De Blasio's 'NYC Care' Card Isn't Health Insurance, But It Could Improve Public Health

Mayor Bill de Blasio’s administration is promoting the NYC Care program, unveiled Tuesday, as a “new health coverage option” that will help achieve the goal of “guaranteed health care” for all—a promise worthy of a presidential candidate.

In reality, though, NYC Care is more of a public awareness campaign about the city’s existing public health services than a new health plan. It’s an effort to make the city’s 600,000 uninsured residents—about half of whom are ineligible for health insurance because they’re undocumented—feel welcome at the city’s public hospitals and clinics, while hiring new doctors to increase capacity. It’s one of several recent efforts at the city and state level to redirect patients from costly emergency room care to preventive health services and chronic disease management programs designed to save money in the long term.

“You will hear some critics who say we can’t afford to give everyone health care,” de Blasio said at a press conference about NYC Care at Lincoln Hospital in the Bronx Tuesday.

But the city already does.

The public hospital system’s mission has always been to provide care to everyone, regardless of whether they have insurance. In fact, NYC Health + Hospitals has only recently started to become diligent about billing insurers, according to Dr. Mitchell Katz, who became CEO at the beginning of 2018. A modern billing department has become a necessity since more people became insured through the Affordable Care Act in recent years, and since Health + Hospitals has gotten more serious about digging itself out of its financial hole.

Despite the somewhat misleading marketing around NYC Care, advocates for universal health care are optimistic that the new program will make the public health system’s services more accessible. The program, which will launch in the Bronx in August before expanding to other boroughs, will issue enrollees their own health card and assign them a dedicated primary care doctor at an H+H facility. It will also give them a number they can call for 24/7 assistance. As part of NYC Care, the city is hiring new doctors at NYC Health + Hospitals facilities, presumably contributing to the $100 million the program will cost annually once it’s fully rolled out. (Gothamist reached out to the city for a full breakdown of the $100 million price tag, but has yet to hear back.)

“Often one of the biggest complaints we have gotten about NYC Health + Hospitals in the past is, ‘Yes, I got an appointment but it’s very far out in the future and on the day I went I waited many hours to see a doctor,’” said Theo Oshiro, deputy director of Make the Road, a nonprofit that serves many undocumented New Yorkers. “So, the investment the mayor is talking about into the Health + Hospitals system, if done right, will go a long way to improving that reality for folks.”

“From a concrete standpoint, having an assigned primary care provider who is taking on more responsibility for care coordination can yield real benefits,” added Max Hadler, director of health policy at the New York Immigration Coalition.

But Hadler said it’s problematic for the city to represent NYC Care as health coverage. It would be up to the state to create a health insurance product that covers undocumented adults; the New York Immigration Coalition has been campaigning for years to get the state to expand its Essential Plan to do just that. (Children up to age 19 who are not eligible for Medicaid or other types of health insurance can get coverage through Child Health Plus, regardless of immigration status.)

The next step of de Blasio’s initiative to “guarantee health care for all,” which he announced in January, will be to encourage people who do qualify for insurance to sign up for MetroPlus, the existing health insurance plan run by NYC Health + Hospitals.

The uninsured need not wait for August or any other milestone (or press conference) to get care, however. As NYC Health + Hospitals states at the end of its FAQ on NYC Care, “You can access health care now. If you need to make an appointment to see a doctor, call 1-844-NYC-4NYC.”