Health benefits being revived

Md. program dropped thousands of legal immigrants last year

October 20, 2006|By Kelly Brewington | Kelly Brewington,Sun reporter

Maryland health officials said yesterday that they will begin reinstating health benefits for thousands of legal immigrant women and children who were dropped from a state health insurance program 16 months ago.

The decision - a week after Maryland's highest court sided with 13 sick immigrant children who were cut from the program - amounts to a major policy reversal by the administration of Gov. Robert L. Ehrlich Jr. In July 2005, administration officials eliminated $7 million from a Medicaid program covering about 4,000 low-income pregnant women and children who have been in the country legally less than five years.

The Republican administration said the funding was eliminated because of budget difficulties. The move outraged immigrant advocates and Democrats, who have used it as ammunition on the campaign trail - particularly among Latino voters - in an effort to unseat Ehrlich.

The battle over immigrant health care benefits entered the courts last fall when the Maryland Legal Aid Bureau and Bethesda attorney Douglas M. Bregman filed a lawsuit against the state alleging that the administration's actions were discriminatory.

In its unanimous decision last week, the Maryland Court of Appeals upheld a Montgomery County Circuit Court judge's preliminary injunction blocking the cuts, paving the way for the restoration of the children's benefits. That decision applied only to the plaintiffs, including a boy with a complex blood disease and a girl with West Nile virus.

Yesterday, the children's attorneys said they were thrilled by the administration's action.

"I am excited beyond belief," Bregman said yesterday afternoon after receiving a call from S. Anthony McCann, secretary of the Maryland Department of Health and Mental Hygiene, informing him of the decision. "This is not only a victory for the 13 plaintiffs; it is a sweeping victory for an entire class of people similarly situated."

McCann said yesterday that his agency had begun restoring benefits to the 13 plaintiffs in the case and would start extending the benefit to similarly eligible families. He said families that were cut from the program more than a year ago and still meet the program's requirements should expect to receive letters in about two weeks informing them whether they are still eligible.

"I think the court was clear on what it decided, so we are implementing the changes," he said.

State health officials plan to work with advocates and social service agencies to inform people who are newly eligible for the program.

The administration's cuts affected about 4,000 pregnant women and children enrolled in the medical assistance program. Determining how many people are eligible now might take considerable time, McCann said.

McCann said he is not sure how much restoring the benefits will cost the state but that he expects the money to come from the approximately $4 billion Medicaid budget.

"The Medicaid budget is growing quite rapidly," he said. "But the courts have made this decision, and we are going to follow it."

A month after the medical assistance cuts were announced, Ehrlich restored $1.5 million to cover pregnant women in the program. And protests by Democrats during this year's General Assembly session prompted the governor to set aside $3 million in his budget for grants to local health departments to help provide coverage.

Kevin Enright, a spokesman for the attorney general's office, which has represented the state in the lawsuit, left open the possibility that the state might continue to fight the lawsuit.

"This is a policy decision," he said. "No decision has been made yet regarding how we will proceed with the Circuit Court."

Bregman said the health department's restoration of the benefits is the "handwriting on the wall."

"The fact that the secretary is going to restore the benefit for the whole class of people says a lot," he said.

It is unclear whether benefits will be restored retroactively. The Court of Appeals disagreed with the lower court's determination that the benefits should be issued dating to July 2005.

Health care and immigrant advocates said the reinstatement of the benefits was long overdue, and a spokesman for Ehrlich's Democratic challenger, Baltimore Mayor Martin O'Malley, continued to blame the governor for eliminating the funding in the first place.

"When a court of law has to force the governor not to throw pregnant women and their children off of health care, it's time for a new governor," O'Malley spokesman Rick Abruzzese said.

"I'm sorry it took a court to point out how mean-spirited and ultimately illegal the governor's original cuts were," said Kim Propeack, director of community organizing and action for the immigrant advocacy group CASA of Maryland. "But I'm happy to see the administration applying the court's decision adequately."

Dr. Joshua Sharfstein, Baltimore's health commissioner, said restoring health insurance to vulnerable people makes medical sense.

"I think there is really a mountain of evidence that access to primary care and specialty care improves health and avoids serious illness," he said. "It's particularly foolhardy to skimp on care for pregnant women and children. If you wind up with inadequate care, there can be expensive complications that last a long time."

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