Health Coverage for the Most Vulnerable

Thanks to the Affordable Care Act, we have seen hundreds of thousands of New Yorkers access health care coverage for the first time in their lives. This has been possible because New York has invested in the successful implementation of the NY State of Health Marketplace and Navigator organizations, which provide in-person enrollment assistance to hard-to-reach communities.

But the gains in coverage are countered by rising health care prices and a complex healthcare system, causing profound barriers to care. Many people, particularly low-income communities of color, struggle to access health care, including mental health care. And the COVID-19 pandemic has exacerbated the health care affordability crisis: thousands of New Yorkers have lost job-based coverage, and many more cannot afford care. These New Yorkers will need help understanding their insurance options and trouble-shooting potential problems accessing coverage and care because of financial barriers.

For New York City’s communities of color, immigrants, people who are LGBTQ+, and people with disabilities and mental health concerns or substance use problems, the COVID-19 pandemic has highlighted flaws in our health care system, including inadequate access to needed mental health services.

The mission of the Urban Justice Center Mental Health Project (MHP) is to disrupt and dismantle the cycle of hospitalization, homelessness, and incarceration that traps low-income New Yorkers with serious mental health concerns. Access to affordable health care, including mental health care, is vital to keeping people from entering psychiatric hospitals, losing their homes or facing incarceration. We help hundreds of people each year who need to access mental health care or who are having problems with their health coverage that prevent them from getting the care they need.

One program that makes a big difference in the lives of our clients who struggle to navigate the health care system, particularly during this time of crisis, is the New York City Managed Care Consumer Assistance Program (MCCAP). MCCAP offers our clients a place to turn so they don’t have to contend with the insurance and health care system on their own when a problem arises. Launched in 1998 by the New York City Council, this model consumer assistance program helped more than 140,000 residents in all five boroughs. The program was discontinued in 2009 amid the economic downturn. Fortunately, Speaker Corey Johnson, Finance Committee Chair Daniel Dromm, Health Committee Chair Mark Levine and other members of New York City Council resuscitated MCCAP in 2019 with a grant of $500,000.

This funding has allowed an organization like ours, which works with some of the most vulnerable New Yorkers, to expand our services to help people with complex coverage problems; assist people in accessing affordable mental health care; and connect people with other resources that play a large role in overall health and well-being, like a source of income and safe housing. More than 80 percent of MCCAP clients are people of color and/or speak a language other than English at home.

During the COVID-19 pandemic, our MCCAP staff and the toll-free helpline remains available to help our clients access these services remotely. For example, Edward (not his real name), a person whose only income is public assistance and who is experiencing homelessness, contacted our office because he could not access a doctor who accepts Medicaid to prescribe him psychiatric medicine. He was scared to go to urgent care or see a doctor in person because of his risk of contracting COVID-19. Our staff explained about telehealth resources available to him, and we are currently working to find a provider covered by his Medicaid plan who can prescribe him medication by telehealth on an urgent basis.

But the current funding for MCCAP is not enough to meet the need. There are many high-need neighborhoods that would benefit from providing in-person services. As the City begins deliberations on an $83.9 billion municipal budget, we urge the City Council to consider increasing funding for MCCAP in the FY21 Budget to $700,000.

These times are dire, particularly for immigrant communities. The federal government’s new public charge rule is stoking genuine fear among many immigrant families afraid of being arrested or deported if they seek care. At the same time, access to affordable quality health care for all New Yorkers has never been more urgent. We need the City Council to fund MCCAP to ensure that all those who need health care can get it.

Rachel Gerson is Director of Guardianship & Health Care Advocacy for the Urban Justice Center Mental Health Project