Mass. Cuts Health Benefits For Some Immigrants
MADELEINE BRAND, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Madeleine Brand in California.
ROBERT SIEGEL, host:
I'm Robert Siegel in Washington.
And we begin this hour with the challenges facing two health care initiatives, initiatives which could offer lessons for the nation's health care overhaul. In a moment, we'll check back with Howard County Maryland's program. It's called Healthy Howard.
BRAND: First to Massachusetts. It was the first state to mandate that everyone have health insurance. As NPR's Tovia Smith reports, due to the state's budget crisis, Massachusetts is now poised to drop 30,000 legal immigrants from its coverage.
TOVIA SMITH: Since Massachusetts' health insurance program went into effect, the rate of uninsured here has dropped to less than three percent - that's the lowest in the nation, which averages 15 percent. But with state revenues now in a free fall, lawmakers say Massachusetts can no longer afford to extend coverage as generously as it has been. Massachusetts House Speaker Robert DeLeo.
State Representative ROBERT DELEO (Democrat, Massachusetts; State House Speaker): These are a whole host of tough decisions that we're going to have to make. There is no way that anyone, at end of the day, that I could look at this budget and say, you know what? We've been able to adequately provide for everyone.
SMITH: Covering immigrants is more expensive for the state because even though they are in the U.S. legally, they are not citizens and do not qualify for federal assistance through Medicaid. DeLeo says the most vulnerable immigrants such as children, the elderly and the disabled, will not lose coverage.
State Rep. DELEO: I think on the whole, with what we were given as a hand, that we played it - we played it pretty well.
SMITH: Governor Deval Patrick is pushing legislation to restore about half the funding for coverage of legal immigrants. But with state revenues down some three billion dollars, Michael Widmer of the nonpartisan Massachusetts Taxpayer's Foundation says even that compromise may not be possible.
Mr. MICHAEL WIDMER (President, Massachusetts Taxpayer's Foundation): The state is facing a really desperate fiscal situation and all programs are on the chopping block. And it's just pain, pain, pain.
Mr. AHUHANIO HERNANDEZ(ph): (Through translator) Why am I losing my health insurance and what can I do next?
SMITH: Ahuhanio Hernandez, an El Salvadoran native, who lives in Boston is one of hundreds of immigrants looking for help now from the advocacy group Health Care for All. Hernandez has been fighting prostate cancer for the past two years.
Mr. HERNANDEZ: (Through translator) In my case, I need to see many doctors because my cancer is not cured. I have two appointments coming up this month. I cannot go without health care because the truth is I don't want to die.
SMITH: Hernandez, a janitor who works the overnight shift, says it's unfair to single out hard working legal immigrants like him.
Mr. HERNANDEZ: (Through translator) I pay my taxes, I pay my insurance so we contribute to this country. And then all of a sudden, they say we're going to cut your insurance?
SMITH: Advocates argue that dropping the 30,000 immigrants coverage will only end up shifting cost around to other state programs and to hospitals. Brian Rosman is research director at Health Care for All.
Mr. BRIAN ROSMAN (Research Director, Health Care for All): A lot of the savings are (unintelligible). We're not going to save in the long run and even the short run savings. It's like a balloon, you know. You can push down on one side, but it's going to pop right up on the other side.
SMITH: Indeed yesterday, a city hospital, Boston Medical Center, sued the state arguing that it's being forced to pick up too much of the cost of treating poor patients. It's all got advocates worried about the message being sent to those in Washington who are trying to overhaul the nation's health care system. Eva Millona is head of the Massachusetts Immigrant and Refugee Advocacy Coalition.
Ms. EVA MILLONA (Head, Massachusetts Immigrants And Refugee Advocacy Coalition): This sends the whole nation the message that, you know, the Massachusetts experiment doesn't work and health care reform cannot be done, or that yes, it can be done halfway by excluding immigrants in the process.
SMITH: Rather than discourage national efforts, Massachusetts' experience should only underscore the urgency, advocates say, for the federal government to come up with a federal solution. As one put it, all this proves is that the states can't do it alone.
Tovia Smith, NPR News, Boston.
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