February 9, 2018. New York State has a long and proud history of trailblazing innovative policies that expand access to healthcare coverage to all its residents. From developing and establishing the nation’s first comprehensive health insurance program for children to the launch of the New York State of Health Marketplace under the Affordable Care Act, New York has often been a national leader in expanding access to quality affordable health coverage.
In the midst of federal attacks against immigrants, Governor Cuomo recently announced that recipients of the Deferred Action for Childhood Arrivals policy will continue to qualify for state-funded Medicaid and the Child Health Plus (CHP). That’s welcome news. Of the 42,000 DACA recipients in the state, about 5,000 currently receive state-funded Medicaid. Continuing their coverage, irrespective of what happens to DACA in Washington, is the right thing to do.
Now New York should go further. Citing analysis by the Community Service Society, the Coverage 4 All campaign, led by Make the Road and the New York Immigration Coalition, has proposed raising the upper age limit of CHP from 18 to 29, making health care coverage accessible to undocumented and DACA young adults who are ineligible for Medicaid, Essential Plan, or Marketplace coverage due to their immigration status. That’s a well-grounded idea based on expansion of a program that has proven its value.
Today, CHP covers children in working families who are not eligible for Medicaid and lack access to affordable private coverage. This program offers health coverage through managed care plans on a sliding scale and is open to all children who reside in New York, regardless of their immigration status. With an allocation of $83 million, a report from the Community Service Society concludes, New York would be able to offer quality subsidized health care coverage to undocumented young adults who are excluded from public programs such as the Marketplace or Medicaid because of their immigration status. Of the 90,000 young adults who will become eligible for this program, 27,900 young adult immigrants will sign up for CHP. This estimate is based on a once-a-year open enrollment period (to reduce the risk of adverse selection) and lower take up rates for young adults compared to older adults.1
Extending the upper age limit of CHP from 18 to 29 is a deliberate effort to afford immigrant New Yorkers, regardless of immigration status, with equivalent access to health insurance as other New Yorkers, who can be covered up to the age of 29 under New York’s Insurance law permitting parents to keep their adult children on their job-based plans.2
Making sure immigrant communities are healthy is good for the young people who get coverage, of course, but it’s also good for their classmates, colleagues, and employers, all of whom benefit when the people they work and study with are healthy. Immigrants make up 23 percent of the state’s population, they should not be an afterthought to health care policy. And, as we wait and wait for a federal resolution to the question of legal status for undocumented immigrants, the reality is that they are New Yorkers and have been here often for decades. They are contributing to taxes, helping revitalize upstate cities, providing a key workforce to a range of New York industries, and have high levels of labor force participation.
The uninsured rate for immigrants, however, is more than triple the rate for other New Yorkers: 14 percent compared to 4 percent. Of New York’s 4.5 million immigrants, 610,000 lack health insurance.3 This measure would make an important step toward closing that gap. As Governor Cuomo noted recently, “An investment in young immigrants’ futures is an investment in New York’s future.”4
By: Shamier Settle
1. Elisabeth R Benjamin, “How Can New York Provide Health Insurance Coverage to its Uninsured Immigrant Residents?: An Analysis of Three Coverage Options,” (New York: Community Service Society, January 2016). Cost estimate has been adjusted for inflation since publication.
2. On July 29, 2009, Governor David A. Paterson signed into law Chapter 240 of the Laws of 2009, which extends the availability of health insurance coverage to young adults through the age of 29. Available from: http://www.dfs.ny.gov/consumer/S6030_Age29.htm
3. Fiscal Policy Institute analysis of 2016 American Community Survey.
4. Governor Andrew Cuomo, FY 2018-2019 Executive Budget.