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A New Opportunity to Provide Health Care Coverage for New York's Low-Income Families


Hundreds of thousands of uninsured low-income parents in New York could gain health care coverage if the state takes advantage of a little-known legislative opportunity. According to a report released by The Commonwealth Fund, New York could use a provision in the 1996 federal welfare reform bill that gives states broad flexibility to decide what counts as income when determining Medicaid eligibility. The federal government would bear half the expansion costs if the state chooses to expand public insurance by changing eligibility rules.

The Fund report, A New Opportunity to Provide Health Care Coverage for New York's Low-Income Families, by Jocelyn Guyer and Cindy Mann of The Center on Budget and Policy Priorities in Washington, D.C., finds that New York could make a substantial dent in the number of uninsured working adults by expanding its definition of who qualifies for subsidized health care insurance.

About 424,000 parents living in New York are uninsured and have incomes at or below 200 percent of the poverty level, which is $27,760 for a family of three. Although six of seven of these parents or their spouses work, their jobs rarely offer affordable health coverage; for the most part, however, these low-income families are ineligible for Medicaid under current state law.

The report describes a ""family coverage category"" provision in the 1996 welfare reform bill that allows states to expand coverage to families at whatever income and resource levels the states deem appropriate. This obscure 1996 provision gained public attention in March 1999 with the Health Care Financing Administration's report, Supporting Families in Transition: A Guide to Expanding Health Coverage in the Post-Welfare Reform World.

Under different expansion strategies, New York could offer coverage to uninsured working parents of various income levels. For example, it could extend coverage to those with incomes up to 250 percent of the poverty level, which would insure approximately 335,000 parents; or up to 185 percent poverty, which would insure 242,000 parents.

Connecticut, the District of Columbia, Rhode Island, and Wisconsin have already taken advantage of the family coverage category option to loosen Medicaid eligibility rules. Other states, such as Ohio, Oklahoma, and Pennsylvania, have eliminated asset tests for low-income working parents.

Facts and Figures

  • There were 3.2 million uninsured New Yorkers in 1997, one million more than in 1991.

  • One of three (35%) low-income working parents in New York is uninsured, whereas one of seven (14%) low-income unemployed parents is uninsured.

  • A single mother with two children earning $11,600 per year (84% of the poverty level) is unlikely to be eligible for Medicaid in New York.


Publication Details



A New Opportunity to Provide Health Care Coverage for New York's Low-Income Families, Jocelyn Guyer and Cindy Mann, Center on Budget and Policy Priorities, The Commonwealth Fund, July 1999