The state Senate’s plan to cut 28,000 legal immigrant residents from Commonwealth Care coverage, the crown jewel of the state’s 2006 health insurance overhaul, is discriminatory and shortsighted, advocates for the immigrant community say.
The targeted immigrants are not only legal residents but taxpayers, said Eva A. Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, the state’s largest immigrant group.
”It is not fair to single out a class of people because they are not citizens,” she said.
The proposed cuts are included in the Senate Ways and Means committee budget released Wednesday. Commonwealth Care, created as part of the 2006 pioneering health law, aimed to make insurance coverage nearly universal in Massachusetts. It extended state-subsidized insurance on a sliding price scale to working-class residents who did not previously qualify.
The Senate budget proposal is the first to reflect just how dire the state’s finances really are - there is $1.5 billion less in revenues than lawmakers had anticipated just days ago - and includes deep cuts across many so cial service programs affecting several groups.
Among the immigrants affected by the Senate commitee’s proposal - if it passes both houses of the Legislature and is signed by the governor - are people seeking asylum from war-ravaged regions such as Iraq, Somalia, and the Sudan. Advocates say the group includes people who have survived torture or were the victims of human trafficking and have serious mental health and posttraumatic problems that require treatment.
Senator Steven Panagiotakos, chairman of the Senate Ways and Means Committee, said lawmakers are not targeting immigrants as such, but propose the cuts because the 28,000 “special status” immigrants at issue do not qualify for matching federal subsidies. Thus, they are more expensive for the state to insure.
Massachusetts receives one dollar from the federal government for every dollar it spends in most of its pioneering healthcare programs. But the match does not apply in programs serving certain legal immigrants, including refugees and those seeking asylum. “The federal government doesn’t recognize them until they’re here five years, and 33 other states don’t cover this population, either,” he said. “With the depths of the budget cuts we are dealing with, everyone is going to have to share in the pain and some, unfortunately, more than others.”
Yet medical specialists said the state will end up paying more in healthcare costs in the long run because many people who lose insurance coverage put off going to the doctor until they are seriously ill and then end up in the emergency room with catastrophic and expensive illnesses. Emergency rooms must treat all comers, and the state often foots the bill for those who cannot afford the care.
”It’s a lot cheaper to treat them preventively than if they have a life-threatening illness,” said Dr. Michael Grodin, director of medical ethics at Boston University’s School of Public Health. Grodin, who heads the Boston Center for Refugee Health and Human Rights at Boston Medical Center, said thousands of refugees he has treated over the years have complex medical problems that need comprehensive care.
”Seventy percent of the patients we see at the refugee center have a torture history, 30 percent of the women have been raped, and 5 to 10 percent of the men have been raped in prison,” he said. “These people have done nothing wrong but try to to save their lives.”
The Senate is likely to vote on the committee’s proposed spending plan next week. Then it must be reconciled with the budget proposed earlier this spring by the House.
As finances have soured, some have pushed for a hike in the state’s sales tax, from 5 to 6.25 percent. Panagiotakos has indicated he prefers a sales tax increase to other tax hikes being considered, including one in the gas tax.
Yesterday, he brushed aside suggestions that the deep budget cuts in his committee’s blueprint, including the healthcare cuts for legal immigrants, are scare tactics to win support for a sales tax increase.
”It’s not a question of trying to manufacture anxieties,” he said. “We have to balance a budget, and our budget right now does not depend on any new revenue.”
The Senate’s proposed Commonwealth Care cuts were highlighted yesterday at a regular meeting of the Connector Authority, which oversees Commonwealth Care. The program covers 174,000 residents, including the 28,000 targeted for possible cuts.
The governor’s secretary of administration and finance, Leslie Kirwan, who chairs the Connector Authority, declined yesterday to say whether the governor would push for the immigrant cut to be restored.
”Thus far, we have avoided significant cuts to health and human services programs by prioritizing safety net programs,” she said. “I know that’s a priority of the governor and he will continue to do his best to protect the Commonwealth’s most vulnerable.”
Kay Lazar can be reached at firstname.lastname@example.org.