Expanding Health Care Coverage

Grantee Name

Community Service Society of New York (CSS) and Mayor’s Office of Immigrant Affairs (MOIA)

Funding Area

Expanding Health Care Coverage

Publication Date

April 2018

Grant Amount

$453,747 ($110,000 to CSS; $343,747 to MOIA)


Although health insurance coverage has expanded in New York State, a significant group of residents has been left behind: immigrants.

Home to one of the largest and most diverse immigrant populations in the country, New York State has nearly 2 million residents who are noncitizens (lawfully present and undocumented), many of whom lack health insurance coverage. Without coverage, many of these immigrants left behind by the Affordable Care Act’s health insurance expansion would continue to turn to emergency rooms and public hospitals.

NYHealth set out to address the insurance needs of immigrants without health coverage through two projects. NYHealth awarded CSS a grant in 2014 to examine the costs and feasibility of multiple insurance options for undocumented immigrants in New York State. A 2015 grant to MOIA was used to connect undocumented New Yorkers eligible for Deferred Action for Childhood Arrivals (DACA) status and existing DACA recipients to State-funded Medicaid coverage, if uninsured and income-eligible.

Outcomes and Lessons Learned

CSS grant:

  • Conducted preliminary research; data acquisition and analysis; interviews with immigration data experts; and actuarial modeling.
  • Produced a report modeling the design, estimated uptake, and costs of each of the following coverage options:
    • Providing comprehensive coverage to undocumented DACA-eligible young adults (19–29 years old) who are too old for Child Health Plus coverage and not income-eligible for State-funded Medicaid;
    • Establishing a limited benefits package for undocumented immigrants who have enrolled in Emergency Medicaid; and
    • Offering comprehensive coverage to undocumented immigrants whose incomes are below 200% of the federal poverty level, through a State-only funded Basic Health Plan (known as the Essential Plan), which would be offered through private health insurance companies.

Since the report was issued, an advocacy coalition managed in part by CSS has continued to seek policy changes to extend coverage to undocumented populations and preserve current coverage options for other immigrant New Yorkers. The Health Care for All New York (HCFANY) coalition has advocated in Albany for various proposals that grew out of this project. In 2016, HCFANY advocated that the Essential Plan use State-only funds to cover income-eligible DACA recipients, particularly those who are losing Medicaid eligibility as they earn higher incomes. In 2017 and 2018, HCFANY advocated that New York State (1) expand the Essential Plan using State-only funds to cover all New Yorkers up to 200% of the federal poverty level, regardless of immigration status; (2) address the needs of immigrant New Yorkers losing Temporary Protected Status (and thus their permanently residing under color of law status, or PRUCOL) as the result of a decision by the Trump Administration; and (3) extend New York’s Child Health Plus program to age 29. Although none of these proposals has achieved passage, in April 2018, the New York State Assembly passed a bill to preserve the PRUCOL Medicaid benefits for New Yorkers who lose Temporary Protected Status because of changes at the federal level. In January 2018, Governor Cuomo announced that New York would preserve State Medicaid eligibility for DACA recipients, should they lose their federal DACA status because of changes at the federal level.

MOIA grant:

  • Conducted the first large-scale public education campaign anywhere in the United States that focused exclusively on DACA recipients’ eligibility for state-funded Medicaid and other health benefits in multiple languages (English, Spanish, Chinese, Korean, Haitian-Creole, Polish, Russian, Urdu, Bangla, French, and Arabic).
  • Ran 100 quarter-page ads in 25 ethnic media outlets, targeting key immigrant populations, reaching a total circulation of more than 1.5 million people.
  • Conducted online advertising, with more than 3.1 million impressions through its paid Facebook, Instagram, and Twitter ads.
  • Conducted public transit advertising, with ads in 2,000 subway cars across New York City over an 8-week period, generating more than 17.3 million impressions. Ads on 50 bus and phone shelters generated more than 24 million impressions over the same time period.
  • Developed education materials, with the distribution of 344,000 info-cards in nail salons, barber shops, laundromats, cash businesses, local pharmacies, and other small businesses frequently visited by immigrants in the campaign’s targeted neighborhoods. MOIA’s outreach team also delivered info-cards to community-based organizations, schools, places of worship, health fairs, immigration clinics, elected officials’ offices, and City health department sites.
  • Trained 30 enrollment Navigators and attorneys and about 90 Certified Application Counselors and health advocates on DACA Medicaid eligibility.
  • Offered centralized resources and referrals to insurance Navigators through MOIA’s DACA website and its NYC 311 public information telephone line scripts.

Following the campaign, first-time DACA applications jumped nearly 500% in New York State. In the quarter before the campaign launched, only about 750 initial DACA applications were filed in New York State. In the months directly following the campaign, more than 3,400 were filed. Monthly visits to New York City’s DACA website increased more than 4,000% following the campaign’s launch.

Read the full grant outcome report.

Co-Funding and Additional Funds Leveraged:

CSS: Co-funding from the New York Community Trust, the Altman Foundation, and the United Hospital Fund ($330,000).