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.