October 14, 2015
New York City Mayor Bill de Blasio’s plan, announced on October 8, 2015, to create a program to improve health care access for immigrants in the nation’s largest city incorporates the principal recommendation from an April 2015 report by The Hastings Center’s Undocumented Patients Project and the New York Immigration Coalition (NYIC). The recommendation for a networked primary care medical home system for uninsured immigrants was presented in Undocumented Immigrants and Access to Health Care in New York City: Identifying Fair, Effective, and Sustainable Local Policy Solutions (See below for summary and link to full text.) Nancy Berlinger and Michael K. Gusmano, co-directors of the Undocumented Patients Project, served on the Mayor’s Task Force on Immigrant Health Care Access convened in 2014 to identify ways to meet the health care needs of thousands of New York City residents left out of the Patient Protection and Affordable Care Act (ACA).
The pilot phase of New York City’s program, called Direct Access, will be launched in Spring 2016 with 1000 patients and an initial investment of $6 million from the Robin Hood Foundation and other funders. Data from the one-year pilot will be used to design a citywide model to provide reliable, coordinated access to low-cost health care for immigrants who are excluded from federal and state insurance programs such as Medicare and Medicaid. This primary care medical home model reflects lessons from innovators in other cities, including Los Angeles and San Francisco, and makes use of the city’s existing safety-net resources to close health care gaps for New York City’s remaining uninsured. This major reform on the part of New York City may also spur fresh thinking about local solutions to a national problem of immigration policy and health care access.
Click for description of NYC Direct Access plan.
Click for NYC Mayor’s Task Force on Immigrant Health Care Access.
Coverage of NYC Mayor’s Task Force report and recommendations:
Undocumented Immigrants and Access to Health Care in New York City
Identifying Fair, Effective, and Sustainable Local Policy Solutions
Click to access the Report and Recommendations
About this report
This independent report is based on a meeting convened by the New York Immigration Coalition and the Undocumented Patients Project of The Hastings Center, which was hosted by the Vera Institute of Justice in New York City on December 11–12, 2014. The goals of this meeting were to sharpen local stakeholders’ understanding of gaps in access to health care for populations left out of the Patient Protection and Affordable Care Act of 2010 (ACA)—in particular, New York City residents who are both undocumented and uninsured—and to identify proven or promising local solutions to closing these gaps in other cities, counties, and states. Although this report and its recommendations focus on challenges and solutions in New York City, it may also be useful to other New York State municipalities, and to other cities and counties in the United States.
This document describes New York City’s undocumented uninsured population, the City’s safety-net health care system, and the specific gaps in coverage and financing that impede access to health care for this population. It also describes special opportunities and challenges for health care system improvement in the City and compares models that are proven or promising as sustainable ways to improve access to health care for undocumented immigrants and other uninsured populations. It concludes with six actionable recommendations for City stakeholders, supported by guidance for ongoing planning, program development, and system improvement. The final draft of this report was provided to the Office of the Mayor of New York City, Task Force on Immigrant Health Access, Care & Coverage Subgroup, on February 28, 2015.
Nancy Berlinger, PhD, is a Research Scholar at The Hastings Center and the co-director of the Undocumented Patients Project.
Claudia Calhoon, MPH, is Health Advocacy Senior Specialist at the New York Immigration Coalition.
Michael K. Gusmano, PhD, is a Research Scholar at The Hastings Center and the co-director of the Undocumented Patients Project.
Jackie Vimo, MA, is Regional Advocacy Director at the New York Immigration Coalition.
The authors of this report are responsible for the recommendations that follow. The authors acknowledge the assistance of Mohini Banerjee and Chelsea Jack, Research Assistants at The Hastings Center, in preparing this report, which was designed by Nora Porter. The December 2014 stakeholder meeting and the subsequent preparation of a working paper and this public report were made possible by a discretionary grant from The Robert Sterling Clark Foundation.
How to Cite this Report
Berlinger, Nancy, Claudia Calhoon, Michael K. Gusmano, and Jackie Vimo, Undocumented Immigrants 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. Full text available at: www.undocumentedpatients.org and www.thenyic.org/healthcare