Health Care
How much would it cost for New York to insure low-income undocumented people? Depends who you ask.
The governor and lawmakers have vastly different thoughts on the price tag to expand public health care to undocumented immigrants, hindering an initiative to do so in the state budget.
Demonstrators from Make the Road New York in Albany on March 22. Rebecca C. Lewis
A deal on health care coverage for undocumented New Yorkers may be in the works, but the executive and legislative branches have a large gap to close. Legislative sources say that Gov. Kathy Hochul has come to the negotiating table, but she has a vastly different cost estimate for the program that has hindered attempts to advance the measure.
Lawmakers have said that expanding the Essential Plan, a state-funded insurance option for low-income New Yorkers, to undocumented immigrants would cost about $345 million. A report from the Citizens Budget Commission and the Community Service Society came to the same conclusion about the price tag for what advocates have dubbed “Coverage for All," accounting for expected reduced emergency Medicaid spending by the state.
However, Hochul’s team came to the table with a very different estimate. Her staff told lawmakers they put the cost at $1.9 billion in the first year, nearly six times higher than what the Legislature proposed. According to one legislative source with knowledge of the negotiations, the governor did not provide lawmakers with data to back up the claim, and the Health Committee chairs in both chambers have been trying to push back on it. The legislative source suggested the difference may come from a disparity in the expected number of enrollees in the first year. A spokesperson for the governor forwarded a request for comment to the state Division of the Budget, which confirmed the $1.9 billion price tag and added that lawmakers have underestimated their proposals, but did not provide data to support the claim.
State Senate Health Committee Chair Gustavo Rivera confirmed to City & State the nearly $2 billion cost the governor proposed, first reported by The New York Times. “It’s not an unusual tactic actually,” Rivera said in a text Monday morning. “They come in with a crazy (amount) and then we fight.” He said that they were still engaging in that fight, apparently with the enormous price difference still at play.
The health care proposal has attracted diverse support among different organizations and groups. Last week, several prominent unions called on state leaders to include it in the budget. It has also led to a coalition of progressive advocates and representatives for health plan providers in the state working together despite disagreeing on other issues like single-payer health care.
Assembly Health Committee Chair Richard Gottfried told City & State Monday afternoon that negotiations are ongoing. “Things are still up in the air,” Gottfried said as he exited the Assembly chamber. He added that he remains uncertain whether Hochul will budge on the cost even as legislators present people with evidence to support their cost estimate. But asked whether “Coverage for All” is still a major priority for his chamber, Gottfried replied with an emphatic “Absolutely.”
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