We should all have learned many lessons from the COVID-19 pandemic. Some important ones concerned the way our health system treats immigrants. As:
• Because some groups of immigrants are not eligible for programs like MaineCare, they entered the pandemic with the underlying conditions COVID much more dangerous.
• When large numbers of people become very sick, there is an impact on the entire health system and economy that affects everyone, whether they are sick or not.
Maine has the chance to fulfill these lessons by passing LD 718, sponsored by the House Assistant Majority Leader Rachel Talbot Ross, D-Portland. It would end the exclusion of people from MaineCare and Children’s Health Insurance programs based solely on their immigrant status.
Current law cuts thousands of newcomers out of these programs, and not just undocumented immigrants. Asylum seekers with work permits are denied coverage while they wait for action by the immigration courts, which can take years.
Permanent residents – Green Card holders who are just one step away from citizenship – will have access to needs-based programs for five years.
Of course, no one is completely excluded from the American healthcare system. Hospitals and other health care providers are required to provide emergency care to anyone who needs them, but preventive and follow-up care is provided for cash for uninsured people.
This means that we all pay, because the costs of free care flow into the prices of those with private insurance and are reflected in their premiums. It also means that for an immigrant who is not eligible for MaineCare, we will pay for the emergency heart surgery, but not the cholesterol-lowering drugs and primary care visits that could have prevented the emergency.
This is not only cruel for those affected, but also a waste of resources that could be used more productively.
Lawmakers are still waiting for a price on the bill, but it’s valued at $ 7 million over two years. Governor Mills has proposed policy changes that would partially remove the exclusion of immigrants and expand protection for pregnant women and people under the age of 21. While we usually support compromises that make incremental progress, in this case half is not enough.
All immigrant groups covered by this bill were eligible for the programs before 2011 when the then government did so. Paul LePage has scapegoated these vulnerable families as part of a wider ideological assault on welfare programs.
LePage and others claimed it was unfair to help newcomers when so many Maine nationals were in need. But LePage didn’t help these other Mainers get health insurance. Indeed, he vetoed laws five times that would have extended Medicaid entitlement to low-income families. It took a referendum and the 2018 election of Mills to finally capture these people.
Restoring insurance coverage for immigrant families would not create any new entitlement; it would only undo the damage done a decade ago. Leaving out some of the people who lost their coverage in 2011 would at least partially support LePage’s perverted policies.
As COVID should have taught us, we all have an interest in each other’s health. Programs that discourage people from getting sick and treating chronic illnesses weigh on everyone’s health care costs and reduce the likelihood that insured people will suffer a catastrophic – and costly – health emergency.
Closing this gap would help us create a more humane health system that uses our common resources more efficiently. Legislators and Governor Mills should find some way to get that done before the legislature closes its deals this month.