URBAN AGENDA: Facing Migrant Crisis, Governor Should Secure $2B in Federal Health-Care Funds for NY
Governor Kathy Hochul and Mayor Eric Adams face intense pressure to pay for the cost of housing, feeding and caring for thousands of asylum-seekers newly moving into New York City. The crisis has created a series of tough choices for state and city leaders, with no simple solutions. Many of these immigrants have entered the country lawfully, but may lose this status due to immigration processing delays while others may not have any status at all.
Immigrants are an essential part of New York’s heritage and tradition. Ultimately, our communities in the five boroughs and the surrounding area are interconnected. We influence each other’s health and families. For everyone’s well-being, migrants deserve the ability to visit a doctor’s office just like other New Yorkers.
New York has an opportunity to provide more than 200,000 undocumented people with health coverage at no cost to the state. There is a pot of as much as $2 billion in surplus federal money to cover the cost. The governor need only amend her Section 1332 Affordable Care waiver submission in order to cover the cost of providing health insurance to immigrant adults, ages 19 to 64 years old.
However, instead of amending the waiver request to cover immigrants, the state amended its waiver request to direct $59 million in surplus funds to insurance companies so that they can be “made whole.” But the insurance companies are already being paid a reasonable premium for the coverage, while immigrant New Yorkers go without access to health care. The state should make our communities whole by offering immigrant community members quality affordable coverage.
This is an easy solution to part of a multifaceted crisis, which has tensions running high. Homeless shelters and food kitchens are bursting at the seams, and advocates for the poor are struggling to keep pace. Protesters are gathering outside migrant housing. With schools poised to reopen, NYC Department of Education officials expect a huge influx of migrant children. Further complicating matters is the threat of a school bus strike that would affect 150,000 kids in the Big Apple.
Why is NY Turning Down Free Federal Funding?
Federally funded health care is low-hanging fruit for the Hochul administration, which is beseeching President Joe Biden to expedite work authorization permits for migrants and offer New York more financial help in response to the crisis. But her 2024 budget excluded immigrants from her request seeking ACA waiver authority, which means migrant adults cannot go to the doctor. The budget simply gave authority to expand insurance coverage to about 20,000 individuals who earn 200 percent to 250 percent of the federal poverty line — just a fraction of the 1 million New Yorkers without coverage.
It is unclear why the governor took this “skinny coverage” approach to a moral and humanitarian problem. Politics could well be a factor here, with the governor concerned about attacks from the right that she’s too soft on migrants. But free federal money is still free. The Centers for Medicare and Medicaid Services has already granted permission to other states to redirect federal funds to provide coverage for undocumented people. New York should follow suit.
Mayor Adams supports New York joining California, Colorado, Illinois and Washington in using 1332 waivers or Medicaid programs to cover immigrants. To not seek the waiver, the mayor said in a March letter to Gov. Hochul, “deepens longstanding inequities based on immigration status by relegating the health needs of undocumented people – the single largest population of remaining uninsured New Yorkers.”
By not authorizing a broad-based waiver, the state is passing up an opportunity to save more than a half billion dollars annually in emergency Medicaid funds spent on immigrant emergency care. New York City and its critical safety net hospitals would also save an estimated $100 million on the NYC Cares program because the target population would be covered by the 1332 ACA waiver.
Opting to fund immigrant coverage through a federal waiver would support our distressed hospital system by yielding relatively rich Essential Plan reimbursement rates and defraying their uncompensated care costs ($1,174 per person covered each year) since more New Yorkers would have insurance.
Federal health care would certainly help ease the crisis, fomented by busloads of migrants mostly from Texas, Florida and Arizona. Since spring, more than 93,000 migrants have entered New York City, according to the mayor’s office.
New York should be a leader on progressive health-care initiatives. Indeed, when Gov. Hochul signed legislation last year protecting New Yorkers from medical debt, which disproportionately impacts low-income Black and brown people in the state, her action perfectly exemplified that vision.
This is another leadership moment. It’s time for the governor to show her mettle and amend her 1332 Waiver. It’s the right thing to do. It’s economically sound. But moreover, it’s morally correct.
David R. Jones, Esq., is President and CEO of the Community Service Society of New York (CSS), the leading voice on behalf of low-income New Yorkers for more than 175 years. The views in this column are solely those of the writer. The Urban Agenda is available on CSS’s Web site: www.cssny.org.
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