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  • Writer's picturePaul Zuber

Commentary: Pass Coverage4All in the State Budget


No one should have to rely on an emergency room for healthcare treatment. Study after study proves that primary care increases preventative treatment measures and leads to overall better health outcomes. Yet even after the passage of the Affordable Care Act, there are millions of people who are still ineligible for coverage due to their immigration status, including 245,000 immigrant New Yorkers.


As representative to more than 3,000 large and small employers across New York, who employ more than 1.2 million New Yorkers, The Business Council is firmly committed to closing the coverage gap through incremental and fiscally responsible policies that bring us closer to universal coverage. We believe that healthcare coverage provides opportunity to individuals and creates a more inclusive and productive economy.


Without coverage, immigrant New Yorkers are unable to seek primary care services without paying out of pocket expenses and potentially incurring debilitating medical debt. In many cases, those without healthcare coverage only seek medical services when they are seriously ill, creating significant challenges and costs for the state’s health care system. This puts pressure on the system, lowering the quality of care and perpetuating inequities in health care and our society. But there is a solution.


A proposal in the State Legislature, sponsored by Senate Health Committee Chair Gustavo Rivera and Assemblymember Jessica González-Rojas, would open access to New York’s Essential Plan for any New Yorker who meets the eligibility criteria, regardless of immigration status. If a waiver isn’t granted by the federal government, then coverage would be provided under an expanded state-funded Medicaid program. With more than 95% of state residents covered, this plan would reduce New York’s uninsured to less than 2% of the population -- extremely close to universal coverage.


This is not unprecedented. New York’s Child Health Plus program provides coverage to children, regardless of immigration status until age 19. Last year, lawmakers took steps to expand Medicaid coverage to undocumented immigrants over 65 and new mothers, and we’re hopeful this will be implemented soon. But that leaves a huge gap in coverage for any immigrant New Yorker between the ages of 19 to 64. All household members should have healthcare coverage, regardless of their age or their immigration status.


And there’s a cost savings to extending coverage to uninsured immigrants. In 2021, New York spent approximately $500 million on emergency Medicaid for undocumented immigrants’ healthcare needs. If New York State includes Coverage4All in its 1332 federal waiver, then their coverage would be of no charge to the state, saving New Yorkers $500 million in emergency Medicaid spending while providing healthcare coverage to those who need it.


Other proposals, like the New York Health Act, while well-intentioned, disrupt the healthcare system by starting from scratch, which could have several unintended consequences. And it comes with a hefty price tag: New Yorkers would pay $139 billion in new taxes in the first year alone, more than half of New York’s total state budget, which was $220 billion last year. Ultimately, it is cost prohibitive and would drastically delay enrolling those who need coverage now.


Coverage4All utilizes existing infrastructure, saves the state money and extends healthcare coverage to New York immigrants who need it now. For us, this is a no-brainer.

Passage of Coverage4All should be prioritized and included in this year’s final state budget. For us to flourish, we all need access to quality healthcare. It’s time to break down the barriers to healthcare and create economic opportunity and healthier families so that we can continue to build a stronger New York.

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