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‘All means all’: Advocates, lawmakers push to end exclusion of immigrant adults from health care

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‘All means all’: Advocates, lawmakers push to end exclusion of immigrant adults from health care

Mar 28, 2023 | 5:05 pm ET
By Evan Popp
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‘All means all’: Advocates, lawmakers push to end exclusion of immigrant adults from health care
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Luc Samuel Kuanzambi speaks Tuesday at the press conference on Ld 199 | Beacon

Speaking about the hardships people experience when they don’t have health coverage, advocates urged lawmakers Tuesday to take action to ensure that all low-income Mainers, regardless of immigration status, can get medical care.  

Lawmakers can do so by passing a bill, LD 199, introduced by House Speaker Rachel Talbot Ross (D-Portland). The measure would provide coverage under MaineCare, the state’s Medicaid program, for income eligible noncitizen residents 21 years or older who are currently not permitted because of their immigration status. Combined with action taken by the legislature and Gov. Janet Mills in 2021 to restore health coverage to younger noncitizens and those who are pregnant, LD 199 would ensure that no one is excluded from care because they are an immigrant. 

Talbot Ross’ bill would rectify action taken by former Gov. Paul LePage, who stripped people with certain immigration statuses from being able to access MaineCare coverage in 2011. Before that, Maine specifically included immigrants in health care programs. 

‘The health of one is the health of all’

Immigrants and health care advocates with the campaign All Means All, which is pushing for passage of LD 199, spoke of the importance of passing the bill during a press conference Tuesday and afterwards during a public hearing on the measure before the Health and Human Services Committee. 

“The health of one is the health of all. We all reap the benefits when our communities are cared for,” said Crystal Cron, founding director of the nonprofit Presente Maine, one of the group’s supporting LD 199. 

In her remarks, Cron noted that many immigrants worked frontline jobs that kept Maine afloat during the pandemic and suffered grave impacts from the virus, with Maine seeing one of the worst racial disparities in the nation for COVID-19 cases. She added that the crisis showed how the health of one person is directly connected to the health of others. 

Other speakers at the press conference told stories about the dire consequences of lacking health coverage. 

Laura Valencia Orozco, behavioral health director for the Maine Mobile Health Program, which provides care for farmworkers, said she often has to make referrals to other providers to support patients’ overall health. If a patient has MaineCare, that process is more straightforward. However, many of the patients Orozco works with don’t have MaineCare because of the current exclusions in the program. As a result, Orozco often has to watch patients make the difficult decision between seeking care without coverage — which often results in extremely expensive medical bills — or waiting to see if a health issue becomes an emergency. 

One example she gave was a patient working in agriculture who Orozco saw in 2021 after they fell sick with COVID-19. That patient had no available sick time, was the sole wage earner in a family of six, and had no MaineCare coverage, Orozco said. Because of this, the patient and their family made the hard choice to delay seeking care before eventually being forced to get emergency treatment when the patient could no longer breathe without assistance.

Orozco said the patient spent several weeks in the hospital before eventually being discharged and immediately returning to work. But during those weeks in the hospital, the patient’s family suffered extreme financial stress and food insecurity at the same time that they racked up staggering medical bills. This has caused continued stress, as the family fears they will never be able to pay that bill, Orozco explained.

Orozco said such stories show why it is essential that everyone in Maine, no matter where they come from, have health care coverage. 

“Health care is a human right, and immigration status has nothing to do with it,” she said.

Another speaker at the press conference was Luc Samuel Kuanzambi, who lives in Portland and is originally from the Democratic Republic of the Congo. He said he and his family have lived in Portland since 2017. They came to Maine because when their daughter was born in 2016, she was diagnosed with a life threatening liver condition. Kuanzambi said the Democratic Republic of the Congo has a shortage of medical care options and that the family looked for the needed medical care in other places around the world before deciding to seek treatment in the U.S. 

