By Hank Russell
A recent analysis published by the Empire Center showed that more than 500,000 illegal aliens in New York State are on Medicaid. It also reported that an additional 730,000 non-citizens were enrolled in the state’s Essential Plan before the One Big Beautiful Bill (OBBB) became law.
According to the think tank, 490,000 undocumented immigrants under the age of 65 whose household income was below 138% of the federal poverty level were enrolled in Emergency Medicaid. Further, an additional 25,000 illegal immigrants over the age of 65 and whose income is less than 138% of the federal poverty level. According to a spokesperson with the state Health Department, the cost of the new enrollees in the state-funded Medicaid program cost an estimated $230 million.
The number of undocumented migrants with income greater than 138% of the federal poverty level who are not covered by any plan was not made available.
The 730,000 enrollees in the Essential Plan are immigrants “permanently residing under the color of law”; that is, immigrants who are not fully documented, but have legal protections to stay in the country.
“This group includes people who have been granted asylum or who have pending asylum applications and those covered by the Deferred Action for Childhood Arrivals,” said the author, Bill Hammond.
Of that number, 506,000 have incomes less than 138% of the federal poverty level, while 224,000 have incomes between 138% to 250% of the federal poverty level. Now that the OBBB is now law, the former group will now on the state-only Medicaid plan, while the latter group will not be covered.
The state was constitutionally obligated to provide health coverage for immigrants — whether the federal funding is there or not — thanks to the 2001 court decision Aliessa v. Novello. “Under that ruling, the state formerly paid the full cost of Medicaid coverage for hundreds of thousands of immigrants in the so-called Aliessa population,” Hammond explained.
Over the years, Essential Plan spending has skyrocketed. According to the Empire Center’s analysis of the New York State Division of the Budget data, spending grew astronomically from $1.539 million in 2016 to $12.417 million this year. Next year, spending is expected to increase by 6.6% to $13.234 million.
In two more years, the Empire Center said, those on the Essential Plan whose incomes are more than 138% of the federal poverty level will no longer be covered. In addition, they will no longer qualify for tax credits to buy commercial insurance.
Health coverage has been a hot topic the past few weeks and it has gotten hotter now with the government shutdown taking effect. The main sticking point has been healthcare coverage; Republicans said they are cutting out waste and fraud, while Democrats said hundreds of thousands of people will lose their health insurance.
Vice President JD Vance posted on X (formerly Twitter) an announcement from the state’s NYStateOfHealth website last year that a new healthcare program for illegal aliens over the age of 65. This was in response to a post by U.S. Senator Sheldon Whitehouse (D-Rhode Island), which read, “‘Health care for illegal aliens’ is the new ‘immigrants are eating cats and dogs in Springfield.’ The Republican playbook is simple: make up a baseless lie, repeat it every chance you get, and hope and pray that everyone blames Democrats for the crises you created.”
U.S. Representative Elise Stefanike (R-Poughkeepsie) responded with a post of her own. “.@KathyHochul is giving FREE Medicaid to illegal immigrants while hardworking New Yorkers struggle to afford healthcare and foot the bill with the highest taxes in the nation,” she wrote on X. “Kathy Hochul and NY Democrats [put] illegals FIRST and New Yorkers LAST.”