Aside from the obvious moral and health-care-as-a-right arguments, immigrants in MA contribute a significant amount as taxpayers to the Commonwealth. A recent study commissioned by The Immigrant Learning Center, with researchers Paul Watanabe and Alan Clayton-Mathews of UMASS-Boston, found that while immigrants make up 14.1% of the MA population they are 16.4% of tax filers. They are also overrepresented among those paying sales and excise taxes. With this group working and paying taxes like any other resident, why should they not have the same access to quality and affordable health coverage?
All stakeholders involved in health reform, from outreach workers to providers and insurers, have invested a significant amount of time and energy to preach the importance of preventative and primary care, particularly to populations who may not have as much history with the insurance model in MA and the U.S. Now, after considerable effort, the proposed cuts will bring us back to square one and the progress that has been made will be stilted.
While ending coverage for this group will cause tremendous personal hardship to the affected individuals, it will also increase the burden on the increasingly fragile health safety net system. Ending coverage won’t suddenly end the need for care for these 30,000 people. When they get sick, they will be more likely to skip primary care, since without insurance they can’t cover the cost. Rather, many will wait until little problems become acute, and show up in the emergency rooms and community health centers in much worse shape.
The cost of covering the more severe problems will put a great strain on our struggling safety net hospitals. The latest report from state officials on hospital finances found that while all hospitals suffered from declining margins, for the first time in seven years the 18 designated safety net hospitals were losing money as a group. The health safety net program, which reimburses hospitals for care to uninsured low-income patients, has been financially stable the past 3 years, as health reform dramatically reduced the numbers of uninsured. However, the funding for next year did not anticipate adding some 30,000 new people to the pool, and the fund will certainly experience a shortfall. When that happens, hospitals and community health centers are left holding the bag, eating losses that they have no choice but to pass on as increased costs to everyone else.
Finally, while national health reform is debated in Washington and all eyes focus on Massachusetts as a model, it is critical to show all Americans the benefits of health reform and increased access to care. Increasing the ranks of the uninsured does the opposite and is a disservice to the progress we’ve made as a state.
We hope the legislature chooses to adopt the Governor’s compromise amendment to outside section 121 and passes outside section 37 of his supplemental budget to ensure continued access to preventative and primary care for this population. It was the legislature that led in bringing us health reform; it is only fitting that they now have a chance to sustain its success.
If after reading this you feel compelled to contact your legislator, please do so by calling 617-722-2000 or visiting here. For a district-by-district look at the impact of the cuts, click here. (Please note that numbers are based on zip code and only include towns with at least 100 total Commonwealth Care members.)
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