Bill would extend MaineCare health coverage to all low-income noncitizens

Jan. 24—House Speaker Rachel Talbot Ross, D-Portland, has proposed a bill that would give low-income noncitizens access to public health benefits through the state's MaineCare program. The proposal is likely to draw opposition from Republicans, who have proposed rolling back welfare benefits.

Talbot Ross sponsored a similar bill in the last legislative session, but it died in committee after Gov. Janet Mills included a more limited expansion in her supplemental budget that extended MaineCare benefits to pregnant women and people under the age of 21, regardless of citizenship. Other noncitizens were excluded.

Talbot Ross said in a written statement provided by a spokesperson that expanding health coverage to all noncitizen residents is both an economic and moral imperative to ensure all Mainers are treated fairly. She said adequate and affordable health care is a "basic fundamental human right."

"Regular, predictable medical treatment is proven to ensure folks can go to work, get to school and take care of their families," she said. "My legislation seeks to remove barriers, improve outcomes and ensure that all people be treated with dignity and compassion — regardless of how long they have lived in Maine."

Advocates say that preventive care is less expensive than emergency care and ensuring that all Maine workers, including noncitizens who have work permits, is vitally important, especially amid the state's workforce shortage.

Democrats controlled both legislative chambers last session, plus the Blaine House, and could have passed the bill without Republican support. But such a move would have been fodder for Republicans during an election year in which Democrats were facing national headwinds.

Neither Talbot Ross, nor spokespeople for Mills, responded to questions about why MaineCare was expanded only to pregnant mothers and those under the age of 21. The Office of Family Independence in the Department of Health and Human Services testified neither for nor against last session's bill.

The governor's office did not respond to a request for Mills' position on Talbot Ross' new bill, L.D. 199.

House and Senate Republican leaders said Tuesday that they had not seen the text of the bill, which has been printed but not yet referred to a committee. Instead, they advocated for national immigration reforms, including making it easier for some noncitizens to work and provide for themselves and their families.

"I don't think our caucus is going to be generally supportive of this idea," said Senate Minority Leader Trey Stewart, R-Presque Isle, adding that he hasn't yet spoken to members. "I'm all for a safety net for those that need it, but that safety net in Maine has become a hammock and we need to move away from that model."

House Minority Leader Billy Bob Faulkingham, R-Winter Harbor, predicted that his caucus would be skeptical about such a bill. But Faulkingham said he looked forward to reviewing it to see if it was "sensible and compassionate" and affordable.

It's unclear how much the expansion would cost. Last session, Talbot Ross estimated that it would cost nearly $8 million, a sum that also included expansions that ended up being in the governor's budget.

Forty states have federal options to cover lawfully residing children or pregnant women, or provide prenatal care regardless of immigration status, or use state funds to cover certain immigrants, according to the National Immigration Law Center. But it's unclear how many states cover all noncitizens who would otherwise qualify for Medicaid.

Maine provided public health benefits to noncitizens up until 2011, when former Republican Gov. Paul LePage successfully eliminated their eligibility.

Kathy Kilrain del Rio, advocacy and program director for Maine Equal Justice, which is part of a coalition advocating for the legislation, said the bill would essentially restore those benefits that were eliminated under LePage, giving noncitizens access to preventive health services, such as regular doctor's visits and medication.

PROMOTING PREVENTIVE CARE

Under the current system, noncitizens often allow their conditions to deteriorate to the point where they either go to the emergency room for care, or die, Kilrain del Rio said. That can leave serious health problems, like cancer or diabetes, undiagnosed, she said.

"It's better to have people have access to preventive care so that conditions can be caught early and treated often in relatively simple ways rather than have them escalate to the point where people have to go to emergency rooms," she said. "That's a much more expensive way to treat problems."

Mufalo Chitam, executive director of the Maine Immigrant's Rights Coalition, said the bill is needed now more than ever, because of the growing number of asylum seekers who are coming to Maine.

For most of last year, Chitam said her organization helped organize health clinics twice a week for asylum seekers staying at the Howard Johnson in South Portland. Those clinics highlighted not only the need for preventive care, with people suffering from the effects of untreated diabetes, eye and ear problems, bone fractures, infections and other injuries sustained on their long journey to the U.S., but also follow-up care, she said.

In one case, Chitam said, a mother of two teenage children was diagnosed with cancer and died.

"By the time she was being seen as an emergency it was way too late," Chitam said. "It's really a matter of life and death."

BILLS TO TIGHTEN ELIGIBILITY

Sen. Eric Brakey, R-Auburn, has submitted several bills that would tighten welfare eligibility. He said the U.S. cannot have "open borders and (a) welfare state."

"I think a lot of Maine taxpayers want to make sure the social safety net is going to folks who paid into the system," Brakey said.

Rep. Deqa Dhalac, D-South Portland, is one of the bill's eight co-sponsors. She said health coverage would relieve the burden on asylum seekers and other noncitizens as they pursue their asylum claims and gain access to work permits, so they can contribute to society. Even noncitizens who do work — such as in home health care or hotels and restaurants — are not always guaranteed access to health care.

"As a social worker, I think it's our responsibility as human beings in general to take care of our communities, our neighbors, and these are some of the people that are really doing a lot of work," she said. "They don't want handouts. They want to work. They want to contribute to the economy or just the country as well as the state, and we're just providing a small stipend for their health and well being."