NYC Care enrollment fell 12% last year as immigrants grew wary of sharing personal data

Enrollment in NYC Care, the city program that guarantees low-cost and no-cost health care to New Yorkers who can't get or afford insurance, fell 12% over the past fiscal year, according to the city's latest Mayor's Management Report. THE CITY first reported the decline.

Membership dropped from 140,222 in fiscal 2025 to 123,124 in fiscal 2026. NYC Health + Hospitals, which runs the program, also served 215,554 uninsured patients, 7% fewer than the year before. NYC Care peaked at 143,503 members in fiscal 2024, the report shows.

What the city says is behind it

The public hospital system attributes the drop mainly to people gaining coverage through state changes: continuous Medicaid eligibility for children under 6, Medicaid for New Yorkers 65 and older regardless of immigration status, and Medicaid and Child Health Plus coverage for a full year after giving birth.

But the report also says the system is hearing, anecdotally, of "an increasing reluctance" in the city's immigrant community to provide the information needed for financial counseling and enrollment in insurance or NYC Care, "due to fear of sharing personal information with government systems."

"It's always alarming and very concerning to see drops in enrollment in healthcare," City Council Member Alexa Avilés, who serves on the immigration committee, told THE CITY. Former city health commissioner Thomas Farley told the outlet that in heavily immigrant areas, some people are not getting care they need because of fear of ICE. THE CITY noted that the Associated Press reported last year that the federal Centers for Medicare and Medicaid Services had shared patients' personal data with immigration authorities.

The city's response

H+H spokesperson Alex Hunter told THE CITY that enrollment is still "well above" 2023 levels and exceeds the program's original goal of 100,000 members, and that the hospital system does not share information with ICE. The system works with 20 community-based organizations and the Mayor's Office of Immigrant Affairs to encourage enrollment, and ran a citywide ad campaign in fiscal 2026, according to the report.

H+H expects more uninsured patients in fiscal 2027, the report says, citing the 2025 federal budget law, H.R. 1, which added paperwork to keep Medicaid and limited immigrants' eligibility for marketplace premium help. Hunter told THE CITY the program expects enrollment to rise, while recognizing "the climate of fear" that may discourage some immigrants from signing up.

How to enroll

NYC Care is not insurance. It is a membership card for primary, specialty and mental health care, medications and other services at NYC Health + Hospitals facilities, with costs on a sliding scale. According to the NYC Care website, New Yorkers can enroll by calling 1-646-NYC-CARE (1-646-692-2273), at any NYC Health + Hospitals location or through a community partner.