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Posted Tuesday, September 1, 2009    

Massachusetts Trims Immigrants' Health Care

By ABBY GOODNOUGH                                                                      

BOSTON — State-subsidized health insurance for 31,000 legal immigrants here will no longer cover dental, hospice or skilled-nursing care under a scaled-back plan that Gov. Deval Patrick announced Monday.

Mr. Patrick said his administration had struggled to find a solution “that preserves the promise of health care reform” after the state legislature cut most of the $130 million it had previously allotted immigrants, to help close a budget deficit. Although their health benefits will be sharply curtailed in some cases, Mr. Patrick portrayed the new program as a victory, saying the services that the affected group tends to use the most will still be covered.

“It’s an extraordinary accomplishment,” he said in a conference call with reporters, “to offer virtually full coverage for the entire population that’s been impacted in the face of really extraordinary budget constraints.”

The new plan, which will cover permanent residents who have had green cards for less than five years, will cost the state $40 million a year. Some of the affected immigrants will be charged higher co-payments and will have to find new doctors, said Leslie A. Kirwan, Mr. Patrick’s finance director.

Still, Mr. Patrick described the new coverage as comprehensive and said it could be a model for less expensive state-subsidized benefits as health care costs continue to rise. Under the 1996 federal law that overhauled the nation’s welfare system, the 31,000 affected immigrants do not qualify for Medicaid or other federal aid. Massachusetts is one of the few states — others are California, New York and Pennsylvania — that provide at least some health coverage for such immigrants.

Because of its three-year-old law requiring universal health coverage, Massachusetts has the country’s lowest percentage of uninsured residents: 2.6 percent, compared with a national average of 15 percent. The law requires that almost every resident have insurance, and to meet that goal, the state subsidizes coverage for those earning up to three times the federal poverty level, or $66,150 for a family of four.

All of the affected immigrants will be covered under the new plan by Dec. 1, Mr. Patrick said; in the meantime they will have to rely on hospitals that provide free emergency care to the poor.

CeltiCare Health Plan of Massachusetts, a subsidiary of the Centene Corporation, based in Missouri, won a yearlong state contract to provide the new coverage.

Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said she was worried about immigrants’ having to find new primary care doctors at a time when the state is suffering from a shortage of such providers. She also said that the new coverage would in some cases require a much higher co-payment — $50 instead of between $1 and $3 — for non-generic prescription drugs, and that enrollment would be capped at the 31,000 current enrollees.

“We see this as a temporary solution,” Ms. Millona said, “and we are still working to get full restoration for this population that deserves the same level of coverage as all other taxpaying residents of the state.”

Copyright 2009 The New York Times Company. Reprinted from The New York Times, National, of Tuesday, September 1, 2009.
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