The press is busy looking for dirt on Romney’s health care achievement in Massachusetts. Unfortunately, most of the muck being heaped on our universal health care law is misguided or incomplete, including a story in today’s L.A. Times which focused on Massachusetts’ Health Safety Net (HSN) program.
HSN provides reimbursement to hospitals and community health centers that provide care to low-income uninsured people, without regard to immigration status. It’s the successor to the program called “Free Care,” or the “Uncompensated Care Pool.”
The story’s angle is that Romney signed into law a program which provides low-income, illegal immigrants with access to free health care services. It’s being trumpeted by the Perry campaign.
Romney’s defense: it wasn’t me, it was Deval. Romney advisor Eric Fehrnstrom was on MSNBC today, claiming that HSN coverage for undocumented immigrants was started only under Deval Patrick’s administration. But that’s just not true, as the rules on citizenship and eligibility didn’t change between the old Uncompensated Care Pool under Romney’s administration, and the HSN under Governor Patick (which officially became effective 10/1/07). Watch this video, posted by “perrytruthteam.”
But the story missed several other key elements of the Health Safety Net program:
1. The Health Safety Net program authorized in Chapter 58, the health reform bill that Governor Romney signed, was not a new program. It was just a new name for a program previously called the “Uncompensated Care Pool.” The HSN program, like the Uncompensated Care Pool, was funded by an assessment on hospitals and insurers. The money went out to reimburse hospitals and health centers for the costs they incurred from providing health care to low-income uninsured patients, regardless of immigration status. The Uncompensated Care Pool goes back to the 1980s. The HSN is the same thing, with a new name. Prior to the passage of chapter 58, the Romney administration administered the Uncompensated Care Pool, which also covered undocumented residents.
2. The HSN program is not an insurance program. No one gets an insurance card, no one gets any guaranteed benefits, no one gets any right to care. It’s a health provider reimbursement program. Under federal law (passed in the Reagan era), all hospitals are required to provide emergency care to anyone, without asking about immigration status. Community health centers have similar obligations. So the HSN program is how Massachusetts deals with the cost of providing those services. While undocumented people are able to get health care because the program, the program exists to benefit hospitals and health centers, not the individuals.
3. Every state has its own method of financing care for the undocumented. In Massachusetts, it’s the HSN program. In Texas, to pick a random example, it’s the county hospital system. Look at this report in the Houston Chronicle, for example: Texas hospital districts spent $677 million in public funds in 2008 to provide care to undocumented immigrants. So the fact that under Governor Romney’s watch the state reimbursed hospitals for care provided to low-income uninsured, some of whom may have been undocumented, is not that surprising. Probably every state does it, one way or another.
From our point of view, all people, regardless of status, are entitled to adequate health care. Even if you reject this value, the economic and community health benefits to legal residents justifies providing access to care to everyone.
The media circus keeps spinning.
Health Care For All
(somewhat different version posted on HCFA’s A Healthy Blog)