Enrollment in a city-run program designed to provide health access to New Yorkers ineligible for insurance, including undocumented residents, continues to decline.
The number of people signed up for NYC Care decreased 12% from 140,222 patients in fiscal 2025 to 123,124 in fiscal 2026, according to the latest Mayor’s Management Report.
The program has served as a medical lifeline for some of the city’s immigrants who are excluded from Medicaid and other public programs.
“It’s always alarming and very concerning to see drops in enrollment in healthcare, right? Especially for vulnerable populations,” City Councilmember Alexa Avilés, who serves on the committee for immigration, told The City Reporter.
NYC Health + Hospitals, which administers NYC Care, blamed the drop on a combination of factors: aging participants transitioning to Medicaid regardless of their immigration status; expansion of Medicaid and Child Health Plus; and continuous Medicaid eligibility for children under the age of six.
Still, the agency is hearing “anecdotally” of an “increasing reluctance” by immigrants to hand over basic information needed to enroll due to fears it could be handed over to Immigration and Customs Enforcement, according to the yearly management report.
“Immigrants in particular are definitely fearful as they see the federal government taking data from other agencies where historically they did not do that,” Avilés said. “So folks are feeling very vulnerable and potentially targeted.”
Last year, the Associated Press reported that the federal Centers for Medicare and Medicaid Services had shared patients’ personal data with ICE.
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It has long been hard to track how undocumented people obtain medical care.
But broader cuts enacted at the federal level — including restrictions to New York’s Essential Plan and stricter Medicaid work requirements — have caused many low-income residents, including immigrants, to lose coverage entirely, according to industry experts.
“It’s very clear in high immigrant populations, there are people who are not getting medical care that they need to have because of fear of ICE,” Thomas Farley, a former New York City health commissioner, told The City Reporter.
‘Stay Invisible’
Dr. Chanelle Diaz, a primary care physician who advocates for immigrant health, began seeing a drop in undocumented patients shortly after Trump was elected in 2024.
“I haven’t seen any of my patients on charity care come into the clinic in recent months,” she told The City Reporter in August 2025. “They’ve just gone off the map.”
On Wednesday, Diaz said that some patients aren’t even taking meetings with lawyers partnering with doctors to assist their immigration cases.
“They want to stay as invisible as possible in this moment,” Diaz said.
Former Mayor Bill de Blasio launched NYC Care as he was ramping up a failed campaign for president. The program guarantees access to care for uninsured New Yorkers, particularly undocumented immigrants who are excluded from Medicaid and other public programs.
City officials stress that the initiative is not insurance: it’s a membership in a network of services provided by NYC Health + Hospitals. Cost is calculated on a sliding scale, with many participants paying little or nothing out-of-pocket.
The program grew from 24,500 enrollees in 2020 to over 143,000 by 2024, according to city data.
Alex Hunter, a spokesperson for NYC Health + Hospitals, noted that despite the drop in enrollment the total number of people signed up is still “well above” the 2023 figures “and still exceeds the initial enrollment goal of 100,000 members.”
Hospital officials insist they do not share info with ICE.
NYC Health + Hospitals said it is taking “several measures” to boost awareness about the NYC Care with the assistance of community-based organizations, government partners, and ethnic media.
As for the future of the program, Hunter said the agency expects membership to grow.
“NYC Care expects the enrollment numbers to increase, but also recognizes the climate of fear bolstered by federal attacks that may disincentivize certain immigrant communities in New York City from enrolling in public programs,” he said.
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