Thousands of Immigrants on track to lose health care

Nearly 23,000 Massachusetts residents – legal immigrants who have been in the country for fewer than five years – are scheduled to lose their health insurance before the New Year, and lawmakers are keeping silent about whether they’ll intervene.

House Speaker Robert DeLeo has declined repeated requests for comment on the matter, and Sen. Richard Moore, co-chair of the Health Care Financing Committee, also declined comment Tuesday.

Gov. Deval Patrick, who said in August that he hoped to extend coverage for these immigrants, indicated to reporters last week he’s still looking for a solution.

“I think it’s the right thing to do … These are people who are paying and making contributions, and I think the right thing to do is to provide them the benefits,” Patrick said. “I don’t have a solution yet. I’m going to look for one. I’m going to search for every possible solution, again, because I think it’s the right thing to do.”

The population of immigrants in question – known as “aliens with special status,” or AWSS – has been singled out because the federal government declines to reimburse states for their care. AWSS immigrants are legal, green card holders who have been in the country for fewer than five years.

Lawmakers last year cut AWSS immigrants from the rolls of Commonwealth Care, a state-subsidized insurance program, to balance the state budget. But Gov. Deval Patrick proposed funding a scaled-back health insurance program. Eventually, legislators agreed to provide $40 million for limited coverage, about a third of what the governor initially estimated it would cost to fully fund the AWSS population.

That limited plan, offered by CeltiCare, a recent entrant in the Massachusetts marketplace, excluded coverage for vision, dental, hospice and skilled nursing and came with significant co-pay increases.

The CeltiCare plan, known as the Commonwealth Care Bridge Program, was reauthorized at $60 million in this year’s budget, but without additional funds, Patrick administration officials say resources are only available to maintain the program through December.

Asked last Thursday whether he planned to file a supplemental budget before the end of the year to extend health care for the AWSS immigrants, as well as to address an expiring sales tax on alcohol used to fund substance abuse treatment programs, the governor called it a “fair question,” but one he could not immediately answer.

“The team is working through to see what kinds of solutions there may be,” he said.

A supplemental budget filed before the end of the year would need legislative approval during informal sessions, when a single member of either branch can block any bill’s progress. Republicans in the House say they’re waiting to see the contours of any proposed supplemental budget before determining whether they would allow it to advance.

Under the national health care law signed by President Obama in February, the federal government is scheduled to begin reimbursing states that cover AWSS immigrants in 2014.

Uncertainty about the program means that for the second straight year, this population of legal immigrants is faced with the loss of health coverage, this time as they head into the holiday season.

Immigrant and consumer advocates have urged lawmakers to fund a limited care program for these immigrants using a portion of federal aid recently sent to Massachusetts over the summer. But a spending bill that moved through the Legislature in September and October, tapping most of the federal funds, did not include an extension of the Bridge Program.

Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said preserving heath care for AWSS immigrants is “an emergency item, given the very short timeframe.” Although the state Connector Authority lists 22,775 enrollees in the Bridge Program, Millona said as many as 12,000 more who could be eligible for the program or who have yet to arrive in Massachusetts would also lack access to care.

Enrollment in the program has declined in recent months from a peak of 26,127 last December as some enrollees attain their five years of residency, leave Massachusetts or obtain coverage through other means.

Massachusetts’s 2006 health reform efforts that officials have hailed for insuring nearly 98 percent of the Massachusetts population, was predicated on providing universal access to care for Bay State residents.

In this fiscal year's budget, signed by Patrick on June 30, funding for the program was made contingent on the arrival of federal aid. Lawmakers authorized Patrick to spend up to $60 million on the program, should aid arrive, but Patrick argued that funds would run out too soon, and he pushed to amend the budget to remove the limit. He also requested authority to apply federal transitional assistance funds to the program. The Legislature has not acted on his amendment.

Separately, Health Law Advocates has spearheaded a lawsuit that is pending in the state's Supreme Judicial Court to overturn the 2009 law that barred AWSS immigrants from obtaining state-subsidized coverage through Commonwealth Care, calling it a violation of the state’s constitutional right to equal protection.

“I think we were able to convey the message that we wanted to, so now we’re just waiting to see what the justices decide,” said Matt Selig, executive director of Health Law Advocates. “There’s been a lot of thought put into advocating through political means to see if the Legislature and administration would want to extend the Bridge Program. In the absence of not putting the AWSS back into the Commonwealth Care program, which is really what we’d like to see, if they don’t do that, we’d like to see them extend the Bridge Program.”