NCPA - National Center for Policy Analysis


July 16, 2009

About 30,000 documented immigrants will lose their health care coverage under Massachusetts' new state budget as policymakers attempt to close a growing state deficit, according to the New York Times.  The cuts are estimated to save the state $130 million and would affect permanent residents who have had green cards for less than five years and are covered under Commonwealth Care, the subsidized insurance program for low-income residents.  The program will save an additional $63 million by no longer automatically enrolling low-income residents in Commonwealth Care.

Commonwealth Care is a key element of the state's landmark 2006 health care law, which is serving as a model for some congressional health reform bills, according to the Times:

  • The 2006 law has helped Massachusetts achieve the country's lowest percentage of uninsured residents -- 2.6 percent compared with a national average of 15 percent -- because it requires that nearly all residents obtain insurance.
  • The state subsidizes health coverage for people with incomes of up to three times the federal poverty level to meet the goal of near-universal coverage.

However, according to the Times, the economic recession has presented challenges to the program, as unemployment hikes have increased enrollment in Commonwealth Care to 181,000.  Cyndi Roy, a spokesperson for the state's Executive Office of Administration and Finance, said the rise in enrollment and sharp decline in state revenues made it impossible to maintain 2008's level of service.

  • In an effort to partly restore the coverage to documented immigrants, Gov. Deval Patrick (D) has proposed restoring $70 million to the program; however, policymakers argue that other vital services would have to be cut as a result.
  • According to the Massachusetts Hospital Association, if the $130 million cut is made, hospitals that provide no-cost care to people with low incomes will need to spend an additional $87 million in 2009 to treat those who lose their coverage.
  • Tim Gens, the association's executive vice president, said that amount would be in addition to a $40 million cut in the state's Health Safety Net, which reimburses such hospitals.

The coverage cut will take effect in August unless the state Legislature approves Patrick's proposal, says the Times.  Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said the cut "either sends the message that health care reform cannot be done, period, or it opens the door to doing it halfway and excluding immigrants from the process."

Source: Abby Goodnough, "Massachusetts Takes a Step Back From Health Care for All," New York Times, July 14, 2009.

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