Supporting Health Care Access for Immigrants and Their Families

NYHealth awarded the New York Immigration Coalition a grant to monitor the immigration policy landscape and support immigrant health care access during these uncertain times.

Grantee Name

New York Immigration Coalition

Funding Area

Special Projects Fund

Publication Date

March 2020

Grant Amount

$121,727

Grant Date:

October 2017 – January 2019

Special Projects Fund

Immigrant New Yorkers have faced the rollback of core health care protections in the face of federal changes to health care financing, publicly financed health insurance, and a wide range of public benefits.

A travel ban targeting Muslim countries, enhanced immigration enforcement activities by U.S. Immigration and Customs Enforcement, and an executive order that radically curtails immigrant use of public benefits created a climate of fear and mistrust. This chilling environment has had a negative effect on immigrants’ ability to access—and level of comfort with accessing—health insurance coverage and care. Health insurers have reported an increase in the number of immigrant families declining enrollment and/or pursuing disenrollment of health insurance for fear the database will be used to identify and deport them. Health care providers also reported a decline in the use of services by immigrant patients for the same reason.

NYHealth awarded the New York Immigration Coalition (NYIC) a grant to monitor the immigration policy landscape and support immigrant health care access during these uncertain times.

Outcomes and Lessons Learned

  • Monitored policy changes in real time, analyzed their impact, and shared findings with its 175 member organizations, communities, health care providers, and elected and appointed officials to support coordinated measures for preserving health care access for immigrants.
  • Held more than 50 meetings with New York State elected and agency officials to advance immigrant health needs in the face of persistent and new federal threats.
  • Conveyed information to immigrants and immigrant-serving organizations on how to respond to anti-immigrant policies on health care and access.
  • Informed decision-makers of the gaps and challenges for immigrants that existed even prior to the current administration.

NYIC’s grant period began shortly after the Trump administration rescinded Deferred Action for Childhood Arrivals (DACA), which had previously given hundreds of thousands of young, undocumented immigrants living in the United States an opportunity to legally work and study without fear of deportation. The program also provided a pathway to health insurance for DACA recipients by allowing those who are income-eligible to qualify for Medicaid. In response to the administration’s decision to end DACA, NYIC worked with partners to quickly provide analytical policy documents to Governor Cuomo outlining New York State’s obligation to maintain Medicaid eligibility for DACA recipients. NYIC organized a hearing for the New York State Assembly on the issue in late 2017, which ultimately moved the Governor to confirm continued Medicaid eligibility for former DACA recipients.

A major focus of NYIC’s work was responding to the administration’s planned changes to public charge rules. The proposed rule expanded the list of programs that would be considered in public charge determinations to include Medicaid, Supplemental Nutrition Assistance Program (SNAP), and housing. As a result, this change would penalize lawfully present individuals who participate in health insurance, housing, and food security programs, making it more difficult—if not impossible—for immigrants to secure permanent residency. In response, NYIC:

  • Convened a group of New York City advocates and government officials to coordinate a response to prospective public charge changes prior to the posted rules.
  • Organized and conducted meetings that generated a critical information-sharing space among local government agencies and immigration advocates, as well as presented on the public charge rule at regional convenings across the State.
  • Created a listserv and workgroups on training providers, coordinating legal services provision, and creating consistent community messaging.
  • Developed a strategy for the public comment period on the public charge rule change, as well as longer-term thinking about ensuring access to health care services, food, and shelter for families.
  • Provided timely, regular updates on public charge threats via webinars for its statewide membership base and other organizations, including for legal service providers and staff members at the New York State Office for New Americans’ Opportunity Centers.
  • Created community information guides, available in seven languages on its website, and broadly disseminated them to City agencies and its member organizations, as well as at meetings, events, and other initiatives.

NYIC’s public charge community information guides have been consistently adopted by its member organizations or used as models to develop their own. Much of NYIC’s work informed NYHealth’s public comments on the proposed public charge changes, urging the U.S Department of Homeland Security to withdraw the rule.

NYIC’s work led to a more educated public and a greater understanding among elected and agency officials about immigrant health concerns and the ability of State and local agencies to effect change. In 2020, NYHealth awarded NYIC a second grant to continue to address new federal policies that restrict health care access and coverage for New York State-based immigrants and their families. This project will continue to focus on federal policies restricting health care access and coverage for immigrants by monitoring policy changes in real time, analyzing their impact, disseminating information to key audiences, and developing alternative policy options.

Co-Funding and Additional Funds Leveraged: N/A