Tuesday, July 14, 2009

Immigrants may lose state health insurance


Thousands of legal immigrants — including hundreds on the Cape — could be cut from state health insurance rolls, making a dent in the commonwealth's vaunted health reform program.

Up to 30,000 immigrants who've held a green card for less than five years were sent letters July 1 saying their coverage under the Commonwealth Care program might be eliminated as of the end of the month. State officials and health care advocates say the ongoing fiscal crisis means the state doesn't have enough money to cover all its programs.

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Health bill could cut costs to businesses Commonwealth Care is a government-subsidized health insurance plan that pays for medical and dental care. Participants pay premiums based on a sliding-scale fee, with the poorest paying no fee.

"They're going to lose their health insurance. They didn't see it coming," said Camila De Oliveira of the Community Action Committee of the Cape and Islands. The organization has enrolled thousands of legal immigrants in the state's new insurance programs that came about as a result of the health reform act of 2006.

Receiving Commonwealth Care benefits allowed many immigrants to go to the doctor for the first time in years, and quite a few found they needed treatment for conditions such as diabetes and cancer, De Oliveira said. "Now their treatment is going to be stopped."

She estimated there are at least 2,000 legal immigrants on the Cape who will be affected, including people from Brazil, Haiti and Jamaica.

Most individuals dropped from Commonwealth Care would be shifted to something called the Health Safety Net and would end up getting their care from already busy community health centers or emergency rooms, said Brian Rosman, research director of an organization called Health Care For All.

"It's definitely a step backward from the progress we've been making," he said.

The closest pharmacy serving Health Safety Net customers is in New Bedford, De Oliveira said.

State legislators have said they need to cut the $130 million in Commonwealth Care benefits for this group of "aliens with special status" because of the budget crisis, Rosman said. The federal government provides no reimbursement for these recent, legal — but non-citizen — residents. Gov. Patrick has come up with a compromise plan of restoring $70 million in benefits that "would at least keep them in the kind of primary care that would keep them healthy," Rosman said.

The compromise is in the state Legislature's hands now, said Richard Powers of the Commonwealth Connector, a quasi-state agency that helps enroll people in insurance plans under health care reform. He said if the compromise funding is approved for September, there will be a gap of at least a month when the immigrants don't have any type of Commonwealth Care coverage and probably will have to be covered by something like the Health Safety Net, which replaces what was formerly known as the free care pool.

"We don't know if it's even going to be approved at all," Powers said. He said Commonwealth Care clients are entitled to 30 days' final notice before their coverage can be pulled.

Samantha Dallaire, aide for state Sen. Therese Murray, said the Senate can't act on the compromise funding until the House takes it up. All revenue bills start in the House, she said. "If they vote it down, it's dead."