New York City Mayor Eric Adams in a letter to Gov. Kathy Hochul this week urged her to support the expansion of a health insurance program to include more undocumented residents living in the state. 

In the letter, Adams called for expanding the Essential Plan to include undocumented adults between the ages of 19 and 64. If approved, about 245,000 New York residents statewide would be affected. 

"We rarely have the opportunity to improve the lives of so many New Yorkers through a single policy modification," Adams wrote in the letter. "Please consider this letter and the city's detailed comment and seize this opportunity." 

Support from Adams for the program is coming from one of Hochul's prominent allies in the state. Undocumented New Yorkers without health insurance must rely on the Medicaid program and safety-net providers, which can further drive up costs, Adams wrote. 

"Expanding EP eligibility to undocumented adults is an imperative of both moral and economic consequence," Adams wrote. 

Undocumented people are among the so-called "last mile" of uninsured people living in the state. The majority of people without health insurance are undocumented residents.

The letter from Adams to Hochul comes as lawmakers and the governor are negotiating a state budget that is due on Saturday. Progressive advocates and lawmakers are making a final push this week to include the provision in a final agreement. 

Health insurance carriers have also supported the change, known as Coverage for All, in recent years even as the bill has faltered in the state Legislature. 

Republicans have decried the coverage. Last year, then-state Republican Chairman Nick Langworthy blasted the idea. 

"The fact that there's a movement in Albany to put special programs in place for undocumented immigrants in place before we've taken care of the needs of so many people who have struggled through the pandemic, who are here legally, that are here as citizens and taxpayers, it just shows you the mistaken priority of Albany Democrats," he said.