Observers both here and across the country are trying to extrapolate lessons from our health care reform ahead of whatever legislation finally emerges from Congress. Some look at Massachusetts as a model, others as a bogeyman. If so, the lesson being offered is unfortunately a stark one, and possibly unconstitutional.
Opponents of the various Democratic health care plans currently winding their way through Congress argue that a government takeover of health care will lead to rationing, that as more and more people receive subsidized health insurance, utilization will increase, costs will spiral and, ultimately, government will be forced to ration care to contain them. They may be right. For that is exactly what the Massachusetts legislature just did.
The State House News Service (subscription needed) reported yesterday that
A state agency will inform about 30,000 legal immigrants this week that their current state-subsidized health benefits will expire on Sept. 1. A spokesman for the state Connector Authority said letters will be mailed out to the so-called aliens with special status (AWSS) – immigrant taxpayers who have spent less than five years in the country – notifying them they will be disenrolled.
The Legislature originally stripped the $130 million needed to provide the coverage from this year’s budget. Governor Patrick fought to restore about half of it, and they settled at $40 million. This is rationing. More disturbingly it is rationing based on little more than popularity. Immigrants, even legal ones, aren’t very popular in the current economic and political climate. (They also can’t vote, which is handy.) And this is where the constitutionality comes in. Legal immigrants were stripped of their subsidized health care as a class, a suspect class no less.
Legal immigrants are covered by our federal constitution. Even if they weren’t, stripping them of their health insurance because we like them less than someone whose family may have been here a generation or two longer is simply wrong. But, ultimately, the lesson here is one of health care rationing. Our state legislature chose to ration health care to contain costs and they did it based on little more than who was the most politically expedient group.