ASPPH logo


Member Research & Reports

Member Research & Reports

CUNY: Researchers Assess the Experience of Undocumented Immigrants with a Health Care Financial Assistance Program

Since the Affordable Care act was implemented in 2010, the percentage of uninsured adults in the U.S. has declined significantly. Despite this progress, over 28 million people remain uninsured, 21 percent of whom are non-citizens, including undocumented immigrants.

New York City Health and Hospitals (H&H) is the largest municipal health care system in the U.S., offering care to all New Yorkers regardless of their ability to pay. The organization Options program is a financial assistance program for uninsured or underinsured patients. They offer a sliding-scale payment structure for a range of inpatient and outpatient services. Since care is offered irrespective of patients citizenship status, H&H is one of the city’s primary providers of healthcare to its undocumented immigrant population.

To assess the experience of undocumented immigrants with the Options program, CUNY Graduate School of Public Health and Health Policy associate professor Dr. Diana Romero and doctoral alumna Dr. Kathleen Flandrick led a mixed-methods study published in the Journal of Health Care for the Poor and Underserved.

The researchers found that few participants were aware of the Options program and identified a need for greater community-based outreach efforts and for activities that address concerns regarding immigrant status and fear of high bills and long-term debt.

“It was through partnership with NYC H&H and numerous community-based organizations that we were able to engage with individuals from myriad cultural and linguistic backgrounds,” Dr. Romero says. “This project provided rich information about immigrants’ experiences with and concerns in accessing health care in NYC that we hope the city hospital system can consider going forward.”