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CIANA Explains: What Options Do Immigrants Have for Healthcare in NYC?

Doctor takes patient's pulse.

As part of a multi-week series, CIANA’s legal and outreach team will discuss all you need to know about topics affecting immigrants and what you can do to help. Read the previous post in the series about the US 2020 Census here.

Astoria, NY- The recent debate about the Trump administration’s proposed “public charge” rule change that we covered a few weeks ago in the first installment of CIANA Explains has led many to argue that the proposed rule would deter many low-income immigrants, with or without legal status, from accessing healthcare due to fears of deportation. Given the increasing hostility of the current political climate, many immigrants and their families have already been discouraged from accessing public health insurance coverage, even if they are eligible. Additionally, with about 40% of New York City’s population made up of immigrants, including about 1.2 million unauthorized immigrants, it is crucial for us to protect and promote their well-being.

But obstacles to health care access are nothing new. Even before the the public charge proposal in October, many low-income, non-citizen immigrants and their families lacked access to adequate medical care. Low-income immigrants face more barriers to healthcare access than low-income native-born citizens, due to language barriers, unfamiliarity with the US healthcare system, and lack of time and monetary resources to try and find coverage.

Obstacles to Healthcare Access

One of the most notable obstacles to healthcare access is citizenship status, which impacts an unauthorized immigrant’s ability to secure healthcare coverage. According to a 2015 report by the NYC Mayor’s Task Force on Immigrant Health Care Access, nearly 64% of unauthorized immigrants or a total of 345,000 people in New York City are uninsured, compared to only 35% of authorized non-citizens. This is more than six times than the number of uninsured NYC residents who are authorized non-citizens or citizens. In part, restrictions on Medicaid are to blame since that insurance is only offered to low-income people with legal status. Although the majority of unauthorized immigrants are low-income, they can only receive Medicaid coverage in the case of medical emergencies. Unfortunately, on most occasions they are left without any coverage at all.

Health Insurance Coverage in New York City, 2013. Source: US Bureau of the Census, American Community Survey, Public Use Microdata Sample 2013.

There are a number of other obstacles that even authorized immigrants face when trying to access healthcare. Lack of proficiency in English language also poses an enormous challenge for immigrants, even for those who can afford medical services. When their healthcare provider cannot speak to them in their native language, they might be deterred from seeking care at all. Many end up traveling long distances just to find someone who speaks their language, which can be prohibitively expensive. Those with medical conditions or disabilities that hinder their ability to travel may not be able to make these trips at all. Receiving medical attention from a healthcare provider that does not speak their language means running the risk of receiving inadequate medical care.

All of these obstacles can have severe consequences. Limited access to healthcare increases the risk of developing chronic illnesses and conditions, which makes it harder to find and maintain a job. Many immigrants may already face discrimination in the workplace, and as a result might have trouble holding down a job and sustaining themselves. They would lose even more money having to pay out of pocket for every doctor’s visit. Being ill or at risk of illness puts an extra physical and financial burden on their loved ones.

How do current and proposed policies affect immigrants and how can they access healthcare?

Fortunately, there are politicians fighting for the rights of all those living in the U.S., including immigrants, to affordable healthcare. Although the Affordable Care Act expanded coverage to millions of Americans, many immigrants were left out. Senator Bernie Sanders’ proposed Medicare-for-All plan would cover 10-12 million undocumented immigrants of all ages by allowing them to purchase government-funded health care.

Currently, all DACA recipients are eligible for Medicaid. However, financial barriers put in place for Dreamers might make it hard for them to access Medicaid and other health benefits. The Simple Dollar's guide for DACA recipients can help them determine how to access all the financial benefits they are allowed to receive, including health coverage.

Pregnant women are also eligible during their pregnancy, regardless of citizenship status. After giving birth or the pregnancy ends, they no longer qualify for Medicaid, but if they have no other healthcare plan, they can enroll in the Family Planning Extension Program. This way, they will remain covered for 26 months after giving birth. All children under 19 years old who do not qualify for Medicaid qualify for Child Health Plus, which is similar to CHIP but issued by New York State, rather than the federal government. Low-income adults over 19 qualify for the Essential Plan.

All these services can be accessed in person by NYC residents. Immigrants can go to a Department of Health office location, which can be found online or by calling 311. Representatives speak many languages, which ensures that immigrants from all over can receive the assistance they need.

When going directly to the government proves to be too time-consuming and burdensome, CIANA is here to help our immigrant neighbors enroll in the healthcare plan that best fits their needs and eligibility. No one in New York deserves to live without health care due to immigration status. We’re committed to protecting laws and government agencies that support this crucial value.

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