Good afternoon.

Welcome to the hearing for the committee on hospitals.

If you're here for the mass, you're in the right room.

Sorry.

At this time, one ask, please, everyone please to silence your electronic devices.

Also at this point moving forward, no one is to approach the dais.

And also there is no food and beverages allowed in the hearing room.

Also, if you'd like to make an in-person uh testimony today, please see you on the sermon at arms here today.

That being said, Chair, we're ready to begin.

Thank you.

Good afternoon.

I am Council Member Mercedes Narcisse, Chair of the Committee on Hospitals.

Thank you for joining us today for our oversight hearing on examining HYC care program and access to health care for uninsured New Yorkers.

Over the years, New York State has made significant progress in expanding access to health insurance, and today has one of the lowest uninsured rate in the nation.

Through investment in Medicaid, the Essential Plan, Child Health Plus, and other public coverage programs, millions of New Yorkers have gained access to preventive care, primary care providers, prescription medications, and treatment for chronic conditions.

Yet, despite this achievements, access to coverage remains uneven.

Certain populations, including immigrants, or our new arrival, Hispanic New Yorkers and Black, and many working families continue to experience higher rates of uninsurance and face barriers to enrollment in an maintaining coverage.

In New York City, a 2025 report from the Department of Health and Mental Hygiene found that immigrant adults were nearly twice as likely as US born adults to be uninsured.

For New Yorkers who fall through the cracks of the traditional insurance system, New York City care by NYC Health Hospitals serve as a critical part of the city's health care safety net.

Established under Mayor Bill de Blasio, the program launched in 2019 as a pilot at H facilities in the Bronx, and has since expanded citywide.

Providing uninsured New Yorkers with low-cost and no-cost health care services, regardless of insurance income or immigration status, including primary care, specialty care services like cardiology, rheumatology, orthopedics, and podiatry, mental health and substance abuse services, referrals to specialists like social workers, therapists, and psychiatrists, obstetrics and gynaecology, family planning, STI testing and treatment, affordable medications, eye care, dental care, emergency services, and other social support services, and access to durable medical equipment, which is DME by most to eligible New Yorker care patients.

However, border cuts to health care eligibility at the federal level have caused approximately one hundred and ninety-seven thousand New Yorkers to lose coverage.

Get that number.

Besides the recent federal policy changes, there are several other ongoing barriers that prevent eligible city residents from enrolling in or maintaining health insurance coverage.

Challenges such as navigating complex eligibility rules, renewal requirements, language barriers, limited familiarity with the health care system, unable, I mean, unstable employment, lack of employer sponsored insurance, housing insecurity, and difficulties accessing enrollment assistance often lead to coverage disruption.

These disrupts uh disruptions in care can have detrimental consequences.

On insurance individuals are more likely to delay or skip medication and treatment because of cost concerns, leading to higher risk of chronic diseases and early mortality.

As a result, New Yorkers may seek care only after their conditions have become more severe.

Increasing demand for emergency department services and uncompensated care, which could place additional financial and operational strand on New York City's safety net hospitals, which already serve a disproportionate share of Medicaid and uninsured patients.

Preventive care plays a critical role in keeping New Yorkers healthy and reducing the need for costly emergency interventions.

We

call it pennywise dollar foolish.

Last week, during the committee's drawn hearing in ambulance response times, we heard firsthand about the significant strength already facing the city's emergency department and EMS workforce.

Ensuring that residents can enroll in and maintenance health coverage is an important part of addressing this challenges.

As access to preventive and primary care can help reduce avoidable emergency room visits and ease pressure on the broader health care system.

Continued investment in programs that support enrollment and re-enrollment in healthcare coverage will be essential to strengthening New York City's health care safety net.

As New York faces a period of uncertainty in health care coverage, understanding how New York City care is serving uninsured residents and how the city can strengthen its healthcare safety net will be more important than ever.

I look forward to today's testimony.

I know the room is not as crowded as expected because this is a big deal.

Testimonies will help us, right?

To hear we today we'll be hearing from shareholders, stakeholders and shareholders, of course, opportunity to expand awareness of the program and any policy, operational or outreach investment that may be needed to ensure New York City care continues to meet the evolving needs of New Yorkers.

Before I conclude, I would like to thank committee counsel Raina Lee, policy analyst Manure Butt, Financial Analyst Molly Howard, and my staff for all their work they do, especially in the district office.

I want to say thanks to Deputy Chief Frank Shea, Drashina Jilo, and of course, my dear fellow, that's Matthew Lee.

Thank you for being here.

I would like to turn it over to the committee council to administer their oath witness from the administration.

Thank you, Raina.

Good afternoon.

We will now hear testimony from the administration.

Before we begin, I'll administer the affirmation.

Panelists, if you could raise your right hand, I will read the affirmation once and then ask each of you individually to respond.

Do you affirm to tell the truth, the whole truth, and nothing but the truth in your testimony before this committee and to respond honestly to council members' questions?

I do.

Thank you.

Um, as a reminder for all of our witnesses, if you could please state your name prior to testimony for the record.

Thank

you.

Okay.

Thank

you, Chairman.

My