California and New York City are looking to give health care to more people, regardless of immigration status — a stark contrast to rhetoric coming out of Washington, D.C., where the president has shut down the government over funding disputes for a proposed border wall.
California Gov. Gavin Newsom (D) announced shortly after taking office on Monday that all low-income residents up to age 26 will be eligible for public health insurance, regardless of their immigration status. California will be the first state to provide health coverage to undocumented young adults through the state’s Medicaid program, Medi-Cal.
The state already covers undocumented children until the age of 19. But under the new proposal, state law will reflect age standards under federal law, as the Affordable Care Act (ACA) guarantees that adults with U.S. citizenship can stay on a parent’s plan until the age of 26. The policy will be included in Newsom’s first budget proposal, set to be released on Thursday.
“Every person should have access to quality, affordable healthcare,” said Newsom during his inaugural address on Monday. “Far-away judges and politicians may try to turn back our progress. But we will never waver in our pursuit of guaranteed healthcare for all Californians.”
Expanding eligibility can benefit as many as 130,000 undocumented adults, Newsom aides told the San Francisco Chronicle. A recent analysis of a bill aiming to provide Medi-Cal to undocumented immigrants between the ages of 19 and 25 estimates that the policy would cost nearly $500 million per year.
Undocumented immigrants make up California’s largest uninsured group because they were excluded from ACA provisions. Somewhere between 1.4 and 1.5 million undocumented immigrants living in California are without health coverage and roughly half qualify for Medi-Cal, meaning they earn no more than 138 percent of the federal poverty level or $33,500 for a family of four, according to a recent analysis from the Public Policy Institute of California.
Meanwhile, New York City Mayor Bill de Blasio announced on Tuesday that the city is launching a new program for residents who don’t qualify for any existing insurance. Roughly 600,000 New Yorkers — including 300,000 undocumented residents — are expected to gain health care through the a new program, dubbed NYC Care. The program will operate within the state’s existing public option for health insurance, known as MetroPlus.
NYC Care will launch this summer and roll out geographically, starting in the Bronx. It will be fully available to all New Yorkers by 2021, and cost at least $100 million annually at full scale.
New Yorkers who don’t have health insurance can enroll in NYC Care and will be given a membership card that’ll enable them to use services at NYC Health + Hospitals, MetroPlus’ partner that already provides inpatient, outpatient, and home-based services to more than 1 million New Yorkers in 70 locations. Members will be offered a range of services, including primary, reproductive, and mental health care. All services will be affordable on a sliding scale.
“The expensive part of health care is hospitalization, expensive radiological tests,” said NYC Health + Hospitals President and CEO, Dr. Mitchell Katz at the press conference, when asked about associated costs. “What needs to be in the system is primary care, preventative care. Those things cost less, but they yield huge benefits over time.”
A similar program in San Francisco, which Katz helped launch in 2006, successfully connected residents to primary care services. A city evaluation found more than 40 percent of Healthy San Francisco members felt access to care was easier and one in three members felt the quality of care improved. NYC Care will be broader in scale, said Katz.
“From this moment on, everyone in this city is guaranteed the right to health care,” said de Blasio during a press conference on Tuesday. “It’s not something that you have to fight for or struggle for.”
The California and New York proposals address a significant group of the uninsured population. There are 3.9 million undocumented immigrants nationwide who are uninsured, but few states provide them options. In fact, only six states and the District of Columbia offer insurance to undocumented children.
Both Newsom and de Blasio stressed that the new proposals do not distract from, but work towards, the ultimate goal: Medicare for All. Indeed, Newsom sent a letter to congressional leaders, asking them to redesign the Affordable Care Act’s State Innovation Waiver so California can submit a single-payer plan.
“Medicare for all, that is the ideal we need. I strongly support the single payer bill that is going to be considered in Albany, but you know what? We don’t wait in NYC,” said de Blasio.
Medicare-for-all legislation in New York and California also covers all residents, regardless of immigration status.