Vol. 73/No. 36      September 21, 2009

As the one state that requires people to purchase health insurance or face fines, Massachusetts has been held up as the model for various “health-care reform” proposals promoted by the Barack Obama administration.

Those cut from the state’s Commonwealth Care plan include permanent residents, political refugees, and other legal immigrants who have been in the country for less than five years. The state program is offered as an alternative to private insurance for “low and moderate-income” residents not eligible for Medicaid.

The state insurance plan is provided free of charge for individuals making less than $900 per month. Those with incomes between $900 and $2,700, can get the insurance for a sliding-scale monthly premium.

While the federal government pays for about half the cost for each resident enrolled in the Commonwealth Care program, it had not covered any costs for the 31,000 immigrants now cut from the rolls.

As part of former president William Clinton’s “welfare reform” in 1996, federal funds for health care such as Medicaid were denied for all legally admitted immigrants for five years after their arrival.

After revoking its insurance for immigrants, Massachusetts struck a deal with a private company, CeltiCare, to provide an inferior coverage for less than a third of the cost.

The new plan is “somewhat less comprehensive,” JudyAnn Bigby, the state’s heath and human services secretary, told reporters. It does not cover dental, vision, hospice, nursing home care, or skilled-nursing services such as rehabilitation or tube feedings. In many cases, patients will also have higher co-payments.

“A two-tier system with second-class health care for residents who arrived [in the United States] later than others, sets a bad precedent for the rest of the country,” Frank Soults, communications director for the Massachusetts Immigrant and Refugee Advocacy Coalition, told the Militant. “Our goal is to get these immigrants re-included [in Commonwealth Care] next year.”

At the same time, Soults said, his organization was grateful to Gov. Deval Patrick for pressing the state to provide some coverage, which was uncertain up to the last minute.

The number of facilities and physicians that accept the new insurance is more limited. For example, in the state’s broader MetroWest area, encompassing nine towns and more than 180,000 people, only one hospital accepts the insurance. Boston’s main public hospital, the Boston Medical Center, Soults said, is among those that does not accept CeltiCare.

“It’s an extraordinary accomplishment,” Governor Patrick said in announcing the new plan the same day the state benefits expired.

Many will not be covered by the plan for a couple months. A letter from the state health department told those being switched that the state would “make every effort to get all members enrolled in the new plan by December 2009.”

The CeltiCare plan is being offered only to the 31,000 immigrants who had been under Commonwealth Care; other immigrants will not be eligible.

Recent immigrants not covered by CeltiCare or a company plan have limited options: purchase insurance or, if they meet income guidelines, apply for the state’s “Health Safety Net.” That program is very limited and available for no more than one year. It covers only “facility charges” and prescriptions at community health centers and hospitals. At most hospitals “services” such as “bills for the doctor,” lab tests, and X-rays must be paid by the patient.

Massachusetts, California, New York, and Pennsylvania are among a small number of states that provide any subsidized health insurance for legal immigrants.
 
 
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