Law Barring Legal Immigrants from Massachusetts Health Care Program Unconstitutional

By Jerry Geisel

Jan. 6, 2012

Legislation that Massachusetts lawmakers passed in 2009 barring legal immigrants from a state-subsidized health insurance program violates state law, the Massachusetts Supreme Judicial Court unanimously ruled Jan. 5.

Under the 2009 measure, which was passed during the Great Recession to save the state money, legal immigrants who had lived in the United States for less than five years no longer were allowed to enroll in the state’s Commonwealth Care program.

Commonwealth Care, which has just under 160,000 enrollees, was created under the state’s landmark 2006 health care reform law, which was intended to move the state close to universal coverage.

Instead, the affected individuals—more than 25,000—were allowed to enroll in a new state program called Commonwealth Care Bridge that offered less generous coverage and required higher premiums than the regular Commonwealth Care program.

Eliminating legal immigrants’ eligibility for Commonwealth Care “violates their rights to equal protection under the Massachusetts Constitution,” the state high court ruled.

State officials say they intend to comply with the ruling.

“This decision has significant fiscal impacts for the Commonwealth, adding somewhere in the range of $150 million in annual costs to what is already a very challenging budget,” Massachusetts Secretary of Administration and Finance Jay Gonzalez said in a statement.

“However, we respect the court’s decision, and we will work expeditiously to identify the resources required and the operational steps that need to be taken to integrate all eligible, legal immigrants into the Commonwealth Care program in accordance with” the ruling, he added.

The U.S. Census Bureau reported in September that at 5 percent—averaged over 2009 and 2010—Massachusetts had the lowest uninsured rate of any U.S. state.

Jerry Geisel writes for Business Insurance, a sister publication of Workforce Management. To comment, email

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Jerry Geisel writes for Business Insurance, a sister publication of Workforce Management.

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