Courts make opposite rulings on care of legal immigrants

State Supreme Courts in Connecticut and Massachusetts have issued opposite rulings on whether low-income legal immigrants should be afforded medical services through state assistance programs.

The Massachusetts Supreme Judicial Court ruled on May 6 that the state was wrong to exclude legal immigrants from a state-run program providing health benefits to residents of six months or longer.

The Connecticut Supreme Court said April 5 that terminating a medical assistance program designed for legal immigrants with less than five years of residency did not violate immigrants' equal protection rights.

In Massachusetts, a group of legal immigrants sued the state in 2010 after the Legislature cut funding for immigrant care under the Commonwealth Care program from $130 million to $40 million. The cut was made to balance the state budget. Commonwealth Care provides free or subsidized health care to low-income residents who otherwise don't have access to health insurance.

Because of the cut, about 26,000 legal immigrants lost their coverage and were transferred to a new plan with fewer benefits and higher out-of-pocket costs, according to the lawsuit. An additional 8,000 legal immigrants were left uninsured.

The high court ruled that the state Constitution entitles legal immigrants to equal protection and that the funding cut was probably invalid. The court sent the case back to the lower court.

The plaintiffs, who have been without health coverage for 18 months, hope the lower court will allow them back into the program, said Wendy Parmet, attorney for the plaintiffs and a law professor at Northeastern University School of Law in Boston.

"It's a strong opinion and an important one that reaffirms the rights of taxpaying noncitizens of our community," she said.

Some see the decision in Massachusetts as a blow to states' rights. The federal Welfare Reform Act of 1998 allows states to choose whether to provide health benefits to lawful immigrants, said Ira Mehlman, spokesman for the Federation for American Immigration Reform in Washington, D.C., which supports reduced immigration levels.

A different ruling

In Connecticut, about 5,000 legal immigrants were left with limited or no health care coverage after the state substantially repealed the State Medical Assistance for Noncitizens Program in 2009. The 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 the residents had lived in the U.S. for a short time, they were not eligible for Medicaid, which bars legal immigrants of less than five years. The immigrants also were prevented from enrolling in State Administered General Assistance, a program that covers citizens not eligible for Medicaid.

"The loss of these benefits is basically the loss of all nonemergency benefits," said Nicholas Yorio, attorney for the plaintiffs. "It really is tremendous."

Hong Pham, a legal immigrant, sued the state in 2009 over the program cut. A trial court in December 2009 found that the Legislature's actions violated Pham's equal protection rights. But the Supreme Court disagreed, ruling that since the program had offered services only to legal immigrants, terminating those services was not discriminatory.

The opinion was disheartening, said Tanya Broder, an attorney with the National Immigration Law Center who co-wrote an amicus brief in the case. Courts in Hawaii and Washington have ruled in favor of immigrants in similar cases, she said. "Legal immigrants live, work and contribute to the communities they live in. They're paying taxes for the very services they're being denied."