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Joan Vennochi

Who comes first in the state?

By Joan Vennochi
Globe Columnist / July 12, 2009
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WHO GETS a lifeline in tough fiscal times? Massachusetts citizens or noncitizens?

Governor Deval Patrick is fighting to protect services for a politically controversial segment of the Bay State population: immigrants.

With state revenues in free fall, lawmakers cut health insurance coverage for some 30,000 noncitizens. Now, Patrick wants to restore it for those legal immigrants who are technically called “aliens with special status’’ but are more commonly known as green card holders.

You don’t have to enjoy beating up on immigrants, Mitt Romney-style, to view Patrick’s decision through a national political prism.

As Washington struggles to put together a federal healthcare initiative, the Massachusetts universal healthcare law is one template under consideration. In the past, Patrick expressed doubts about using the Massachusetts law as a national model. Now, Patrick is saying, “We have to keep faith with that element of our healthcare experiment, particularly when the whole country is watching.’’

But is keeping faith with every aspect of the Bay State experiment the right economic choice, just because the whole country is watching? Maybe it’s the best time to demonstrate an equal commitment to moral and fiscal responsibility.

Michael Widmer, who heads the Massachusetts Taxpayer Foundation, supports the universal healthcare law. What Patrick is trying to do is “the right thing,’’ said Widmer. But, given the current budget crisis, “it’s problematic,’’ he added. “It requires cutting in other areas. . . . There are a lot of moving pieces.’’

Philip W. Johnston, a former state secretary of health and human services and current chairman of the Blue Cross Blue Shield of Massachusetts Foundation, played a major role in the effort to expand healthcare coverage here. He was also an early Patrick supporter in the 2006 gubernatorial campaign. But he, too, questions Patrick’s effort to transfer money from already decimated budget accounts to immigrant healthcare.

“I don’t see how they can do it,’’ said Johnston, “. . . It’s a big lift for the state with such little money available.’’ State revenue has already dropped $3.2 billion below initial expectations. The June report shows another plunge - $180 million below even the worst-case prediction.

Of course, when you’re talking about immigrants, you’re talking about a hot-button political issue, even in liberal Massachusetts. They are “a little bit of a third rail in the Legislature right now,’’ L. Harriett Stanley of Newbury recently told the State House News Service.

That burst of honesty provides part of the backdrop for the Legislature’s decision to slice $130 million from Commonwealth Care subsidized coverage. But there were many tough choices to make, affecting virtually every state program and millions of citizens. With the governor’s vetoes and amendments, the budget for fiscal 2010 represents a reduction in spending of $2.4 billion from the level required to provide the same services for the previous year, according to the Massachusetts Budget and Policy Center.

Lawmakers did what they could to limit the impact of the health insurance cut. It applies only to nondisabled adults between the ages of 18 and 65. Children, pregnant women, and the disabled are still covered.

In a recent radio interview, House Speaker Robert DeLeo was asked where he stood on Patrick’s call to restore $70 million for health insurance for immigrants. “I don’t think there’s anyone in the building opposed to doing that,’’ he said. But, DeLeo also noted that the governor is proposing to take money from housing, rental assistance, senior care, substance abuse, and other budget accounts, in order to shift it to health insurance for immigrants.

The $70 million Patrick wants to restore is a tiny piece of a $28 billion state budget. But if I were being asked to do it, I would first consider the big picture. The Massachusetts healthcare reform law was passed in 2006 without a dedicated revenue stream to support its costs and with the expectation that serious cost containment measures would be implemented.

Until then, there isn’t enough money to pay for the universal coverage promised by the law. Until then - as cold as it sounds - the most vulnerable Massachusetts citizens should come first.

Joan Vennochi can be reached at vennochi@globe.com.

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