NEW YORK - Two years after the opening of the Health Exchange, more than 90 percent of New Yorkers have health insurance - but the state's immigrant population is lagging far behind.

Statewide, 17 percent of Latinos still are uninsured, and in Suffolk County, 44 percent of all uninsured individuals are immigrants. One issue has been application materials that primarily are in English.

Andrew Leonard, senior policy associate for the Children's Defense Fund, said another issue is cost.

"For those who either don't qualify for Medicaid because of their immigration status or have earned too much to qualify for Medicaid," he said, "some of the premiums in the private health plans may have been unaffordable."

Last year, online applications were made available in Spanish, and Leonard said the introduction this year of new, low-cost insurance called the Essential Plan should help close the gap.

The children of immigrants also are disproportionately uninsured. All children in the state under age 19, regardless of immigration status, are eligible for free or subsidized health care under the Child Health Plus program. Leonard said making insurance accessible to parents makes a difference for kids, too.

"Our end goal is to make sure that all children and all families are healthy," he said. "So, we want to make sure that that insurance coverage really leads to care, and we know that that's better achieved when parents are also insured."

Some immigrants may fear that enrolling in health insurance through the state could put them at risk.

Leonard said the state's insurance Marketplace doesn't report that information, but some people may need more assurance.

"One of the really important tools in addressing that is the navigator program that the state runs through community-based organizations that are able to communicate that in a more trusted way than maybe a notice from the state could," he said.

According to advocates for the uninsured, reaching out to immigrant communities in their own language and with cultural sensitivity can help eliminate the health insurance gap statewide.

New York State Health Exchange is online at mystateofhealth.ny.gov.


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Legislation in Albany would create the first right to counsel for people in immigration court.

The Access to Representation Act would provide immigrants the right to an attorney in their New York immigration cases, ending the tendency to represent themselves if they cannot afford one.

Estimates show a backlog of more than 330,000 immigration court cases, and fewer than half have attorneys. Studies show without legal counsel, migrants are less likely to remain in the U.S.

Marlene Galaz, director of immigrant rights policy for the New York Immigration Coalition, described what the bill would do.

"It has a six-year ramp-up to start implementing and building infrastructure," Galaz outlined. "Having a pipeline between law schools for law students to go into immigration practice, and getting to nonprofits and so on."

Galaz noted most opposition centers around the $150 million to fund the program but pointed out the total expenditure is less than 1% of the state's $229 billion budget. She added anti-immigrant rhetoric has also damaged support for the bill. Currently, it is in the state Senate Finance Committee.

The New York City Comptroller's office said enacting the bill would benefit the state financially. It could keep about 53,000 people from being deported, which would result in almost $8.5 billion in local, state and federal taxes over the next 30 years.

Galaz emphasized the influx of migrants has saturated the court system, leading to what could have been an avoidable backlog.

"I firmly believe that if these investments had been made when we first asked for them, I believe, like, three years ago, then we wouldn't be struggling," Galaz contended. "We would have had the infrastructure built to address an increase in welcoming our newest neighbors."

A Vera Institute survey showed 93% of New Yorkers across party lines and regions support access to attorneys for all people, including those in immigration court, and government-funded attorneys for them.


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Story has been updated to reflect late-night 5th Circuit Court of Appeals decision.(8:01 a.m. MST, Mar. 20, 2024)


The U.S. Supreme Court handed Texas Gov. Greg Abbott a big but temporary win Tuesday in his battle to stop the flow of migrants crossing the Texas-Mexico border.

Late Tuesday night, the 5th Circuit Court of Appeals put the law known as Senate Bill 4 on hold again. It would give state and local law enforcement the authority to arrest migrants as they cross into the U-S.

The Biden administration argued that the law would interfere with federal immigration law and is unconstitutional.

David Coale, an appellate attorney in Dallas, said if the state gets the authority to make arrests, he thinks it will move with caution.

"I think that Texas will want to make some very high-profile moves under this statute," Coale predicted. "But they also don't want to potentially expose themselves to massive civil rights liability if it turns out they're wrong."

Under SB-4, crossing the border illegally is a Class B misdemeanor, punishable by up to six months in jail. The appeals court hears oral arguments in the case today. Meanwhile, a Mexican government official said his country won't accept migrants deported under SB-4.

The Supreme Court justices did not issue a reason for allowing the law to go into effect and there's been no clear timetable for how or when Texas will start enforcing it. In 2012, the Supreme Court struck down parts of a similar law in Arizona, saying an impasse in Congress over immigration reform did not justify state intrusion.

Coale noted if the law is ultimately upheld, it would give each state the right to make its own immigration laws.

"If you give Texas a pass, you know, New York will have a different policy and California will have a policy and Montana will have a policy," Coale pointed out. "And they will not be consistent."

All six of the court's conservative justices agreed with the decision to allow the law to take effect - a ruling that, at least for now, was in effect for only a few hours.


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Both chambers of the New York state Legislature have included coverage for all legislation in their respective budgets.

The bills would update the state's Affordable Care Act Section 1332 waiver to make coverage available for all income-eligible people, regardless of their immigration status. Studies show half of likely undocumented immigrants and around 18% of lawfully present immigrants are uninsured.

Arline Cruz Escobar, health programs director for the group Make the Road New York, said the challenges stemming from a lack of coverage make life harder for the undocumented population.

"A lot of these preventable illnesses are going undetected and so, unfortunately, people are getting sicker," Cruz Escobar pointed out. "It also means that a lot of people who currently are sick aren't able to actually access the medication that they need."

One of the biggest obstacles to passing the bill is anti-immigrant rhetoric spreading across the country. However, many groups across the state submitted testimony declaring their support and need for this bill.

Cruz Escobar argued the growing migrant population in places such as New York City makes the bill more necessary. The New York City Comptroller's Office found the number of migrants not living in New York City but still in its care grew from 276 last May to more than 2,100 last September.

Beyond helping immigrants, supporters said the bill will benefit the state financially. The New York City Comptroller's office estimates passing coverage for all will generate $710 million in annual benefits.

Cruz Escobar described other elements of the bill.

"We have also included in our legislation language around giving the Commissioner of Health the ability to set up guardrails to ensure that for this expansion we don't over-cede the amount of surplus that's available."

She added the commissioner would also ensure there would be no additional cost through state dollars. Estimates showed New York State plans to spend more than $4 billion between 2022 and 2026 on issues related to migrants. Current spending is estimated at around $690 million.


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