Advocates Frustrated By Lack Of Action To Restore Health Coverage To Low Income Immigrants

By Evan Popp, Maine Beacon:

Advocates are frustrated and disappointed that a bill to restore health benefits through MaineCare to all low-income people in the state regardless of immigration status won’t be receiving a work session in a Maine legislative committee. Still, leaders of the campaign supporting the bill said they will push for the policy to be included in this year’s state budget.

The bill — LD 718 — will not be considered by the Health and Human Services Committee during this year’s session, advocates told Beacon, meaning it won’t advance to the floor of the legislature. However, there is still a narrow path for the policy to be included in the supplemental budget, which is currently being negotiated.

But proponents say getting the policy in the budget could be challenging, as they believe Democrats in the legislature are worried about perceived political consequences of supporting LD 718 in advance of the November 2022 elections.

“I think there is a lot of focus and fear around the upcoming election and the implications of talking about or taking a vote on such a bill and how that could impact constituents who may not be in support of immigrants,” said Crystal Cron, executive director of Presente Maine, one of the organizations pushing for LD 718. “And so it has been put to the side.”

The election later this year will see the entire legislature up for grabs along with the Blaine House, with former Gov. Paul LePage running against incumbent Democratic Gov. Janet Mills. LePage himself created the problem that LD 718 seeks to fix when his administration in 2011 barred immigrants from accessing a variety of programs, including MaineCare, the state’s Medicaid program.

Along with such policies, LePage had a demonstrated history of making racist comments while serving as governor, including when he referred to people of color or those of Hispanic origin as “the enemy” or said that “Black people come up the highway and they kill Mainers.” Republicans nationally, including some in Maine, have long deployed racist anti-immigrant rhetoric and will likely continue to in the lead-up to the 2022 election.

In order to solve the health care gap created by LePage, LD 718 was introduced last year in the first session of the 130th Legislature, during which the bill was passed by the House but tabled in the Senate. A portion of the bill was included in Mills’ budget last year, restoring coverage through MaineCare to those who are pregnant and people under 21 regardless of immigration status but still leaving out most low-income immigrant adults. Some argued the compromise served to shield Mills and Senate Democrats from having to take a direct stand on the issue. A spokesperson for Mills did not respond to a recent request for comment on whether Mills supports full immigrant inclusion in MaineCare.

Election year politics

Supporters of LD 718 — which is sponsored by House Assistant Majority Leader Rachel Talbot Ross (D-Portland), who declined to comment on the status of the measure — hoped to pass the rest of the bill through the legislature this year so low-income adult immigrants could also gain access to coverage. Advocates have argued that the pandemic has underscored the importance of making sure everyone has health care, particularly those in service or frontline industries.

But Mufalo Chitam, executive director of the Maine Immigrants’ Rights Coalition (MIRC), said some Democrats in Augusta seem wary of supporting LD 718 along with other bills designed to help immigrants.

“I’d say most of our priority bills that we’ve been really advancing this year specifically that would benefit immigrants, communities of color, asylum-seekers, undocumented [people] … are either being tabled or some of them are just dead,” she said.

In an email, MIRC advocacy manager Tobin Williamson said another example is an emergency bill some Portland-area legislators tried to put forward to request statewide coordination to help address housing challenges as the city sees an increase in asylum-seekers. That bill — a significant priority for MIRC — was eventually withdrawn, Williamson wrote, adding that he believes “election year politics” played a role in that.

Other bills MIRC is focused on that have not yet advanced on the floor of the legislature during this year’s session, Williamson said, include an act to require the state to provide 100% reimbursement for general assistance costs to tribes (LD 910), a measure to increase funds for civil legal services for people who can’t afford a lawyer (LD 1326), a bill to streamline the building of affordable housing (LD 1673) and legislation that in its amended form seeks to shut down Maine’s last youth prison by October 2025 (LD 1897).

While Chitam acknowledged she doesn’t know exactly why many of MIRC’s priority bills — including LD 718 — aren’t advancing, she said her sense is that “Everything is pointing to the same. That it’s because it’s an election year,” a sentiment echoed by others Beacon spoke to about LD 718. Chitam added that she believes “Democrats are choosing to take up bills and policies that don’t give a very direct narrative to communities of color.”

If that is the case, that choice could be prove to be politically risky for Democrats. Communities of color are often significant supporters of the Democratic Party, particularly in the run-up to elections. For example, during the November 2020 election cycle, New Mainers organized in their communities and turned out in large numbers to help defeat then-President Donald Trump in a contest that also saw legislative Democrats win both the Maine House and Senate. In addition, research from the think tank Demos states that those on the political left should in fact discuss race overtly and intertwine such conversations with economic issues.

