In a climate of relentless attacks on immigrants, including as to their right to quality health care, it’s easy to get discouraged. But California has recently provided us with a ray of hope.
In July, California’s Democratic governor, Gavin Newsom, signed legislation to cover (with state funding) an estimated 90,000 low-income undocumented young adults aged 19 to 25 through that state’s Medicaid program. California is the first state to cover some young adults through Medicaid. Coverage will begin in 2020. California immigration advocates had originally hoped to cover far more of the undocumented, including older adults.
The Affordable Care Act — while in many ways a big step forward — failed undocumented immigrants by excluding them from the major benefits of the law, including the right to enroll in Medicaid, to receive subsidies, to purchase qualified health plans (QHPs), or even to enroll in QHPs without receiving a subsidy.
Denying health coverage to the undocumented is punitive, bad health policy and bad health policy. People without health coverage often delay care or go without necessary care, often leading to more severe problems that are ultimately more expensive to treat. And hospitals are required to provide emergency care to everyone, including the undocumented, which means those who disproportionately treat immigrants get an unfair share of the costs.
HCFANY and Coverage4All, a HCFANY project, are campaigning for comprehensive coverage for undocumented New Yorkers through our state’s Essential Plan, which covers people up to 200 percent of the federal poverty line for no or a minimal premium and minimal cost-sharing. We estimate that over 100,000 additional New Yorkers would get coverage. The passage of “Green Light” legislation in 2019 (driver’s licenses for undocumented New Yorkers) and New York City’s creation of NYC Care to provide care to the undocumented gives us reason to hope that we can see action on health coverage. In the 2020 session, we’ll be campaigning for New York to follow California and provide comprehensive coverage for those now denied coverage due to their immigration status.