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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.

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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.

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.

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.”