AOC, Nadler and other NY pols call on Hochul to extend health coverage to undocumented migrants

Members of New York’s congressional delegation, including Reps. Jerry Nadler and Alexandria Ocasio-Cortez, sent Gov. Kathy Hochul a letter on Tuesday urging her to expand public health coverage to undocumented immigrants in the upcoming state budget.

“We believe that health care is a human right, regardless of immigration status,” the federal lawmakers wrote.

Hochul received a similar letter this week from city Comptroller Brad Lander and other local politicians from across the state. Mayor Eric Adams fired off his own version last week. All are hoping to reverse Hochul’s stance on the issue as budget talks continue past the April 1 deadline. The measure was left out of the budget the governor proposed earlier this year.

Some 255,000 immigrants stand to gain access to health coverage under the measure, according to the coalition of groups involved in the ‘Coverage for All’ campaign. The idea is to request permission from the Biden administration to use federal dollars to fund the coverage, so that it wouldn’t cost the state anything.

Advocates argue it would actually save New York an estimated $500 million annually on emergency Medicaid, a program that kicks in to cover emergency care for undocumented immigrants who can’t pay for it themselves.

But in an email to Gothamist Tuesday, Aja Worthy-Davis, a spokesperson for Hochul, countered the narrative from advocates was too simplistic. She argued that the proposal would actually carry “significant financial uncertainty and risk,” adding that it’s challenging to accurately estimate the size and characteristics of the undocumented population.

Those arguing in favor of expanding coverage say it should be an easy sell.

“The proposal comes at no cost to the state and is an imperative of both moral and economic consequence,” Adams wrote in his letter. He noted that the move would also shift costs for caring for the uninsured away from safety net health care providers in New York City, such as the public NYC Health + Hospitals system.

The coverage expansion was also included in the one-house budget proposals the state Senate and Assembly submitted last month.

Undocumented immigrants are generally barred from enrolling in federally subsidized insurance plans, but states can request an exception. Within the last year, states such as Colorado and Washington have had success in getting permission from the Biden administration to create insurance options for undocumented residents using federal funds.

New York is currently in the process of crafting a request for a new federal waiver to expand its Essential Plan, which provides health coverage to low-income New Yorkers who don’t qualify for Medicaid. Federal funding for the Essential Plan typically exceeds the cost of administering it, and New York is able to pocket the difference. Since it was approved in 2015, the plan has generated a surplus of more than $9 billion, state Comptroller Thomas DiNapoli told New York Focus in February.

Worthy-Davis said New York is unlikely to get permission to use that existing money pot to fund coverage for undocumented immigrants because it has only been approved to provide coverage for citizens or immigrants who are lawfully present in the U.S.

Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York, agreed with that assessment. But she and other advocates said there’s nothing stopping the state from seeking permission to use future surplus funds to expand who is covered under the Essential Plan.

Hochul is still planning to submit a request to the federal government to expand the Essential Plan in other ways. She is seeking to make the plan available to New Yorkers making up to 250% of the federal poverty level, rather than the current maximum of 200%.

"Gov. Hochul's executive budget makes transformative investments to make New York more affordable, more livable, and safer, and she continues to work with the legislature to deliver a final budget that meets the needs of all New Yorkers,” Worthy-Davis said in a statement.

In last year’s state budget, Hochul also agreed to expand coverage to undocumented immigrants over 65 – although the implementation has been delayed until 2024. Children under 19 and pregnant New Yorkers are already eligible for Medicaid coverage, regardless of immigration status. Some noncitizens, such as asylees and green card holders, are also eligible for Medicaid.

But advocates argue there are still too many people left out, exacerbating health disparities.

“I have to be very careful not to get sick,” Marcia Pico, a Jackson Heights resident who has asthma and works in construction, told Gothamist. Pico isn’t able to get health insurance because of her immigration status, and said as a result she doesn’t get regular check-ups.

Pico said she typically only gets care when she has an emergency – such as last year, when she got into a car accident while pulling out of her driveway. At the time, she said, she went to the emergency room for pain in her neck and back, but has since been unable to get rehab. “My neck hurts a lot,” she said.

Ongoing budget talks have primarily been dominated by debates around bail reform, said state Sen. Gustavo Rivera. But Rivera, who sponsored the bill extending coverage to undocumented immigrants in his chamber, said he will continue to push for the measure until the budget is finalized.