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.

Already more than two million New Yorkers have gained affordable health coverage through the NY State of Health marketplace, but there are still some people (namely women!) who may find themselves left behind. First-in-the-nation legislation providing special insurance enrollment options for pregnant women passed both the State Assembly and State Senate a few weeks ago and awaits the Governor’s signature.baby talking 2

In the past, moderate- and higher-income uninsured women who become pregnant had to wait to enroll in private health insurance. Low-income women can enroll in Medicaid at any time, but their higher-income counterparts can be left without affordable prenatal and maternity care. Lack of coverage can lead poor health outcomes for mom and baby. Improved maternal and child health outcomes support the New York State Prevention Agenda, and it’s the right thing to do.

Senate Bill 5972/Assembly Bill 6780-B creates a special enrollment period (SEP) for uninsured women who become pregnant and seek coverage outside of the open enrollment period. HCFANY urges Governor Cuomo to sign it into law. You can send a message here or call 518-474-8390 to ask him to sign S.5972/A.6780-B today!

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.

Pride table

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.Pride outreach

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.