Expanding Access to Health Insurance Coverage for Low-Income Immigrants in New York State

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A new study of health insurance coverage among New York State's legal immigrants finds that nearly 170,000 low-income adults who would otherwise be eligible for public insurance programs are denied coverage solely because of their immigration status. Through any of a number of changes in state policy, the report says, tens of thousands of legal non-citizens could gain health coverage.

The report, Expanding Access to Health Insurance Coverage for New York's Low-Income Immigrants, was conducted by Deborah Bachrach, Karen Lipson, and Anthony Tassi of Kalkines, Arky, Zall, and Bernstein, LLP.

Immigrants, a large and growing proportion of New York's population, pay approximately 15 percent of the state's income taxes and 17 percent of its residential property taxes. Were it not for the large waves of immigration during the past decade, the number of workers in both the state and New York City would have dropped significantly. Today, 4.2 million residents-23 percent of New York State's population-are foreign-born. Forty-one percent are naturalized citizens, and the vast majority of non-citizens are lawfully present in the United States.

Despite their key contributions to the state economy, nearly half of legal non-citizens (46%) are uninsured, according to the study. Moreover, most cannot enroll in Medicaid because of a provision in the federal welfare reform law that ended federal funding for most legal immigrants entering the country after August 1996. Although at least 10 states have since chosen to provide health coverage for low-income immigrants using state dollars—among them California and New Jersey, both with large immigrant populations—New York has not. In addition, the state has denied legal immigrants eligibility for its latest insurance coverage expansion for low-income adults, Family Health Plus (FHP), because it is partly financed by Medicaid.

The report, published by The Commonwealth Fund, describes several options that New York could pursue to provide uninsured low-income immigrants with health coverage. Restoring full Medicaid benefits and expanding FHP coverage, the authors say, would place legal immigrants on the same footing as citizens and cover the most people. A more modest approach would allow adult immigrants to join FHP and finance their care with a separate pool of state funds-just as New York has elected to do for non-citizen children who join Child Health Plus.

Facts and Figures

  • Of the 454,000 legal non-citizen adults who arrived in the United States since welfare reform passed in August 1996, about 96,700 would be eligible for Medicaid and 70,800 would be eligible for Family Health Plus.

  • By 2003, the number of lawfully present, non-citizen adults with low incomes below Medicaid or FHP limits will exceed 238,000.

  • Approximately three of four foreign-born New Yorkers, about 3.2 million people, reside in New York City.

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Publication Details

Publication Date:
March 1, 2001
Authors:
Deborah Bachrach, Karen Lipson, and Anthony Tassi, Kalkines, Arky, Zall, and Bernstein, LLP
Citation:

Expanding Access to Health Insurance Coverage for Low-Income Immigrants in New York State, Deborah Bachrach, Karen Lipson, and Anthony Tassi, Kalkines, Arky, Zall, and Bernstein, LLP, The Commonwealth Fund, The Commonwealth Fund, March 2001