Court: Immigrants can join Mass. health care plan
BOSTON—Massachusetts cannot prevent tens of thousands of legal immigrants from enrolling in Commonwealth Care, the state's subsidized health care program, the state's highest court ruled Thursday.
The unanimous decision by the Supreme Judicial Court, which an administration official estimated could force the state to spend an additional $150 million, came in a lawsuit filed after the Legislature made a cost-cutting move to exclude noncitizen immigrants from the program in 2009.
The court said the restriction was unconstitutional.
"The discrimination that its limiting language embodies violates their rights to equal protection under the Massachusetts Constitution," Justice Robert Cordy wrote.
The court, as it did in a previous decision related to the case, said the state couldn't justify the exclusion on the basis of fiscal concerns alone.
The decision by lawmakers to bar legal immigrants from Commonwealth Care marked the first significant rollback to the state's landmark health care law that was signed by then-Gov. Mitt Romney, a Republican, in 2006.
Democratic Gov. Deval Patrick later moved to create a new entity, Commonwealth Care Bridge program, to provide more basic health care coverage for low-income immigrants. Patrick asked lawmakers to fund the new program at $70 million, but the appropriation was reduced by lawmakers to $40 million.
About 13,400 legal immigrants are enrolled in the bridge program, and about 24,000 are on a wait list, according to Glen Shor, executive director of the Massachusetts Health Connector, which oversees the health care law. The court's ruling would require that those people again have access to Commonwealth Care as long as they meet eligibility guidelines.
The group Health Law Advocates, which filed the lawsuit on behalf of immigrants, praised the high court's ruling.
"Massachusetts justifiably takes great pride in our `first in the nation' adoption of a health reform program that expanded access to quality health care to virtually all residents," the organization's executive director, Matt Selig, said in a statement.
"It was critical that low-income immigrants, a group of already vulnerable, tax-paying residents, not be left behind," he said.
"From a legal perspective, it was clear that legal immigrants couldn't be denied access without violating the premise of equal protection," added Lorianne Sainsbury-Wong, an attorney for Health Law Advocates.
State Secretary of Administration and Finance Jay Gonzalez predicted the ruling would have a significant fiscal impact on the state, "adding somewhere in the range of $150 million in annual costs to what is already a very challenging budget."
But Gonzalez said state officials respected the decision by the court and would "work expeditiously to identify the resources required and the operational steps that need to be taken to integrate all eligible, legal immigrants into the Commonwealth Care program in accordance with today's decision."
Shor said among the key differences between Commonwealth Care and the bridge program is that Commonwealth Care has five health plans, while the latter is operated by a single plan.
"There is a greater degree of choice under Commonwealth Care," he said.
The bridge program doesn't provide all the same benefits as Commonwealth Care, and some of its co-payments are higher, Shor added.
Health Law Advocates said it hoped the enhanced health care coverage for legal immigrants would reduce unnecessary trips to hospital emergency rooms.