Community Service Society of New York

New York is home to more than 4 million immigrants, making up approximately one quarter of the State’s population. While the vast majority are naturalized citizens, legal permanent residents, or lawfully residing, it is estimated that 625,000 individuals are undocumented.

The Affordable Care Act has created access to affordable health insurance coverage for many New Yorkers, but undocumented individuals are not permitted to use their own money to purchase a private unsubsidized plan on the NY State of Health Marketplace, and most are barred from accessing public insurance coverage. A well-functioning, stable, and strong health care market, as well as continued access to care, will depend on creating an insurance mechanism for New York’s undocumented immigrants. To establish what such an insurance system might look like, NYHealth awarded the Community Service Society of New York (CSS) a grant to conduct a rigorous examination of the costs and feasibility of three insurance options for undocumented immigrants in New York State.

Under this grant, CSS modeled the design and cost of each of the following coverage options: (1) providing comprehensive coverage to undocumented Deferred Action for Childhood Arrivals-eligible young adults (19–29 years old) who are too old for Child Health Plus coverage and not income-eligible for State-funded Medicaid; (2) establishing a limited benefits package for undocumented immigrants who have enrolled in Emergency Medicaid; or (3) offering comprehensive coverage to undocumented immigrants with incomes below 200% of the federal poverty level through a State-only funded Basic Health Plan, which would be offered through private health insurance companies. Specifically, CSS conducted preliminary research; data acquisition and analysis; interviews with immigration data experts, State officials, advocates, and providers; legal and policy research; and actuarial modeling. A final report detailing the options, analysis, and assumptions was produced by CSS. At the project’s conclusion, NYHealth and CSS jointly convened a roundtable forum to initiate a broad-based discussion among multiple stakeholders on the coverage options and next steps.

Read the report associated with this grant, “How Can New York Provide Health Insurance Coverage to its Uninsured Immigrant Residents? An Analysis of Three Coverage Options.”