By Jillian Jorgensen
Mayor de Blasio vowed Tuesday that for $100 million New York City can guarantee healthcare to every New York City resident -- including around 300,000 undocumented immigrants.
"No one will be turned away, and the care will be comprehensive," de Blasio said at Lincoln Hospital in the Bronx.
The program, dubbed NYC Care, is aimed at providing either insurance or health services to the 600,000 New Yorkers who are uninsured, 300,000 of whom are undocumented immigrants who cannot be insured. The other 300,000 are people who cannot afford healthcare on the Affordable Care Act exchanges, the city said, or who simply opt not to purchase it.
The city will take a two-pronged approach to reaching those people. For those who cannot be insured, the city will provide a NYC Care membership card that will allow them to access a primary care doctor at the city's Health + Hospitals network. Pricing will be done on an a sliding scale, and patients will be able to get specialty care, prescription drugs, and mental health help.
For those who can be insured, the city will expand its MetroPlus program, which functions as the city's public option for free or affordable health insurance. That program is already available on the ACA exchange, but de Blasio said it would be revamped in ways to make it more attractive to people who have so far opted not to sign up.
It will cost $100 million a year when scaled up, de Blasio said. Undocumented people are already guaranteed healthcare at the city's public hospitals, but de Blasio and other officials said the new program would allow them to better manage their health -- preventing the costly emergency room visits that often make up the bulk of their interaction with the healthcare system.
"We're spending a lot of money right now and we're not spending it the way we want to," he said. "A number of hospitalizations are caused because people didn't get care earlier and better."
The scale of the effort is smaller than universal healthcare or Medicaid for All, proposals that have become increasingly popular. In Albany, lawmakers are considering legislation to create a single-payer healthcare system in the state, something de Blasio said he supported.
"We're going to work for those changes, but our people need healthcare now. They need it right now," he said.
The program comes as de Blasio said Health + Hospitals is in the midst of a remarkable turnaround. In 2016, de Blasio had to funnel hundreds of millions from the city budget into the public hospital network just to keep the doors open. In 2017, amid a spat between the city and state over federal funding for the hospital network, its interim head said Health + Hospital had just 18 days worth of cash on hand.
Now, the system is in a "very good cash position," city Budget Director Melanie Hartzog said. The wait time to see a primary care doctor -- which was months last year -- is down to one to two weeks, Katz said.
"The situation has changed dramatically," Katz said, in part due to hiring more primary care doctors.
The large percentage of Health + Hospitals patients who are uninsured was one part of the massive financial strain the system was under -- and expanding MetroPlus, which would bring in more paying patients, could help bolster it further. But Dr. Katz said that wasn't the goal.
"I see it as a way of meeting the need in the community and keeping people out of the hospital," he said.
Still, de Blasio said he did believe the expansion would bring in new patients to Health + Hospitals.
"It's going to show more and more New Yorkers that they can get what they need through Health + Hospitals," he said.
As for how to convince young people who have felt they do not need insurance to sign up for MetroPlus -- which has long been available -- de Blasio said the city was rolling out a "much better MetroPlus" that he hoped would appeal to younger people who "are not thrilled about giving their money to a big for-profit" insurance company.
The proposal was met with criticism from pols on de Blasio's right, including Assemblywoman Nicole Malliotakis (R-Staten Island), who ran against de Blasio for mayor in 2017.
"Our citizens have a hard enough time covering their own healthcare costs and now Mayor de Blasio also wants them to pay for the healthcare of 300,000 citizens of other countries. The Mayor must stop abusing the middle class and treating us like his personal ATM," she said.
De Blasio said those undocumented immigrants were simply people's neighbors and co-workers.
"I just refused the notion that these folks don't deserve healthcare and I refuse the fiction that they have some other place to turn for it that's so wonderful and easy," de Blasio said.
He argued it was both the "morally right choice" and one that will save taxpayers money in the end, by reducing trips to the emergency room for which taxpayers are already picking up the bill.
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