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Is it Constitutionally Legal to Deny Immigrants Medical Assistance?

This legal issue is currently being debated by the State Supreme Courts in Connecticut and Massachusetts, with different rulings issued in both of these. The Massachusetts Supreme Judicial Court ruled that the state was wrong to exclude legal immigrants from state-run programs that provide health benefits to those who have resided in the state for six months or longer. However, The Connecticut Supreme Court ruled that terminating a medical assistance program designed for legal immigrants with less than five years of residency did not violate immigrants’ equal protection rights guaranteed by the U.S. Constitution.

Last year, a group of illegal immigrants sued the state of Massachusetts after the Legislature cut funding for immigrant care under the Commonwealth Care program from $130 to $40 million in a measure that was deemed necessary in order to balance the state’s budget. The state-funded program Commonwealth Care provides free or subsidized health care to low-income residents who otherwise do not have access to health insurance. Because of the significant decrease in funding, about 26,000 legal immigrants lost their coverage and were transferred to a new plan with fewer benefits and higher out-of-pocket costs. In addition, an estimated 8,000 legal immigrants were left uninsured. This case has since produced a favorable ruling for the petitioning immigrants who have been without health coverage for 18 months now. The high court ruled that the state Constitution entitles legal immigrants equal protection and that the cut in funding was probably invalid. “It’s a strong opinion and an important one that reaffirms the rights of taxpaying non-citizens of our community,” said Wendy Parmet, the attorney for the plaintiffs and a law professor at Northeastern University School of Law in Boston.

In Connecticut, about 5,000 legal immigrants were left with limited or no health care coverage at all after the state substantially repealed the State Medical Assistance for Non-citizens Program in 2009. This program had provided health benefits for legal immigrants with less than five years of residency who were elderly, pregnant, blind, disabled or the parents of dependent children. Because these residents had lived in the U.S. for a short time, they were not eligible for Medicaid and were also prevented from enrolling in the State Administered General Assistance program. “The loss of these benefits is basically the loss of all non-emergency benefits,” said the attorney for the plaintiffs. “It really is tremendous.” The case that was turned down by the state courts was brought by a legal immigrant who sued the state in 2009 over the program cut. While the trial court had found that the Legislature’s actions violated the plaintiff’s equal protection rights, the Supreme Court found it otherwise and reversed the ruling. This, of course, was a very disheartening. As an attorney with the National Immigration Law Center put it, “legal immigrants live, work and contribute to the communities they live in. They’re paying taxes for the very services they’re being denied.”

While the Massachusetts decision is largely seen as one that reduces the power and discretion of the state and undermines its intent to reduce immigration levels, it goes without being said that the outcome is highly favorable for the immigrants of the state. In stark contrast, the decision in Connecticut is one that is considered by many to be discriminatory in intent, and a double-edged sword in nature, for cutting this program may end up costing the state a lot more in the end in the form of a hike in medical costs and emergency room care.

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