Seeking treatment (photo: Michael Appleton/Mayor's Office)
Gloria thought she was in good health and was managing her diabetes well. Then the unthinkable happened – she was hospitalized for 10 months due to COVID-19. Gloria suffered severe effects from the virus and had to be intubated, after which she was left paralyzed. Now Gloria needs ongoing nursing care and physical therapy to regain mobility and work on her speech.
Gloria is originally from Colombia and now lives in New York City – due to her immigration status, she is not able to receive Medicaid or other state-funded health care to cover her medical needs. For nearly 400,000 immigrants who are uninsured in New York, this is their reality.
We’ve been battling COVID-19 for more than a year now. Immigrants remain at the forefront of this battle, and yet continue to be excluded from necessary and comprehensive health-care coverage. Accessible health care has always been a necessity, but as we continue to learn about the long-term effects of COVID-19 infections and the required follow-up care, New York State leaders must immediately provide health-care coverage to those impacted by the virus and ensure health care is accessible to all.
This means taking one key step in the state budget that is being negotiated right now by the State Legislature and Governor Cuomo and due by the April 1 start of the new fiscal year.
Immigrants have always kept our city running, and this became especially true when only essential businesses were open during the height of the coronavirus crisis. Immigrants make up one-third of essential workers in New York State, with 70% of people who are undocumented in the labor force working in essential businesses and putting their own health at risk. The resulting ongoing exposure has no doubt contributed to the disproportionate impact of the virus on immigrant communities in New York.
However, exposure is not the only issue. Access to health care has been proven to improve one’s overall health, which may reduce the risk of serious COVID-19 complications. Yet many New Yorkers like Gloria continue to be blocked from necessary coverage or are deterred from accessing care by confusing and draconian immigration and enforcement policies. A recent study showed that “nationally roughly 1 out of every 3 COVID-19 deaths are linked to health insurance gaps” and that “more than 40% of all COVID-19 infections are associated with health insurance gaps.”
COVID-19 testing and immediate treatment is available to everyone in New York through Emergency Medicaid, but that doesn’t help Gloria and the thousands like her to receive the ongoing care they need after devastating covid infections. Emergency Medicaid is only meant to provide coverage for immediate medical treatment of acute symptoms in often life-threatening circumstances. It does not cover all medically-necessary services or ongoing care, even if that lack of coverage has fatal consequences for the patient. New York explicitly excludes nursing facilities from coverage, like the ones needed by Gloria to recover from this devastating virus.
After 10 months in the hospital, Gloria’s husband, Marco, found a way to pay out of pocket to transfer her to a nursing home for necessary ongoing treatment and care. He does not know how long he can maintain these payments, or if the facility he can afford is really providing competent care for his wife. Gloria has been at the nursing home since January and has been readmitted to the hospital at least twice because of bacterial infections. Marco wants her moved to another nursing home, but has no way of doing that.
Insurance coverage and health-care access are huge problems for COVID-19 patients, as the long-term effects of the virus are far-reaching and not yet fully understood. The virus may affect a person’s heart, kidneys, lungs, brain and other organs. Other people survive the virus without any specific injury to an organ, but are called “long-haulers” because of chronic fatigue, shortness of breath, inability to concentrate, and other symptoms. Some studies find more than 50% of people “recovered” from COVID-19 affected by these symptoms three months later.
For many years, activists and public health experts have advocated for universal health care. A year into a global pandemic that has killed more than 500,000 Americans, some states are at least proposing ways to mitigate the effects of the public health and health-care crises. Bills now pending in the New York State Legislature propose broad change as well as temporary solutions to expand the state’s Essential Plan during this health crisis and provide health-care coverage to anyone who has survived COVID-19 but is excluded from coverage because of their immigration status.
While this proposed Essential Plan expansion would be temporary, and not nearly enough, it is urgently necessary to meet the immediate and urgent needs of thousands of New Yorkers who, like Gloria, have been shattered by this virus. New York leaders should pass it immediately; in the new state budget if needed.
The ongoing public health crisis has further illuminated the need for universal health coverage in New York. Accessible and comprehensive healthcare should be guaranteed to every state resident regardless of immigration status, age, disability or employment status. While we work towards a thorough solution to our broken healthcare system, right now the New York Legislature must support expanding the Essential Plan. We are living through an emergency, and we must at least provide a lifeboat.
Amber Khan is Director of the Health Justice Program at New York Lawyers for the Public Interest. On Twitter @NYLPI.