Mutual Responsibility: A Study of Uninsured Immigrants’ Perspectives on Health Insurance in New York City

Data show that while immigrants comprise 22% of New York State’s population (nearly 4.2 million immigrants) and 37% of New York City’s population, they are approximately three times more likely than citizens to be uninsured.

A significant number of these immigrants are currently eligible for existing public health insurance programs; yet, they remain uninsured. This United Hospital Fund report seeks to uncover the barriers this population faces to maintain health insurance, the factors influencing their choices, and policy blueprints that help in increasing insurance enrollment among eligible immigrants.

The research study gathered information from talking with immigrants and the professionals they work with in three New York City communities to understand barriers to and perceptions of public health insurance. Among the various findings, the study reports the following limitations to coverage:

• Some groups held negative perceptions of public insurance plans, often related to discrimination, cultural competence, and impact on immigration status.
• The groups shared similar and unique concerns regarding cost of coverage related to value, affordability (and income), and availability.
• There are limited resources that address issues related to language barriers, application understandability, and immigration status eligibility to care; additionally, very few health education programs exist to assist immigrants obtain more comprehensive information about public health insurance coverage.