California, New York City move to provide health care coverage to undocumented residents

(CNN) — The Democratic leaders of California and New York City are taking steps to provide health care coverage to some undocumented residents.

On his first day in office, California Gov. Gavin Newsom proposed a budget on Monday that would make California the only state in the nation to provide coverage to undocumented young adults through its Medicaid program.

New York City Mayor Bill de Blasio announced an even more ambitious program on Tuesday called NYC Care that would provide coverage for all New Yorkers. There are roughly 600,000 residents without health insurance, half of them undocumented immigrants.

“From this moment on in New York City, everyone is guaranteed the right to health care,” said de Blasio, comparing it to the universal pre-K program his administration implemented several years ago.

NYC Care will start rolling out in coming months and will take more than two years to be fully implemented, de Blasio said. It will cost at least $100 million, but the mayor said that the city would save a lot because fewer people would go to the emergency room, which provides pricey and inefficient care.

De Blasio told MSNBC’s “Morning Joe” that the city would not raise taxes but would instead fund the program through the city’s public health care system, which is now in better financial shape after years of dire straits.

“We’re spending a lot of money right now and we’re not spending it the way we want to because people go to the emergency room,” de Blasio said at a news conference. “You have a lot of savings over time by not having people get health care the wrong way.”

The mayor’s two-pronged approach will harness the MetroPlus Health Plan, a subsidiary of the city’s public hospital system that offers coverage to more than half-a-million New Yorkers via Medicaid, Medicare and Affordable Care Act policies. It will seek to boost enrollment among those who qualify, but are uninsured.

Also, the city will use NYC Care to connect New Yorkers who are not eligible for health insurance, especially the undocumented or those who can’t afford coverage, to health care. They will be assigned a primary care doctor and have access to specialty care, prescription drugs, mental health services and hospitalization. Services will be priced on a sliding scale and will be free for the poor.

Wait times to see a primary care doctor would be in line with the one to two weeks it currently takes, officials said.

One question is whether undocumented immigrants will sign up at a time when the federal government has increased deportation efforts, said David Sandman, CEO of the New York State Health Foundation, a health care policy, research and grantmaking organization.

“It’s a very challenging time to roll out that welcome mat,” Sandman said.

In California, Newsom would allow undocumented residents up to age 26 to enroll in Medi-Cal, the state’s Medicaid program. The Golden State became the first to cover undocumented children up to age 19 in 2016.

“Undocumented young adults should not have to worry about losing their health coverage when they turn 19,” said Newsom, describing the effort as “another major step toward universal coverage.”

In a nod to creating a state-based single-payer system, the Democratic governor sent a letter to President Donald Trump and congressional leadership on Monday requesting that the federal government “empower States like mine to design and implement truly transformative solutions for securing affordable health care for all.”

Covering more undocumented Californians is part of a broader health care package Newsom unveiled Monday. The new governor also signed an executive order to create “the largest single purchaser for prescription drugs and allow private employers to join the state in negotiating drug prices,” according to a statement from the governor’s office.

“No state has more at stake on the issue of health care. California must lead,” Newsom said in the statement. “We will use our market power and our moral power to demand fairer prices for prescription drugs. And we will continue to move closer to ensuring health care for every Californian.”

High drug prices have been in the national spotlight lately, with the Trump administration and Congress both promising to lower costs.

In addition, Newsom wants to expand the Affordable Care Act’s financial assistance to middle-income Californians. More than 80% of Obamacare enrollees take advantage of federal premium subsidies, and one of the main criticisms of the law is that premiums are unaffordable for those who don’t receive subsidies.

Newsom’s plan is to expand access to financial assistance to individuals earning up to $72,840 and families of four earning up to $150,600. Currently, individuals making up to $48,000 per year and families of four earning up to $98,000 can receive federal subsidies under the Affordable Care Act.

Peter Lee, the executive director of Covered California, the state’s Affordable Care Act exchange, praised Newsom’s sweeping new proposals and actions.

“We applaud Governor Newsom for building on the strong foundation of the Affordable Care Act in his first official action,” Lee said in a statement. “At a time of ongoing uncertainty from Washington, the governor is not only embracing policies that will lower the cost of coverage for millions in the individual market, he is also offering increased help to those who are struggling with rising costs.”

Lee also noted that the governor’s plan to restore an individual mandate penalty — which would be levied on those who don’t have health insurance — would lower health care costs and increase enrollment. Congress essentially eliminated the federal individual mandate by reduce the penalty to $0 as part of the 2017 tax cut law.

Californians have through January 15 to sign up for Affordable Care Act coverage through Covered California.

Newsom also signed an executive order to establish a California surgeon general, according to the statement.

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