Iden­ti­fy­ing Fair, Effec­tive, and Sus­tain­able Local Pol­icy Solutions

April 2015

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About this report

This inde­pen­dent report is based on a meet­ing con­vened by the New York Immi­gra­tion Coali­tion and the Undoc­u­mented Patients Project of The Hast­ings Cen­ter, which was hosted by the Vera Insti­tute of Jus­tice in New York City on Decem­ber 11–12, 2014. The goals of this meet­ing were to sharpen local stake­hold­ers’ under­stand­ing of gaps in access to health care for pop­u­la­tions left out of the Patient Pro­tec­tion and Afford­able Care Act of 2010 (ACA)—in par­tic­u­lar, New York City res­i­dents who are both undoc­u­mented and uninsured—and to iden­tify proven or promis­ing local solu­tions to clos­ing these gaps in other cities, coun­ties, and states. Although this report and its rec­om­men­da­tions focus on chal­lenges and solu­tions in New York City, it may also be use­ful to other New York State munic­i­pal­i­ties, and to other cities and coun­ties in the United States.

This doc­u­ment describes New York City’s undoc­u­mented unin­sured pop­u­la­tion, the City’s safety-net health care sys­tem, and the spe­cific gaps in cov­er­age and financ­ing that impede access to health care for this pop­u­la­tion. It also describes spe­cial oppor­tu­ni­ties and chal­lenges for health care sys­tem improve­ment in the City and com­pares mod­els that are proven or promis­ing as sus­tain­able ways to improve access to health care for undoc­u­mented immi­grants and other unin­sured pop­u­la­tions. It con­cludes with six action­able rec­om­men­da­tions for City stake­hold­ers, sup­ported by guid­ance for ongo­ing plan­ning, pro­gram devel­op­ment, and sys­tem improve­ment. The final draft of this report was pro­vided to the Office of the Mayor of New York City, Task Force on Immi­grant Health Access, Care & Cov­er­age Sub­group, on Feb­ru­ary 28, 2015.

Con­trib­u­tors

Nancy Berlinger, PhD, is a Research Scholar at The Hast­ings Cen­ter and the co-director of the Undoc­u­mented Patients Project.

Clau­dia Cal­hoon, MPH, is Health Advo­cacy Senior Spe­cial­ist at the New York Immi­gra­tion Coalition.

Michael K. Gus­mano, PhD, is a Research Scholar at The Hast­ings Cen­ter and the co-director of the Undoc­u­mented Patients Project.

Jackie Vimo, MA, is Regional Advo­cacy Direc­tor at the New York Immi­gra­tion Coalition.

The authors of this report are respon­si­ble for the rec­om­men­da­tions that fol­low. The authors acknowl­edge the assis­tance of Mohini Baner­jee and Chelsea Jack, Research Assis­tants at The Hast­ings Cen­ter, in prepar­ing this report, which was designed by Nora Porter. The Decem­ber 2014 stake­holder meet­ing and the sub­se­quent prepa­ra­tion of a work­ing paper and this pub­lic report were made pos­si­ble by a dis­cre­tionary grant from The Robert Ster­ling Clark Foundation.

How to Cite this Report

Berlinger, Nancy, Clau­dia Cal­hoon, Michael K. Gus­mano, and Jackie Vimo, Undoc­u­mented Immi­grants and Access to Health Care in New York City: Iden­ti­fy­ing Fair, Effec­tive, and Sus­tain­able Local Pol­icy Solu­tions: Report and Rec­om­men­da­tions to the Office of the Mayor of New York City, The Hast­ings Cen­ter and the New York Immi­gra­tion Coali­tion, April 2015. Full text avail­able at: www.undocumentedpatients.org and www.thenyic.org/healthcare

Click to access the Report and Recommendations