Health care bill for immigrants appears to be stalling in state Senate

Activists from CASA, the regional immigrants’ rights group, have been a fixture on Lawyers Mall in front of the State House in Annapolis for the past several days. On Tuesday, in a moment of tension and high drama, several frustrated members of the group pushed into one of the Senate President’s offices in the Miller Senate Office Building, until they were dispersed, peacefully, by state police.

But the legislation the activists have been agitating for over the past few days, to allow undocumented immigrants to buy health insurance coverage through the state’s Health Benefits Exchange, appears to be dead in the waning days of the General Assembly session. Senate Finance Committee Chair Melony Griffith (D-Prince George’s), told Maryland Matters on Wednesday that she doesn’t plan to send the bill to the Senate floor.

“I appreciate the passion behind the issue,” Griffith said. “I share the desire to make health care available to our most vulnerable communities. But I don’t think we’re moving it this year.”

The bill, which passed in the House on a 100-38 party-line vote on March 15, would remove immigration status as an eligibility requirement for purchasing a health plan through the Maryland Health Benefit Exchange. It would require the exchange, which was created as a result of the national Affordable Care Act to launch a health insurance marketplace for uninsured Marylanders, to seek a waiver from the federal government to allow qualified undocumented immigrants to buy an insurance policy.

“I felt that the bill got to a certain population of folks who could have afforded to buy health insurance but aren’t eligible to do so now,” Del. Bonnie Cullison (D-Montgomery), the vice chair of the House Health and Government Operations Committee and chief sponsor of the legislation, said in an interview.

State hospitals reported spending between $120 million and $150 million in uncompensated care for undocumented immigrants in 2022, so the bill would represent a significant cost savings to the sprawling state health care system, Cullison said.

“This bill respects and values every Marylander seeking equity in health care, which is essential to quality of life,” she testified during the bill hearing in February. “I strongly believe that providing this kind of equity strengthens our communities and benefits everyone in our state. I also believe that equitable access to health care is a human right.”

CASA echoed the same sentiments. The legislation “addresses critical health disparities faced by the immigrant community in Maryland,” Ninfa Amador-Hernandez, a CASA research and policy analyst, told House lawmakers.

Yet the potential high cost of providing insurance coverage to undocumented immigrants in Maryland appears to be giving members of the Senate Finance Committee pause. A 2021 study by the Maryland Health Benefits Exchange estimated that there were 224,700 undocumented immigrants in the state and that 115,900 had no health insurance.

California’s Medicaid program is now providing health care coverage to all income-eligible individuals of all ages, regardless of their immigration status. The Golden State at one point submitted a waiver application to the federal government that would have permitted undocumented immigrants to purchase coverage through the state’s health benefit exchange without subsidies, but the application was withdrawn. A handful of other states have subsequently put in waiver requests with the federal government; Washington state has received one and is implementing the program to sell health insurance to undocumented immigrants.

The Maryland legislature is moving another bill on immigrant health, also sponsored by Cullison in the House, that would require the Maryland Department of Health and the health benefit exchange to study options for offering affordable health care and dental care coverage to undocumented immigrants who are ineligible for Medicaid or other government health care programs. Griffith said she saw this legislation, sponsored in the Senate by Sen. Ariana Kelly (D-Montgomery), as a companion to the other immigration health care bill that’s stalled in her committee.

The Kelly bill passed the Senate 32-14 on March 17 and a hearing was held in the House Health and Government Operations two weeks later.

Cullison said she disagreed with Griffith’s analysis.

“These two bills have very different purposes,” she said.

Cullison said she remained hopeful that her bill seeking a federal waiver to make the health benefit exchange accessible to undocumented immigrants might still become dislodged in the final days of the legislative session, which ends at midnight Monday.

But some Senate leaders have compared the push for health benefits for undocumented immigrants to the multi-year effort to craft the Blueprint for Maryland education reform plan, and say it may take a little longer to develop a comprehensive battle plan. And as Senate President Bill Ferguson (D-Baltimore City) has repeatedly pointed out during this year, some good bills aren’t going to pass but will be back and improved later in the legislative term.

“It’s a matter of prioritizing,” he said Wednesday, speaking generally about legislation, not Cullison’s bill specifically. “We’ll be back in a year. If we don’t get it through this year we have other opportunities to get it across the finish line.”

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