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HEARING ON IMMIGRANT ACCESS TO HEALTHCARE ASSEMBLY STANDING COMMITTEE ON HEALTH ASSEMBLY HISPANIC/PUERTO RICAN TASKFORCE ASSEMBLY TASKFORCE ON NEW AMERICANS Testimony of the New York Immigration Coalition

 

Presented by Claudia Calhoon, Director of Health Policy

 December 13, 2017 Good afternoon. My name is Claudia Calhoon, and I am the Health Policy Director at the  New York Immigration Coalition. The NYIC is an advocacy and policy umbrella organization for more than 200 multi-ethnic, multi-racial, and multi-sector groups across the state working with immigrants and refugees. The NYIC Health Policy program and its Health Collaborative bring together immigrant-serving organizations and other stakeholders from the frontlines of the battle to improve health access. We are grateful to Assemblymembers Gottfried, Crespo, and Solages for convening this important hearing. Since the presidential election, the federal administration has leveraged an existing false narrative about the dangers of immigration and prompted unprecedented levels of fear and anxiety in immigrant communities. Immigration policies have included threats and attempts to create a mass deportation force, wall off

the United States’ southern border, ban the entry of

immigrants based on their religion, suspend the refugee resettlement program, and prevent immigrants from obtaining public benefits to which they are legally entitled. Most recently, many

of immigrants’

worst fears were realized with the September 2017 announcement of the end of the successful Deferred Action for Childhood Arrivals (DACA) program, and recent announcements of the end Temporary Protected Status for people from Nicaragua and Haiti. Much has been done in New York State to support immigrant communities during this time of rapid and alarming change. Many key programs and services support immigrant health throughout the state. But there are critical gaps requiring sustained action and leadership at the state level. Additionally, threats to health care financing and access at the federal level make state measures to protect and sustain health access for immigrants even more important than before. We cannot go backwards on the progress we have made to make health care available to New York State residents.

 

 

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I. General Landscape

As we approach a projected tight budget process, it is important to note that New York

State’

s nearly 4.5 million immigrants are among the key economic drivers of the state economy. This is particularly true of the approximately 850,000 undocumented individuals who contribute their labor in a wide array of sectors, especially in service occupations, leisure and hospitality, construction, and agriculture.

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 The Fiscal Policy Institute estimates that undocumented individuals contribute $1.1 billion per year in combined sales and excise, personal income, and property taxes.

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 They make up 5% of the labor force. As a group, they also contribute $40 billion to the New York State economy. Despite their contributions, immigrant communities are on the receiving end of a host of hostile federal actions and policy changes. We are gravely concerned about impact of the environment on health utilization and population health outcomes for immigrants over the long term. Periodic reports of drastic drops in immigrant health care utilization from NYIC members and  partners, resistance to signing up for public benefits, and inappropriate scrutiny of patient  background and status by frontline service providers raise questions about the long-term population health impacts of the current political environment. Several members and partners who provide pre-natal care have noted that undocumented women who are pregnant, and thereby eligible for Medicaid, are hesitant to enroll in it, and may not be accessing health care during their pregnancies. In New York City,

Health + Hospitals (H+H)’s Open Letter to Immigrants

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 and a series of community forums to reassure patients about the safety and security of seeking health services were important first steps in counteracting misinformation and fears of patients. We do not know of other hospital systems across the state who have undertaken similar campaigns to educate their  patients about the safety and security of health services. An important resource for legislators and their staff that may interface with health care providers in their districts is the National Immigration Law Center (NILC) toolkit for health care providers on creating safe spaces for all patients.

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 During 2017, New York State policy makers, agency leadership and advocates acted in concert at the forefront of efforts to defend the Affordable Care Act (ACA). The constant drumbeat to roll back federal financing for programs that cover millions of New Yorkers continues today with negotiations underway around a tax reform bill that could end the individual mandate and lay the groundwork for a massive contraction of Medicare, Medicaid, and Social Security. Immigrants in  New York State have benefitted tremendously from the successful implementation of the ACA. A

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 http://fiscalpolicy.org/wp-content/uploads/2017/03/fpi-brief-on-undocumented.pdf

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 https://itep.org/immigration/

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https://www.nychealthandhospitals.org/wp-content/uploads/2016/12/immigrantCampaign_LetterFlyer.pdf 

 

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 https://healthtoolkit.nilc.org/register/

 

 

3 recent assessment by the New York State Health Foundation shows that the number of uninsured immigrants (both naturalized citizens and non-citizens) was reduced by 36% between 2013 and 2016. The same report shows that non-citizens are more than 5 times more likely to be uninsured when compared to citizens.

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 Despite the challenges on the federal level, New York State must continue in its commitment to address these disparities. It is neither moral nor fiscally wise to allow  New York State to be taken backwards in the work of linking immigrants to coverage.

II. The Importance of Coverage

In the wake of these tremendous challenges, the NYIC has joined with health care consumer and immigrant advocacy groups to address the challenges described in this testimony by also working to identify solutions for the remaining 433,000 undocumented individuals that are uninsured because of federal exclusions.

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 We have undertaken this work through Coverage 4 All, a campaign of Health Care for All New York which we co-lead with Make the Road New York. Creating a coverage program to ensure individuals excluded from federal programs are able to access health insurance is not only good for immigrant communities, but also strengthens the fiscal stability of the health care providers that care for them, and in that way also strengthens the fiscal health of municipalities across New York State. Although expanding coverage with state dollars represents an investment, the benefits of closing coverage gaps to population health are numerous. Individuals with insurance are more likely to receive timely and preventive care, have improved mental health, less likely to incur medical debt, and more likely to experience reduced mortality and outcomes.

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 The healthcare system will work better for everyone if New York State continues to be a leader in insuring everyone. For all of these reasons, the NYIC supports the New York Health act to create a single-

 payer system. We applaud the Assembly’s effor 

ts to pass that groundbreaking legislation and we hope the New York Senate will vote on it during the upcoming session. In the meantime, we continue to promote incremental progress towards closing the gap for immigrant New Yorkers who are unauthorized. New York has a history of providing state-funded coverage to immigrant communities excluded from federal programs. New York state elected officials, led by Governor Cuomo, have publicly and passionately committed to protecting and supporting immigrant communities under attack from Washington. We respectfully request that the Assembly advocate as part of budget negotiations for the expansion of Child Health Plus (CHP) program to individuals through age 29. CHP is a national model for providing coverage to all children, regardless of status. It is an ideal platform for offering

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 https://nyshealthfoundation.org/uploads/resources/success-in-the-empire-state-health-insurance-trends-NY.pdf

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 http://www.migrationpolicy.org/data/unauthorized-immigrant-population/state/NY

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 For a concise review of the literature on the benefits of coverage see: http://www.cssny.org/publications/entry/covering-new-yorks-uninsured-immigrant-residents