By Kyle Cheney and Michael Norton
STATE HOUSE NEWS SERVICE
STATE HOUSE, BOSTON, JULY 8, 2009…..With health insurance for 30,000 legal immigrants set to lapse at the end of the month – their coverage cut by the Legislature to balance the fiscal 2010 budget –Senate President Therese Murray said Massachusetts’s extensive health reform efforts refuted “the assertion that health care reform is a luxury we can no longer afford.”
Murray, speaking to a Senate panel, said the state’s health care expansion initiative should not just influence the national effort toward the same goal, but be protected from it in case the federal reform forces retreats on the state level.
During the hearing of the Senate Special Committee on National Health Reform, chaired by Sen. Richard Moore (D-Uxbridge), Murray, in prepared remarks, said, “Whatever the final make-up of the federal legislation, it is essential that it support and strengthen our efforts in Massachusetts, and in no way undermine the successes we have already achieved.” She also backed the formation of a “public plan,” currently at the crux of the debate in Washington, with supporters saying it would compete with private insurers and opponents asserting that it would lead to more bureaucracy and regulation.
Murray cited “painful adjustments to our reform efforts” but said that the cost of covering the uninsured has diminished as the state shifts fund from emergency to primary and preventive care. Her assertion came as, one floor above, hospital advocates warned that cutting coverage for the 30,000 immigrants would stick hospitals with $87 million in unbudgeted costs this fiscal year, potentially forcing hospital closures or cuts in hospital personnel and programs and longer patient waiting times.
The ongoing fight over funding coverage for the immigrants has worried consumer advocates, who said Wednesday that eliminating coverage for any group could spawn xenophobia, drive up costs for hospitals, sever ties between patients and primary care doctors and dampen the mood for national health reform.
Lawmakers voted to eliminate the coverage to balance the fiscal 2010 budget, and a top House lawmaker said Tuesday that the members had made their position clear with that vote. House leaders have been mum about how they intend to address the issue but Speaker Robert DeLeo framed the matter as a choice between covering the immigrants or funding legislative priorities cut by the governor.
In a bill filed with his budget vetoes, Gov. Deval Patrick has proposed funding coverage for the immigrants – known as “aliens with special status” because they have been in the country legally for less than five years – using $70 million obtained through vetoes to the fiscal 2010 budget. Although coverage for the immigrants was initially anticipated to cost $130 million, Patrick has charged state health care officials to develop a less costly plan, with limited benefits, to meet his funding level.
The move to outline a plan could prove fruitless if lawmakers refuse to go along with Patrick’s proposal. House Speaker Robert DeLeo said Wednesday morning on WRKO that funding insurance for the 30,000 immigrants would require lawmakers to uphold the governor’s vetoes on numerous other legislative priorities.
“We’re going to have to make a decision. It can be one or the other. We really can’t do both unless there’s some middle ground that we can work on,” he said.
Treasurer Tim Cahill, during a radio interview, expressed reservations about the affordability of universal health care and said some businesses have been allowing the state to cover their employees and paying penalties under the law rather than covering employees under their own plans.
“Overall we may not be able to cover everyone when we’re in a recession and we may have to just stop encompassing and trying to make it universal even though I know it’s the goal,” Cahill said on WRKO-AM. “At the end of the day, you guys know – if you can’t afford it and we’re going to bankrupt the state to get it, what have we accomplished at the end of the day? We’ll get more unemployed people getting health care paid for by the state.”
House Minority Leader Brad Jones told reporters Wednesday that he was skeptical about how coverage could be funded, considering many of the governor’s spending vetoes were replaced by other spending in the subsequently filed supplemental budget. Jones suggested that lawmakers should wait until after Labor Day to consider overriding the governor’s vetoes, or until the state’s fiscal situation becomes clearer.
Health Care Financing Committee co-chairwoman Rep. Harriett Stanley (D-West Newbury) told the News Service Tuesday that the House and Senate, by axing $130 million in funds for the immigrant health program, had made their position clear on funds that help those in the state legally but who are not citizens. She suggested that the governor could shift funds within the $13.67 billion Health and Human Services budget his fiscal year to maintain coverage.
Patrick’s budget chief, Leslie Kirwan, countered that the governor has already shifted funds to make room for immigrant health coverage.
“Governor Patrick’s proposal to fund this $70 million already reflects a number of hard choices and vetoes that, in part, shift funds within health care,” she said in a statement to the News Service. “Overall, the Governor’s proposals reflect careful consideration of the best way to prioritize our health care needs in an extraordinarily difficult fiscal environment.”
Patrick budget officials met with health care stakeholders Wednesday in what Health Care for All officials initially billed as an effort to outline the structure of the new health care plan. After the meeting, Health Care for All and the Patrick administration put out similarly worded statements “reiterating our support” for the governor’s proposal.
Rep. Antonio Cabral (D-New Bedford), as well as Reps. Mary Grant (D-Beverly), Marty Walsh (D-Boston), Kay Khan (D-Newton) and Frank Smizik (D-Brookline), told the News Service they hadn’t received word from House leaders about how the House would address the coverage issue.
“That’s still alive and that’s still out there,” said Rep. William Straus (D-Mattapoisett), a chairman in DeLeo’s leadership lineup. “I think people are talking about that.”
Rally for Coverage
At a State House rally Wednesday, consumer, religious and immigrant advocacy organizations said the governor’s proposal was already a middle ground.
“If we fail here, it says one of two things – either the nation takes the lesson that health care reform cannot be done or we open the door to doing it only halfway, excluding immigrants and refugees,” said Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition.
A South Boston pastor, representing the Greater Boston Interfaith Organization, said 943 residents in the South Boston area stand to lose health insurance if the governor’s plan is not adopted.
Bazlul Wahab, a resident speaking at the rally, said his 62-year-old diabetic mother would be losing coverage at the end of the month, although she has been insured since June 2007. “My mother is frightened and confused by these unexpected changes,” Wahab said. “All U.S. citizens and lawful commonwealth residents deserve health care.”
Tim Gens, executive vice president of the Massachusetts Hospital Association said the state’s move to drop coverage for the 30,000 immigrants will cost hospitals about $87 million, bringing the projected shortfall in a program that pays providers who care for the uninsured to $125 million, according to association estimates. He told reporters Wednesday that the MHA was worried about the ability of some of its hospitals to stay solvent, although he declined to name any.
The shortfall in the Health Safety Net program, previously known as the uncompensated care pool, reflects the state’s difficulty in affording its universal health care push in the recession.
Three lawmakers who support maintaining insurance coverage for the immigrants, Reps. Cabral, Denise Provost (D-Somerville) and Carl Sciortino (D-Medford), said they would urge their colleagues to restore funds.
“It’s important here to maintain coverage for all legal residents of the commonwealth regardless of titles or other status,” Cabral said. “I think it’s absolutely unacceptable in this state today to accept any kind of singling out.”
The coverage was dropped despite the budget’s inclusion of authorization for nearly $1 billion in new taxes, the bulk of which will be derived from a 25 percent increase in the state sales tax.
Cabral said supporters would be sending letters to the speaker and House Ways and Means Chairman Charley Murphy, who declined comment on the issue Tuesday.
Amy Whitcomb Slemmer, executive director of consumer advocate Health Care for All, said that even if the governor’s plan is accepted, the state needs additional revenue to support health care. Human services lobbyist Judy Meredith, who said she has been patrolling Beacon Hill through the last four fiscal crises, said advocates would start “from square one” if they lose this fight, scouring the budget for additional funds to patch together coverage for the immigrants.
