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PRESS RELEASE: Undocumented Immigrants and Access to Health Care in New York City

Advocates and researchers release recommendations for improving services for undocumented immigrants in advance of New York City mayor’s report on immigrant health access.

The Hastings Center and the New York Immigration Coalition (NYIC) today released a report,“Undocumented Immigrants and Access to Health Care in New York City: Identifying Fair, Effective, and Sustainable Local Policy Solutions,”that offers recommendations to the administration of Mayor Bill de Blasio on expanding access to needed health care for New Yorkers who are undocumented.

The report was written by Nancy Berlinger and Michael K. Gusmano, co-directors of the Undocumented Patients Project at The Hastings Center; Claudia Calhoon, health advocacy senior specialist at the NYIC; and Jackie Vimo, regional advocacy director at the NYIC, and was funded by a grant from the Robert Sterling Clark Foundation.

To launch the report, Steven Choi, executive director of the NYIC, said: “Enormous gaps exist in service and access for immigrants not eligible for coverage because of their status. The report highlights important opportunities for the city to improve access and coordination of care. The NYIC is looking forward to working with city stakeholders to improve care and access for all immigrant New Yorkers.”

“Health care providers in New York City provide important safety net services, and we believe the city can build on existing programs to do even better,” said Calhoon, one of the report’s authors. “There are promising models from around the country that the city can draw on to improve access for populations that remain uninsured. Creating a program that links patients to a designated primary care provider or “medical home” and coordinates care from different institutions will result in meaningful improvements for health access for this population.”

“How to treat people when they are sick or injured and how to share limited resources fairly are societal questions that play out every day in hospitals and clinics,” said Berlinger, the report’s lead author. “These questions are especially important in immigrant societies, and in all cities shaped by global migration. New York City’s leadership in addressing these questions is of great significance locally and may encourage other cities to undertake similar initiatives.”

An estimated 500,000 New York City residents are undocumented. About 250,000 of these immigrants are uninsured and lack access to affordable health care because of their ineligibility for most forms of public insurance, making them heavily reliant on insufficient “emergency” provisions. In 2014, the de Blasio administration convened a task force on immigrant health access to identify more effective ways to meet the health care needs of populations left out of the Patient Protection and Affordable Care Act of 2010 (ACA).

“For too many people in New York City the emergency room is the only entry point to our health care system. We must do more to give them access to primary and preventive health services, and reduce our over-reliance on costly and episodic emergency care,” said Deputy Mayor Lilliam Barrios-Paoli. “The city’s immigrant health task force has been actively discussing strategies to address this problem, and we are glad to see our partners engaged in this conversation – the findings and recommendations in this report are important, and very welcome as we design our map to improve the health of all New Yorkers.”

As part of this effort, health policy experts at the NYIC and the Undocumented Patients Project of The Hastings Center partnered to convene a meeting, held in December 2014, of New York City policymakers, clinicians, and advocates to identify gaps in access to health care for undocumented and uninsured New York City residents and to explore proven or promising local solutions to closing these gaps elsewhere. The meeting also included participants with experience devising and implementing such solutions, from Healthy San Francisco, My Health LA, Houston’s Access Care program, Nevada’s Access to Healthcare Network, and Massachusetts’s Health Care for All.

The report released today, which was provided to the mayor’s task force in draft, builds on insights from this meeting and describes the specific gaps in coverage and financing that impede access to health care for the undocumented uninsured. It identifies opportunities, challenges, and lessons for the nation’s largest city.

The report concludes with six actionable recommendations, which include improving access primary care medical homes for uninsured individuals, better linking services among existing safety-net providers, and supporting the creation of statewide coverage solutions for all immigrants.

“The productivity and performance of our city depends on our ability to integrate all our residents, and making sure that everyone has access to preventive health services that will help them live long, healthy, and productive lives,” said New York City Immigration Commissioner Nisha Agarwal. “We have worked very closely with our partners at the NYIC on this effort, and look forward to reviewing these recommendations and working together on solutions to improve health care access for all immigrants.”

The full text of the report is available at: www.undocumentedpatients.org and www.thenyic.org/healthcare.

Founded in 1969, The Hastings Center has been a preeminent source of research and recommendations on health care ethics and policy. The Hastings Center’s Undocumented Patients Project, launched in 2011, provides analysis, commentary, and resources on issues of access to health care for this population. The NYIC, which includes nearly 200 member groups, was founded in 1987 to promote immigrants’ full civic participation, foster their leadership, and provide a unified voice and a vehicle for collective action for New York’s diverse immigrant communities.