United Hospital Fund Report Focuses on New York's Noncitizens and Health Insurance Coverage
Nearly 30 Percent of New York's Uninsured Are Noncitizens;
A Second New Report Takes a Snapshot of Insurance Coverage Both Statewide and Citywide, and Identifies Key Trends
Noncitizens represent a large and disproportionate share of New York's uninsured population, according to a new report published by the United Hospital Fund. Nearly 30 percent of the state's uninsured are noncitizens, and noncitizens are three times more likely to be uninsured than citizens—important facts for state and federal policymakers to consider as discussions on expanding health insurance coverage proceed.
“Characteristics and Health Insurance Coverage of New York's Noncitizens” looks at similarities and differences in health insurance coverage patterns, not just between citizens (14.6 million) and noncitizens (1.9 million) , but also, where possible, between documented (1.2 million) and undocumented (0.7 million) noncitizens.
In New York, while citizens and documented noncitizens are equally eligible for public insurance programs, noncitizens are disproportionately uninsured. Among the reasons identified by the report's researchers:
• Noncitizens have more limited access to employer-sponsored insurance, largely because they tend to be low-wage workers in the service sector, where employer-sponsored insurance offer rates are low.
• Noncitizens face barriers to enrollment in public programs, including fear that applying for coverage or enrollment may adversely affect the ability to gain citizenship and access issues related to language. (Undocumented non-citizen adults face these barriers as well as additional eligibility obstacles.)
Among the surprising findings, the report dispels the widely held belief that noncitizens, because of their limited access to employer-sponsored insurance and low incomes, must have especially high rates of enrollment in public insurance programs. In fact, 27 percent of noncitizens are enrolled in public programs. (For comparison, the enrollment rate among citizens is 23 percent.)
“Representing 30 percent of our uninsured population, noncitizens can't be ignored in federal and state discussions on insurance coverage expansion,” says James R. Tallon, Jr., president of the United Hospital Fund. “If significant portions of this population are excluded from health care reform, the burden of their care will continue to fall largely on our hospitals and clinics, so we would need to maintain a significant charity pool to compensate these providers for such care.”
Also just released is “Health Insurance Coverage in New York, 2006-2007,” the United Hospital Fund's annual chartbook, which provides an invaluable snapshot of the uninsured in New York—detailing income, employment status, age, and other demographic information, tracking the coverage distribution among workers and low-income New Yorkers, and estimating the number of uninsured New Yorkers who are eligible for public health insurance.
Among the findings in the new chartbook:
• There are 1.3 million non-elderly uninsured residents in New York City (18 percent of the population) and 2.5 million non-elderly uninsured residents in New York State (15 percent of the population).
• Eight out of ten uninsured persons are workers or their dependents.
• An estimated 1 million (or 44 percent) of uninsured New Yorkers are eligible for public coverage but unenrolled.
• While between 2000 and 2004, the uninsured rate declined significantly in New York State because of increases in public coverage, between 2004 and 2007, the uninsured rate increased (though not significantly) as a result of erosion in employer-sponsored insurance.
Prepared by Danielle Holahan of the United Hospital Fund and Allison Cook of the Urban Institute, Characteristics and Health Insurance Coverage of New York's Noncitizens is available on the Fund's website.
Prepared by Allison Cook and Aimee Williams of the Urban Institute and Danielle Holahan of the United Hospital Fund, Health Insurance Coverage in New York, 2006-2007 is also available on the Fund's website.
Note: The data from these two reports look at snapshots from different time periods. Special attention should be paid to avoid inaccuracies when comparing these data.
About the United Hospital Fund: The United Hospital Fund is a health services research and philanthropic organization whose mission is to shape positive change in health care for the people of New York.