Budget plan will not restore immigrants’ health care

By Chelsea Conaboy
Globe Staff / May 19, 2011

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The Senate budget plan released yesterday does not include money for expanding health insurance coverage for legal immigrants, and the chamber’s chief budget writer said lawmakers will not act to reinstate immigrants to a state health plan unless a court tells them to.

“This is not the moment to do it,’’ Stephen M. Brewer, chairman of the Ways and Means Committee and a Democrat from Barre, said in an interview. “We will honor the dictates of the court, as specified when it is completed.’’

Immigrant advocates had hoped the Senate would consider reinstating immigrants to the full state-subsidized health plan for low- and moderate-income residents after the Supreme Judicial Court ruled earlier this month that their exclusion might be unconstitutional. Instead, Brewer’s committee released a budget proposal that preserves the Commonwealth Care Bridge program, a limited health plan created in 2009 when the Legislature decided to cut 26,000 legal immigrants from the full program to save the state $130 million.

The court did not order the state to reinstate people to the plan, but it paved the way for advocates to file legal action that could lead to such a mandate. The ruling was the result of a lawsuit filed by Health Law Advocates, a Boston public interest firm, in February 2010.

“We are eager to see the approximately 40,000 legal immigrants impacted by earlier budget cuts integrated back into Commonwealth Care,’’ Amy Whitcomb Slemmer — executive director of Health Care for All, a Boston-based consumer advocacy group — wrote in an e-mail. “We will be working with Senate leaders to find a way to restore full coverage to all individuals in need of quality health care coverage.’’

Eva A. Millona, executive director of Massachusetts Immigrant and Refugee Advocacy Coalition, said she had hoped the Legislature would act more quickly, though she understands that the change would require a big financial commitment. Adding as many as 40,000 legal immigrants to the health plan could cost the state $100 million or more.

“The writing on the wall is there,’’ she said. “This population needs to be reinstated.’’

About 19,000 people use the bridge program, though advocates say nearly twice that could be eligible if the program were not at capacity. The Senate proposal allots $42 million for the program, less than the $50 million budgeted this year. The budget passed by the House sets aside $25 million for the first six months of the fiscal year.

Matt Selig, executive director of Health Law Advocates, said he is meeting tomorrow with lawyers representing the state and the Commonwealth Connector Authority, which administers the Commonwealth Care subsidized insurance plan. His office will decide whether to proceed with another lawsuit after that, he said. If lawmakers took action now, however, he said his case would become moot.

Overall, public health advocates were pleased with the Senate budget, which proposed a fraction of the cuts to the Department of Public Health that the House passed. The department’s current budget would be reduced about $4 million in the Senate plan, compared with a $33 million cut by the House.

The improvement would be very significant, said Valerie Bassett, executive director of the Massachusetts Public Health Association. “We really appreciate the Senate’s understanding of the importance of investing in public health in these difficult economic times.’’

Bassett said it remains to be seen how the Senate budget would affect disease prevention efforts and the Women, Infants, and Children nutrition program. Those line items would be cut 43 percent and 21 percent, respectively, but the cuts may be offset by other revenue. The Senate proposal would also cut money from HIV prevention that the House voted to restore.

The Department of Public Health had announced that the governor’s proposed budget would force 50 layoffs.

A spokeswoman from the Department of Public Health declined to say what impact the Senate proposal would have on that plan.

Chelsea Conaboy can be reached at