Estelle Khairallah, of Syracuse, is a second-year medical student at the State University of New York Upstate Medical University, in Syracuse.
Undocumented immigrants make up 3.2% percent of the U.S. population, 4% of the country’s workforce and12% of the uninsured population, even though they contribute $3 billion per year in taxes to New York state.
For the second consecutive year, state Sen. Gustavo Rivera’s Coverage For All bill has passed the state Senate and has been delivered to the state Assembly for consideration. The bill would enable New York state to use federal funds to expand Essential Plan coverage to income-eligible undocumented New Yorkers using a 1332 waiver, and has another chance to pass the Assembly before the end of the 2023—2024 legislative session. This bill could potentially save New York state hundreds of millions of dollars if it passes this year, and it’s up to our community to advocate for its urgent passage.
The financial contributions necessary to enact this bill are already present: New York state has a $2 billion surplus in federal funding. Only approximately $1.6 billion would be used to fund this program, and on top of that, New York would save $500 million in state funding that is currently being spent on emergency-only Medicaid, currently the only healthcare option for most undocumented immigrants in New York. This results in net savings for New Yorkers, since the bill clearly outlines that no state funds are to be used to fund the bill. Additionally, health providers will benefit from the program since they will be paid Essential Plan rates, known to be much higher than the emergency-only Medicaid rates.
Because 41% of undocumented immigrants are uninsured (compared to 23% of documented immigrants and 8% of citizens), many delay or forgo care due to costs, which can lead to worse health outcomes as well as more expensive treatment costs. In states that have already implemented more expansive coverage policies for undocumented immigrants,immigrants are more likely to receive care and to have a trusted health care provider compared to those living in states with less expansive coverage policies.
If immigrants in New York had better access to healthcare, they would be of minimal cost to the state: Immigrants tend to be healthier than nonimmigrants and spend less on health care compared to citizens, and in past precedent the Medicaid expansion showed that the cost of providing insurance to immigrant adults was less than half the per person cost of doing so for citizens. Additionally, as we saw during the Covid-19 pandemic, the health of each individual in a community contributes to the health of the whole community, and undocumented immigrant workers comprised the majority of our essential workers during the pandemic.
If this bill is passed, it would be a major stepping stone towards the New York Health Act, which would provide healthcare to 90% of all New York state residents and save New York another $15 billion in revenue. Therefore, not only will passing the Coverage ForAll bill expand healthcare access to undocumented immigrants, but it will also pave the way for greater healthcare access to all New Yorkers. Small businesses will save money on healthcare costs; our aging senior population will have hearing, vision and dental coverage; and healthcare workers will see improvements in healthcare quality and an increased capacity to advocate for their patients — especially important considering the post-pandemic burnout most hospitals are currently combating.
New York is not revolutionary in introducing a policy like Coverage All: The same concept has already been implemented in states like California, Washington and Colorado, as well as in the District of Columbia. Similar to CoverageAll, Colorado and Washington successfully used a 1332 waiver to expand their coverage to all qualifying undocumented residents, and are expecting the programs to generate millions of dollars in savings over the next five years.
The Coverage For All bill benefits all New Yorkers: documented, undocumented, and native-born. It saves New Yorkers money while providing more equitable healthcare to all its residents. It’s up to New Yorkers to advocate for the policies that benefit us. Several New York unions have already shown support for Coverage For All, so call Assembly Speaker Carl Heastie and advocate for you and your neighbor’s health today.
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