NEW YORK - Undocumented immigrants aren't covered under the Affordable Care Act, leaving about 457,000 people ineligible for coverage in New York alone.

A new report from the Community Service Society, which advocates for impoverished New Yorkers, outlines what it calls "practical and affordable" ways to close the coverage gap.

The group's vice president of health initiatives, Elisabeth Benjamin, says covering more immigrants, even under the most expensive proposal, would cost less than one-half of one percent of the state's Medicaid budget.

"The extension of the 'Essential Plan,' which provides health coverage to people up to 200 percent of poverty. There would be 241,000 eligible New Yorker's eligible," says Benjamin. "We think 111,000 would potentially join and it would cost $462 million a year."

Benjamin adds people who are uninsured are more vulnerable to illness, death and economic ruin from expensive medical costs. She says those who have health coverage end up sharing the cost burden, through higher taxes, medical bills and insurance costs.

More importantly, says Benjamin, her group believes insuring people no matter what their immigration status is the right thing to do.

"We have lots of new Americans in New York State," says Benjamin. "They contribute substantially in taxes and in providing us great workers and so, it's sort of a matter of justice. It's only fair to treat our immigrant residents equally as other residents."

She notes under the Affordable Care Act, federal funding to offset hospital costs for the uninsured will gradually be reduced starting in 2017, so the state needs to plan for that. She says New York receives more of this funding than any other state.


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Lawmakers and immigrants-rights activists in the Commonwealth are hoping to pass the Language Access and Inclusion Act, which would dramatically expand the availability of non-English language resources at government agencies.

Key documents for MassHealth or unemployment insurance would be translated for non-English speakers while interpretive services and staff would be made readily available at state offices.

Sen. Sal DiDomenico, D-Everett, said the bill would help the one-in-10 state residents considered having limited proficiency in English.

"We can't wait two, three, four more years for our friends in our community getting lost in the shuffle and not being valued for what they bring to our state," DiDomenico asserted.

DiDomenico argued the government owes language services to the immigrants and essential workers who showed up during the pandemic and kept the economy running.

In fact, DiDomenico noted while bus routes in many parts of Boston operated at 10% capacity throughout the pandemic, buses in his district were at 50% capacity, because many of his constituents did not have an option to work from home.

Rep. Carlos González, D-Springfield, the bill's co-sponsor, said every lawmaker in the Commonwealth has a large immigrant community who would benefit from this legislation, because everyone is an immigrant.

"So we have a commitment to make sure that Massachusetts speaks as loud as it can to make sure that everybody is represented in whatever language is their first language," González stated.

González added structural change is needed to address a discriminatory issue holding people back from the benefits and services to which they are entitled and need to survive.

The bill would create an advisory board with representatives from limited English-speaking communities, the deaf or hearing-impaired community, and legal service providers to help agencies best implement the law.

Undocumented workers in Washington state do not have access to unemployment insurance, but some state lawmakers aim to change it this session.

The bill proposed in the House and Senate would create a wage replacement program for undocumented Washingtonians who lose their jobs.

Sasha Wasserstrom, policy director for the Washington Immigrant Solidarity Network, said immigrants are a vital part of the state's economy, and called the measure long overdue.

"We are hoping for this legislation to pass in order for undocumented workers to finally get what is due to them," Wasserstrom contended. "Which is having the security that if they lose their jobs -- through no fault of their own -- that they can have the same security that any other resident has of Washington state."

Wasserstrom pointed out undocumented workers pay the taxes which support unemployment benefits, but are not eligible for them. Data from 2019 found households headed by undocumented immigrants paid $371 million in state and local taxes. Businesses are pushing back on the legislation, saying employers who knowingly hire ineligible workers face penalties under federal laws.

Wasserstrom noted workers who have no safety net when they are laid off put not only themselves in a difficult situation, but their families as well.

"We've heard so many stories of how not having that security has put folks in dangerous or violent situations -- has created food insecurity issues for families, made it more dangerous for parents and children in the home -- without having the possibility of income replacement," Wasserstrom recounted.

Other states have established programs to provide benefits for undocumented workers, including Colorado.

The Senate version of the Washington state measure is scheduled for a public hearing on Thursday.

Connecticut lawmakers are being asked to expand HUSKY - the state's Medicaid program - to include immigrants, regardless of their status.

Two years ago, legislation was passed to provide HUSKY Medicaid for undocumented children from birth to age eight, and for pre- and postnatal care for pregnancies of undocumented people beginning this year. Last year, kids were added up to age 12.

Now, advocates hope to expand HUSKY to immigrants and kids of all ages. Several groups are meeting with lawmakers today to discuss legislation for this expansion.

Luis Luna, coalition manager for the group "HUSKY 4 Immigrants," noted what he's hoping will come from this conversation.

"What we want to show is the issue, the issue at hand, that we must provide healthcare beyond 18," said Luna. "The other one, too, is we want to show, like, the broad support - not only from folks who are affected by this, but also from legislators, organizations, from healthcare providers."

More than 300 healthcare providers signed a letter in support of HUSKY expansion. In to a survey by the Universal Healthcare Foundation of Connecticut, it's a view shared by 57% of the state's residents.

A 2021 bill to expand HUSKY failed in committee in the General Assembly, because of cost. Opponents said it would also mean the state couldn't get federal funding for those who qualify for the expanded coverage.

A report from the Rand Corporation shows that adding immigrants to HUSKY would cost $83 million, but would provide over 21,000 people in the state with coverage.

Luna said the critical need for healthcare during the pandemic is part of what has fueled support for this expansion.

"In the beginning of the campaign, the first challenge was to change the narrative," said Luna, "that undocumented folks deserve healthcare. We've been continuing to push that narrative beyond 18. We do not want to get stuck in just having children only access HUSKY through this program, because it just brings a whole set of problems if you don't have an inclusive program."

He said one challenge of the campaign is rooted in legislators' views of who does - or doesn't - deserve healthcare.