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Hastings Center News

New York City Initiative to Cover the Uninsured Reflects Hastings Research, Recommendations

On May 7, New York City officials unveiled details of NYC Care, a new  program in the nation’s largest public health system that aims to improve health care access for about 300,000 low-income New Yorkers who are ineligible for insurance because of their immigration status. The initiative, announced in January, reflects lessons from a 2016-2017 pilot program, ActionHealth NYC, which was informed by recommendations made by a 2014 Hastings Center convening, in partnership with the New York Immigration Coalition, which produced recommendations for a direct-access approach.

Nancy Berlinger and Michael K. Gusmano, who co-authored these recommendations, also served on two advisory groups, the Mayor’s Task Force on Immigration Health Access and the ActionHealthNYC Community Advisory Panel, aligned with these public policy developments.

“Most immigrants in the United States and globally live in cities,” said Berlinger. “Municipal solutions are a key mechanism for providing and coordinating care where people live and work, although they cannot fully compensate for a population’s lack of access to federally funded insurance such as Medicaid or Medicare. They also demonstrate how a city can recognize immigrants as local citizens by investing public funds in the health of this urban population.”

Listen to this new AMA podcast on immigrant health, featuring Berlinger.

The focus of The Hastings Center’s ongoing work on immigrant health has expanded in response to federal policy changes affecting legally present immigrants and asylum seekers. In October 2018 the Center held a national meeting on creating systems of safety for immigrant health to explore how health systems in collaboration with other sectors should respond to policy changes with negative health consequences for immigrants and their families. Participants included immigrant health practitioners working in health care, health law, community-based organizations, and municipal government from New York City, Boston, Baltimore, and the US/Mexico border region. Experts in health care ethics, health policy, and public health communications contributed further perspectives. The convening was made possible by a rapid-response grant from the Public Health Program of the Open Society Foundations.

Learn more:

Nancy Berlinger, Claudia Calhoon, Michael K. Gusmano, and Jackie Vimo, “Undocumented Patients and Access to Health Care in New York City: Identifying Fair, Effective, and Sustainable Local Policy Solutions: Report and Recommendations to the Office of the Mayor of New York City,” The Hastings Center and the New York Immigration Coalition, April 2015.

Nancy Berlinger and Rachel Zacharias, “Resources for Teaching and Learning About Immigrant Health,” AMA Journal of Ethics, January 2019.

Nancy Berlinger, “Is It Ethical to Bend the Rules for Undocumented and Other Immigrant Patients?” AMA Journal of Ethics, January 2019.