Reviving a Muni-Based Health Care Option for NYC’s Uninsured and Undocumented

City Hall in NYC/ (Photo: By Christopher Lee via Documented)

How will New York City respond if the federal government goes ahead with plans to redefine “public charge” to include a wide array of non-cash benefits, putting the health and welfare of hundreds of thousands of immigrants at risk? City officials have vowed to fight the move, meant to restrict the number of applicants for permanent U.S. residence, and the comment period for the proposed changes in definition recently closed.

Beyond opposing the move, though, there is something that city officials could do to extend health care to the uninsured, many, but not all of whom, are undocumented. Based on a pilot program that stopped in 2017, and a program adopted in San Francisco some years ago, they could offer access to comprehensive health care through a municipal access program, writes Felipe de Hoz in Documented. Coincidentally, he notes, a federal judge in Texas last week declared the Affordable Care Act unconstitutional, while single-payer insurance is likely to be debated in the New York State Senate. A municipal plan could prove easier to implement than a state plan, writes de la Hoz:

“A lot of the pieces are in place, and that’s one of the reasons that doing this in New York City wouldn’t be as hard as in other places,” said Max Hadler, the Director of Health Policy at the New York Immigration Coalition. He has been speaking with “pretty much anyone who would listen” in city government about the benefits of a building out a citywide access-to-health program, he said.

The New York pilot project, ActionHealth NYC, ran for one year until June 2017 and provided benefits to 1,265 uninsurable New Yorkers, comparing outcomes with results for a control group of 1,139 others. It offered reduced health costs through managed care at the city’s clinics and hospitals or through community-based Federally Qualified Health Centers (FQHCs), and referrals to specialists. Evaluations of the program were positive.

Naturally, such a program would be costly, and the city wouldn’t want to pull in people who might otherwise qualify for federal assistance.

Go to Documented to read comments about the idea from Mitchell Katz, the CEO of NYC Health + Hospitals, who when he ran San Francisco’s public health department created the first municipal subsidized medical care program, Healthy San Francisco. And find out what City Council Speaker Corey Johnson, council member Mark Levine, and Robert M. Hayes, president of Community Health Network, an FQHC in New York, have to say about the possibility of a city-based health access program in NYC, in the story in Documented.

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