommends that ultimately a coverage-based solution be developed for immigrants:
The Task Force believes that all individuals, regardless of immigration status, should have access to affordable health insurance coverage. Accordingly, it urges the State of New York to expand public health insurance options to the undocumented population and urges Congress and the federal government to remove harmful restrictions on immigrant health insurance access.
Consistent with the report’s findings, HCFANY will continue advocated for health coverage for all New Yorkers, regardless of documentation status and lauds New York City for taking this important interim step while the goal is secured.