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2024: Our Promise to Immigrant New Yorkers- Let’s Pass Coverage for All

As we usher in the new year, we are presented with an opportunity to honor a commitment made by Governor Hochul in 2022 – by passing and enacting Coverage for All, a bill that would offer health coverage to low-income undocumented New Yorkers. The federal government has since confirmed the feasibility of funding Coverage for All by using surplus “pass-through” funds generated by a 1332 State Innovation Waiver, meaning there would be no cost to the state. Now, all that is neededis the political will to translate commitment into action.

Acknowledging progress, as of January 1, 2024, the state has begun to provide Medicaid coverage to poor people 65 and older regardless of their immigration status. More strides were made last year, when the state announced it would offer Medicaid to low-income people for 12 months after their pregnancy, regardless of immigration status. And now, in response to the testimony of Coverage for All’s primary sponsor in the Assembly and dozens of health industry and consumer stakeholders at a late November public hearing, the state’s proposal includes coverage for New Yorkers who have Deferred Action for Childhood Arrivals (DACA) status. However, failing to provide healthcare to all who need it was a contributing factor to why so many undocumented New Yorkers died during the COVID-19 pandemic.

Colorado and Washington have already used the 1332 waiver to cover undocumented residents.

The Coverage For All bill is an opportunity for New York to use federal funds that may otherwise go unspent and could offset costs that are currently being shouldered by our State and county governments. The State already provides emergency care to residents of the State through a program known as Emergency Medicaid. Unfortunately, this care is only for when a health condition has hit life-threatening levels. Emergency intervention is often more costly than preventative care that could be provided under Coverage for All. In 2022 the amount spent on Emergency Medicaid for those who would potentially be eligible under this expansion exceeded $850 million. A significant portion of this funding could also be repurposed to support the coverage expansion.

The Coverage for All bill has amassed calls to action and garnered support from New York Members of Congress, the New York City’s Mayor, the healthcare industry, and the business sector. We know the well-being of every New Yorker is intrinsically tied to the health of our neighbors, and failing to recognize this puts a greater strain on our healthcare system and economy. In New York City, the NYC Health and Hospitals system already provides care to these neighbors but is unable to receive compensation for it. Implementing this legislation could result in up to five hundred million dollars in State Emergency Medicaid savings, a crucial step towards being more efficient with our state dollars and shrinking our deficit.

Moreover, data suggests that this population of patients is also comparatively more healthy than US-born adults, making this a financially sound investment. For the skeptics, don’t just take our word for it. A recent study published in the JAMA Network by Drs. Kaushal and Muchomba found that “estimates suggest that providing insurance to immigrants costs the healthcare system approximately $3,800 per person per year, less than one-half the corresponding cost ($9,428 per person per year) for US-born adults.” This recent study underscores the economic viability of this policy change – a win-win for all.

While progress has been made, there is more work to do. The State Senate passed the legislation on the floor at the end of the 2023 legislative session and the Assembly has seen an increase in co-sponsorships compared to years prior. The bill has already cleared the Committees on Health but is awaiting consideration by the Assembly Ways and Means Committee.

So many of our state’s leaders, past and present, have pointed to the Statue of Liberty as a beacon of hope that welcomes all to our state–a state that has been built with the support of undocumented immigrants. It is true, and in recent years, when our state suffered the deadliest pandemic of our generation to date, it was these neighbors who rose to the occasion and worked to ensure that our basic needs were met so we could survive as a state and a nation. They deserve the same access to basic services, including healthcare. This year, New York officials at all levels of government must coalesce once again and secure federal assistance during these difficult financial times. Let’s make history by earning the honor of that beacon in our harbor and finally pass coverage for all in New York.

Gustavo Rivera is a state senator representing the 33rd state Senate District in the Bronx. Jessica González-Rojas is an Assembly member representing Assembly District 34 in Queens. They are the lead sponsors of the Coverage for All bill in their respective chambers.

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