Last year, in her first budget as New York’s chief executive, Governor Kathy Hochul and the State Legislature agreed to extend comprehensive health coverage to immigrants over 65 who are ineligible for insurance because of their immigration status. It also extended Medicaid coverage – to all pregnant people, including immigrants — in their first year post-pregnancy.
Both mark progress toward covering all New Yorkers. Given New York’s unconscionably high maternal mortality rate, especially for Black and Latino families, this extension of post-pregnancy coverage in the first year of the life of a child was significant. But these incremental gains fell short of our calls for expansion to all low-income immigrants, who are far more likely to be uninsured than their citizen counterparts.
After her first budget, the governor asked for patience as her administration searched for a solution to tackling the larger issue of extending coverage to all immigrants of all ages, something she indicated she would pursue in her FY24 budget through applying for a Section 1332 Waiver under the Affordable Care Act.
On that basis, we expected the governor to use this year’s budget process to secure authority to cover immigrants and chip away at the state’s coverage gap—by seeking federal underwriting to do so.
But instead of taking advantage of the opportunity to have the federal government cover the cost of health insurance for immigrants, the governor’s current budget proposal features waiver language that excludes immigrants. In doing so, the state is passing up an opportunity to save more than $500 million annually on Emergency Medicaid funds spent on immigrant emergency care.
And that’s not all. Opting to fund immigrant coverage through a federal waiver would support our distressed hospital system by yielding relative rich Essential Plan reimbursement rates and defraying their uncompensated care costs ($1,174 per person covered each year) since more New Yorkers would have insurance.
Other states, including California, Colorado, Illinois and Washington State have all moved forward on immigrant coverage. New York should be a leader, not a laggard, on progressive health care initiatives.
As Albany lawmakers negotiate a budget, it is imperative that immigrant coverage is included in the 1332 Waiver and its implanting statute. And that our governor keeps her pledge to fund immigrant coverage.
David R. Jones, Esq., is president and CEO of the Community Service Society of New York; Theo J. Oshiro is co-executive director of Make the Road NY