SJC immigrant health care ruling expected to cost $150 million
File photo by Nelson Sigelman
A ruling by the state's high court invalidating a state health care program for legal immigrants could add $150 million to the taxpayers' annual budget tab, Gov. Deval Patrick's top fiscal adviser estimated Thursday, as lawmakers and state agencies scrambled to respond to the decision.
Patrick administration officials and top lawmakers pledged to comply with the ruling, which comes as state officials are planning for further budget cuts and austerity measures, the State House News Service reported.
The unanimous ruling of the Supreme Judicial Court to strike down the health care program for thousands of legal Massachusetts immigrants paves the way for those residents to rejoin Commonwealth Care, a heavily subsidized health program for low-income Massachusetts residents. About 30,000 immigrants were removed from that program in 2009 as lawmakers sought to balance the state budget, and many were placed on a plan with reduced benefits and sharply higher co-pays.
The reduced plan – known as the Commowneawlth Care Bridge Program – violates the equal protection clause of the Massachusetts Constitution, the SJC determined. "Fiscal considerations alone cannot justify a State's invidious discrimination against aliens," Justice Robert Cordy wrote, arguing that lawmakers had presented limited other justification for their action.
Glen Shor, executive director of the Connector Authority, which oversees Commonwealth Care, said he's "going to be working hand-in-hand" with the Patrick administration and the Legislature to bring immigrants back into the more expansive health program.
"I don't think anybody here is thinking of doing any foot-dragging, but you know, on the other hand, I don't think it's fair to say it's as simple as flipping a light switch," Shor said. "It would take operational work, at a minimum."
Asked how long it might take to bring as many as 35,000 excluded immigrants back onto Commonwealth Care, Shor noted that it took about three months to remove the immigrants from the program, and he called that timetable "illustrative." He also emphasized that immigrants currently on the Bridge Program are in no jeopardy of losing health coverage as a result of the ruling.
Sen. Stephen Brewer (D-Barre), chairman of the Senate Way and Means Committee, said he anticipates the court ruling to "have an impact on this year's budget and next year's budget, no doubt about it.
"In our budget scenario that we looked at, we had pretty much agreed it was going to be very challenging. This makes it more challenging. We are vetting exactly how we're going to address it collectively," he said in a phone interview, adding, "We will comply with the order of the court."
"What's done is done, the court has ruled and we need to honor Mr. [John] Adams himself, who would've wanted us to follow the rule of law," Brewer said.
In a statement, Brewer's counterpart in the House, Rep. Brian Dempsey (D-Haverhill), said the potential impact of the court decision had been on the Legislature's radar since last year.
"Now that we have a final decision from the court, we can consider all options for dealing with the impacts to the Commonwealth Care program," he said. "While the result of this decision will present an additional cost of approximately $150 million to this year's budget, we anticipate working with the administration and the Senate to find a resolution that will allow us to provide health care services in a fiscally responsible manner."
Gov. Deval Patrick's top fiscal adviser, Secretary of Administration and Finance Jay Gonzalez, also estimated the cost of the ruling to taxpayers at "somewhere in the range of $150 million."
"However, we respect the Court's decision, and we will 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," he said.
When the immigrants were first removed from Commonwealth Care in 2009, the Patrick administration estimated their annual cost of health care would amount to $120 million. Shor said the increased cost reflected higher health care costs and a potentially larger number of enrollees.
In 2009, Gov. Deval Patrick opposed removing immigrants from Commonwealth Care but eventually worked with lawmakers to craft the Bridge Program at a budget of $40 million, less than a third of what full coverage was expected to cost.
Those immigrants — designated by the federal government as "aliens with special status" because they've been permanent legal residents for fewer than five years — had previously received coverage through Commonwealth Care.
That program, managed by CeltiCare Health Plan, includes basic levels of coverage but eliminated certain services and charges sharply higher co-pays for others. Currently about 14,000 immigrants are enrolled in the program, down from a peak of just over 26,000 last year.
"This court ruling affirms a principle that is intuitive to all Americans and Bay Staters: it is a matter of basic fairness that everyone who is paying taxes into our health care system should be able to access it," said Sen. Sonia Chang-Diaz (D-Jamaica Plain). "I'm so glad the court has confirmed this value here in Massachusetts."