Eventually, they were able to obtain a visa and arrive in Maine, where Kuanzambi’s daughter received MaineCare and was put on a waiting list for treatment. In 2019, when doctors said she had less than 48 hours to live, Kuanzambi’s daughter finally received an organ transplant.

“As I stand before you today, our daughter is now a very healthy and thriving little girl. She attends Portland Public Schools and her favorite role play includes pretending to be a medical doctor. This future of hers would have been impossible without MaineCare,” Kuanzambi said, choking up as he spoke about how the health care program saved his daughter’s life.  

However, Kuanzambi said too many adult immigrants still lack the access to the health care his daughter received. He noted that this has taken a toll on many in the Maine community through undiagnosed or untreated conditions. He urged lawmakers to take action to end exclusions to coverage and help improve the overall health of all people in the state. 

Bill receives widespread backing at public hearing

Later at the committee hearing, a wide range of speakers came out in support of the measure, with over 40 people submitting testimony in favor of the bill. Those supporters included advocates, health care professionals, municipal officials, as well as immigrants without health care and everyday citizens of Maine. The bill received very little opposition during the hearing, although the measure is expected to face pushback from some Republicans. 

In her testimony, Talbot Ross told the Health and Human Services Committee that health care is a human right and noted that immigrants collectively pay hundreds of millions in taxes each year even though many are not allowed to access the health care systems supported by those dollars. She also said immigrant populations in Maine are less likely to receive health coverage through work, as many in the state do. 

The House Speaker added that passing LD 199 would be transformative for scores of people.  

“LD 199 is simple in language, yet wide-reaching in impact and will provide life-altering benefits for the individuals who gain coverage as well as their families, their communities, and their places of employment,” Talbot Ross said.

Another person testifying at the hearing, Hilrish Bampoli of Lewiston, said he knows firsthand how expensive it is to not have access to affordable health care. Bampoli said after he spent two years paying off bills for a small surgery, he no longer seeks care as a first resort, even when he had severe tooth pain. 

“People around me pay a lot of money for simple medical procedures like x-rays or visits to the doctor,” Bampoli said. “This makes me even more sure that I will never go to a hospital unless I am brought there unconscious.” 

‘All means all’: Advocates, lawmakers push to end exclusion of immigrant adults from health care
Immigrants and advocates at the State House in 2021. | Beacon

The Mills administration, through Antony Pelotte, director of the Office for Family Independence, also submitted testimony on the bill. The administration did not take a formal stance on the measure. However, Pelotte expressed concern that the bill’s implementation date of January 2024 isn’t feasible. And while the legislation calls for the Department of Health and Human Services to seek matching federal funds to help with the cost of the program, Pelotte said that would be difficult under federal law and noted that the initiative would require state general fund dollars.   

The cost of the measure hasn’t yet been determined. However, given that Maine went into this legislative session with a surplus, proponents argue that the program could be paid for if lawmakers choose to fund it. 

The push for LD 199 comes as other states are also seeking to provide health coverage for immigrants. Some states are providing coverage for only some populations — such as children and older individuals — while other states, such as California and Oregon, are moving to provide health care for all low-income residents, regardless of immigration status. 

Last year’s effort in Maine to follow that path and expand coverage to all low-income immigrants was made more difficult by what advocates said was a fear among some Democrats in the legislature about the potential political implications of supporting the bill in the lead-up to the 2022 election. But research shows that the policy is popular with Maine people. A recent poll found that 83% of voters in the state believe that ensuring every Mainer has affordable health insurance should be a priority for state lawmakers.

That sentiment was echoed by health care experts who submitted testimony for Tuesday’s hearing.

“Offering MaineCare, regardless of immigration status, would allow access to preventative care sooner which in turn should reduce overall emergency medical expenses,” said Ann Tucker, chief executive officer at Greater Portland Health, a community health center. “Healthy community members are able to work and positively impact the state’s workforce shortage. All Maine residents deserve to have access to health care.”