S.2237-B/A.3020-B – EP Coverage for Undocumented Individuals

The New York Health Plan Association (HPA), which represents 26 health plans that provide coverage to eight million New Yorkers, supports S.2237-B/A.3020-B.  The legislation would direct the Commissioner of Health to seek a waiver from the Federal government to use funding in the Essential Plan (EP) Trust Fund to enable individuals who would otherwise meet the criteria to enroll in the program but are currently precluded from participating based on their immigration status.

Every New Yorker deserves coverage for high-quality, affordable health care.  Over the last decade, through the efforts of the State and private sector working together, New York has made remarkable progress in expanding access to health care coverage to millions of residents, achieving near universal health care coverage.

Although New York has also historically been a national leader when it comes to addressing the health needs of our immigrant community, undocumented immigrants represent the last group of uninsured New Yorkers without access to coverage.  While many immigrants obtain private coverage through their employer, family members, or in the individual market, 23% of noncitizens lack coverage.  Additionally, low-income immigrants have fewer coverage options than other low-income residents because of real and perceived eligibility restrictions related to their immigration status.  In their 2022 report, Narrowing New York’s Health Insurance Coverage Gap, the Community Service Society and the Citizens Budget Commission examined a proposal to expand eligibility for low-income immigrants through the creation of a State-only funded Essential Plan option that uses the same income eligibility (individuals with incomes below 200% of the Federal Poverty Level).

According to the report, of the 245,000 immigrants with incomes below 200% FPL, 154,000 are uninsured.  Utilizing moderate enrollment assumptions, the analysis estimated this new EP option would result in 46,000 newly insured immigrants.  The report estimated that by leveraging existing State Emergency Medicaid spending on this population coupled with additional HCRA revenues and a reduction of $19 million in annual uncompensated care costs to hospitals, the annual net State cost of this new program would be $345 million.

A state-funded program in New York providing health insurance to these individuals would be an important step to building a more equitable health care system for all of the State’s residents if the Federal government did not approve the use of federal funds under the EP program.  Other states have taken steps to cover low-income immigrants, including California where Governor Newsom’s 2022-23 state budget included funding to expand the state’s Medi-Cal program to provide coverage for 700,000 undocumented residents ages 26-49 beginning no later than January of 2024.

This proposal would provide access to coverage for hundreds of thousands of New York’s low-income, uninsured immigrants, helping to narrow the coverage gap and further the goal of achieving universal coverage. For these reasons, HPA supports S.2237-B/A.3020-B.