Tens of thousands of children and young adults in Massachusetts are unable to access the health care they need because their immigration status poses a barrier, advocates told state legislators Tuesday.
Lawmakers on the Health Care Financing Committee heard testimony on bills that would extend comprehensive MassHealth coverage to Massachusetts residents under age 21 who are currently ineligible only because of their immigration status.
Children without legal immigration status are not eligible for full MassHealth coverage. Bill supporters said that leaves families to navigate a complicated patchwork of safety net programs that have limits on coverage for some services like mental health, dental care or prescription drugs, and do not cover others, like eyeglasses or home health care.
Chelsea resident Ruth Gomez told the committee that she and her family came here from Honduras to seek a better life for her son Dylan, who was born without eyes, is mostly deaf, and has severe developmental disabilities and limited mobility.
Speaking in Spanish with an interpreter, Gomez said the limited insurance Dylan initially had didn’t cover much of what he needed, including walking aids, hearing aids, behavioral therapies and tests recommended by doctors. When the family received a new immigration status this year and Dylan could get standard MassHealth, it “made a world of difference,” she said.
“Before, feeding him used to be very stressful for me because I was was so fearful he would choke every time,” Gomez said, “Now, with the new health coverage, we have access to a treatment which helps him swallow with more ease, allowing Dylan to eat solid foods and have better nutrition.”
Covering more than 2 million people, the state Medicaid program MassHealth is the single largest piece of the state budget.
In this year's roughly $56 billion budget, still under negotiation between the House and Senate, lawmakers are eyeing a funding level somewhere around $20 billion, much of which would be reimbursed by the federal government.
The bill pending before the committee would direct state health officials to "maximize federal financial participation for the benefits" that would be extended to previously ineligible children, but says that the benefits shouldn't be conditioned on whether federal money is available.
Similar bills have been filed on Beacon Hill multiple times over the years, but legislative leaders have never brought them to a floor for a vote.
This year’s push comes as the state Senate is also seeking a law change that would let Massachusetts high school graduates without legal immigration status pay the lower, in-state tuition rates at public colleges and universities, and as the state’s shelter system struggled to meet demand amid an influx of migrants.
Amy Grunder of the Massachusetts Immigrant and Refugee Advocacy Coalition said many of the new arrivals are families with young children.
She said some newly arriving immigrant children, such as Haitians and Venezuelans participating in an immigration parole process, are able to access comprehensive medical coverage, while others, including asylum seekers, cannot. An asylum claim can take months, assuming a pro bono lawyer is even available, Grunder said.
“These children often need access to mental health services as well after undergoing the trauma of a harrowing journey of months or in some cases years to get here,” she said.
Twelve other states already have similar laws on their books, according to Health Care for All, including Connecticut, Vermont, Rhode Island and Maine.
Casey Thompson, an assistant attorney general in AG Andrea Campbell’s children’s justice unit, said there are between 30,000 and 48,000 children and young adults in Massachusetts whose only barrier for insurance eligibility is their immigration status.
Thompson said her office hasn’t done a formal cost-benefit analysis putting a price tag on the proposed change.
“We believe that there is a cost here to doing nothing – in the form of financial [costs], with regard to having kids be forced into having more inpatient stays, more hospitalization visits, and chronic conditions in the long-term,” she said. “But we also believe there’s a non-financial cost here, when you look at the parents, the families of these children and young adults as well as the children and young adults themselves, in terms of their life and well-being, and we believe that deserves due consideration in a cost-benefit analysis as well.”