Cron said that, given how immigrants have helped keep Maine going during the pandemic by often working frontline jobs that put them at more risk of exposure to COVID-19, Democrats should want to clearly demonstrate their support for the community in advance of the election.

“It seems like now would be the time to say, ‘We do stand with immigrants, look at all they’ve done for us and look at how they’ve paid up to this point, and now it’s our time to pay them back and take care of them’,” she said, referencing a racial disparity in COVID-19 cases in Maine that during the earlier parts of the pandemic was the largest in the nation.

Advocates need Democrats’ support to pass LD 718 or include it in the budget, as Republicans currently do not support extending health care benefits to all low-income Mainers regardless of immigration status. In fact, during the House vote on the bill last year in which the measure passed an initial vote with Democratic support, not one Republican in that chamber voted for LD 718.

But Democrats in the legislature have been tight-lipped about the bill as of late. Spokespeople for Senate President Troy Jackson (D-Aroostook) and Speaker of the House Ryan Fecteau (D-Biddeford) did not respond to a question about whether the two leaders support passing LD 718 this session. In addition, neither Sen. Ned Claxton (D-Androscoggin) nor Rep. Michele Meyer (D-Eliot), the chairs of the Health and Human Services Committee, which LD 718 was assigned to, responded to a question about why the committee isn’t taking up the bill this session.

As a result, it’s unclear which people specifically within the Democratic caucus made the decision not to have the bill considered in a committee work session this year. However, immigrant leaders said the challenge that creates for enacting the policy is extremely frustrating for the New Mainer community.

“It’s disappointing that the issues we’re talking about aren’t the main focus, that they’re more concerned about their own elections or what the future might hold instead of what is actually impacting community members here,” said Christina Ocampo, program director at Presente.

“For us, we deal with people’s lives,” Chitam added. “You can’t table people’s lives and people’s crises and needs.”

A crucially important bill

Chitam said not passing LD 718 this year would be a huge missed opportunity, pointing out that a lack of health benefits causes many immigrants to not seek preventative care and only go to a doctor when health issues become an emergency. That leads to both poorer health outcomes and is more expensive for the system overall, given the costs of emergency room care, she said.

“I can’t emphasize [enough] how important this bill really is,” Chitam said.

Chitam added that the pandemic has shown the deeply interconnected nature of health care. She said as long as some communities have less access to benefits, public health events like COVID-19 will weaken the state more than they otherwise would have and contribute to already existing inequities.

Others also believe it is long past time to address the gap in health care for immigrant communities. During a public hearing last year on LD 718, lawmakers heard hours of testimony from immigrants themselves along with advocates about the harmful impacts of the current system. Such disparities can have fatal consequences, with one New Mainer, Henoc Ngoy, telling the Health and Human Services Committee about deaths in the community linked to a lack of health coverage.

“We beg you, for the well-being of all our neighbors and community members, please vote yes” on LD 718, Ngoy said in April 2021.

Cron added that while the community is proud of its work to get immigrant kids under 21 and pregnant people included in health programs, it’s harmful that the campaign to get everyone covered is facing significant hurdles.

“It adds to the feeling of competition and that some people are more worthy and some people are better than others or seen in the eyes of the general public as more deserving,” she said. “That’s really what we’re trying to counter: to say that we all deserve and we shouldn’t have to prove why we need basic coverage. Because health is a human right.”

Moving forward this session, advocates are still pushing for the policy included in LD 718 to be inserted into this year’s budget. Maine has a projected surplus of around $1.2 billion, which progressives are arguing should be used to invest in social programs that meet unmet housing, health care and economic needs.

However, short of that, proponents will continue advocating for LD 718 going forward.

“It remains something that is important to many of us,” said Rep. Sam Zager (D-Portland), a member of the Health and Human Services Committee and a supporter of the bill. “And whether through this vehicle or another future legislative vehicle, it will be something that we keep pushing for.”

That is Presente’s mindset as well. Ocampo said regardless of who is in power, leaders in the community will keep arguing for health coverage for immigrant populations.

“Their goal is pretty clear,” she said. “So I think regardless of who the players are, they’re going to keep pushing for these rights that they all deserve.”

Beacon is a website and podcast created by the Maine People’s Alliance to highlight the experiences of everyday Mainers, share information about the political and policy processes that affect Maine people and promote a progressive worldview based on community, fairness and investing in the future. Sign up for our daily newsletter and follow us on Facebook, Twitter and Instagram.