New York Mayor Bill de Blasio on Tuesday announced a plan to provide health care for New Yorkers who cannot qualify for health insurance, including undocumented immigrants.

With the initiative in place, all 8.6 million people living in New York will be able to get physical and mental health care, de Blasio said at a press conference Tuesday at Lincoln Hospital in the Bronx.

“No one should have to live in fear,” the mayor said. “No one should go without the health care they need. Health care is a human right. In this city, we’re going to make that a reality. ... From this moment on in New York City, everyone is guaranteed the right to health care.”

The city will roll out the program borough by borough, the mayor’s office announced, starting in the Bronx this summer and covering the entire city by 2021.

There are roughly 600,000 uninsured New Yorkers. The initiative’s goal is to reach as many of them as possible, at a cost of $100 million per year ― money, de Blasio said, that the city is already spending through the treatment of uninsured New Yorkers in emergency rooms and other settings for acute care.

Health care is a human right. Join me in the Bronx to discuss our plan to guarantee care for all New Yorkers. https://t.co/u8IL0X44bQ — Mayor Bill de Blasio (@NYCMayor) January 8, 2019

The new program, NYC Care, will not offer free health care to all New Yorkers. Instead, it will provide a primary care doctor and access to specialty care priced on a sliding scale according to patients’ income. The program will be available to anyone who does not have an affordable insurance option, de Blasio said.

New Yorkers can already get care at clinics and hospitals when they need it, and many are eligible for one or several state and federal programs, including Medicaid, which the state expanded through the Affordable Care Act. But, de Blasio noted, many aren’t eligible for those programs and many more aren’t aware of the kind of care that is available to them.

A major focus of the effort, de Blasio emphasized, is making sure people get care before they get sick ― or, at least, before ongoing conditions explode into acute catastrophes ― by linking people with primary care doctors and clinics, so that they have “medical homes.”

De Blasio said he still believes the ultimate solution for health care is to create a single-payer or “Medicare for all” system ― that is, one government-run insurance program that would cover everybody ― either at the state or, better still, at the national level.

But with the prospects for a single-payer bill in Albany highly uncertain and no chance of single-payer at the national level while Republicans control the presidency and one house of Congress, de Blasio said, it made sense for the city to act.

“We don’t wait here in New York City,” de Blasio said. “Our people need health care right now and we can get it to them.”

New York is not the first city to undertake an ambitious effort to make sure all residents get health care. In 2006, San Francisco launched “Healthy San Francisco,” which makes medical services available throughout the city to the uninsured.

The chief architect of that program, Mitchell Katz, is now the chief executive of New York City’s hospital association and a member of the city’s board of health.

He helped to design NYC Care and, at the press conference, said the new program had a lot in common with the San Francisco initiative, although he expected the New York program to be more comprehensive and to cover many more people. “This is just a much broader scale,” Katz said.

During the press conference, de Blasio and his advisers said they were already increasing the capacity of public clinics and hospitals, to make sure people who need health care won’t have to wait for it.

The mayor also addressed critics who, by Tuesday morning, were already attacking the initiative because it will mean financing care for undocumented immigrants.

Paying for them to get health care, de Blasio said, would ultimately save money because paying for their emergency care ends up costing more. But, he added, “They are our neighbors, they work right next to us, they help us to keep the city going, and that’s true of the whole country. I refuse the notion that these folks don’t deserve health care.”

This has been updated throughout.