Hochul Inches Toward Health Insurance for Undocumented Immigrants

The final budget, passed earlier this month, included a waiver application expanding income eligibility for state-funded health plans, but it left undocumented immigrants out. Senator Gustavo Rivera, who sponsors a bill to extend coverage to undocumented New Yorkers, said that negotiations over this issue were “the most frustrating part for me during the entire budget process.”

“The best that they could come up with was, ‘Well, we might not get it,’” said Rivera. “That’s not a good answer.”

On top of Hochul’s letter, 64 legislators sent their own ask to federal health officials on Friday, inquiring whether New York can get a waiver to provide health coverage to undocumented immigrants — an attempt to increase political pressure for the coverage expansion.

Like anyone who’s uninsured, undocumented immigrants without coverage can go long stretches without seeing doctors. They often don’t seek medical care due to cost, and they face the added fear of attracting attention from immigration authorities.

“I have pressure in my chest constantly after having Covid,” Selene Aguilar, a housecleaner in Queens who contracted the virus twice, told New York Focus through an interpreter. “It was impossible for me to go to a doctor. It just costs too much money.”

Both houses of the legislature supported the expansion in negotiations over this year’s state budget, as did many prominent New York politicians, including US Representatives Jerry Nadler and Alexandria Ocasio-Cortez, New York City Mayor Eric Adams, and New York City Comptroller Brad Lander.

New York would not be the first state to implement such changes. Colorado recently got a federal waiver to do the same, and Washington also got approval for a similar measure.

“New York has a fantastic chance to get what Colorado and Washington have already,” said Elisabeth Benjamin, vice president of health initiatives at the nonprofit Community Service Society. “What I hope and expect the Department of Health and Human Services to say is, ‘Look at these two other state waivers and give us a proposal.’”

Referring to Colorado and Washington as examples, the federal Centers for Medicare and Medicaid Services suggested that New York could expand government-funded health care to undocumented immigrants in a statement to New York Focus. “A state could elect to cover the undocumented through a Section 1332 waiver plan,” the statement noted, referring to a section of the Affordable Care Act that allows states to apply for federal health care funding.

This year’s state budget process led to an informal agreement that the Hochul administration would send a letter to the federal Department of Health and Human Services requesting guidance on the using of federal dollars to provide coverage to undocumented immigrants, as she recently did.

Hochul’s office and the Department of Health declined to share the text of the letter with New York Focus. A Hochul spokesperson said that if the federal government denies New York a chance to get federal funds, the administration will look for other ways to provide the coverage.

Rivera called the letter “a good start,” but supporters of the measure are concerned that it may allow the Hochul administration to stall. “We don’t want this to be a delay tactic or not done in good faith,” said Assemblymember Jessica González-Rojas, who sponsors Rivera’s bill in the Assembly. “We could have done this without a letter.”