Others v. Commonwealth Health Ins. Connector Auth. & Others
| Decision Date | 01 November 2010 |
| Docket Number | SJC-10748. |
| Parties | Dorothy Ann FINCH & others [FN1] v. COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY & others. [FN2] |
| Court | United States State Supreme Judicial Court of Massachusetts Supreme Court |
NOTICE: The slip opinions and orders posted on this Web site are subject to formal revision and are superseded by the advance sheets and bound volumes of the Official Reports. This preliminary material will be removed from the Web site once the advance sheets of the Official Reports are published. If you find a typographical error or other formal error, please notify the Reporter of Decisions, Supreme Judicial Court, John Adams Courthouse, 1 Pemberton Square, Suite 2500, Boston, MA 02108-1750; (617) 557-1030; SJCReporter@sjc.state.ma.us
Constitutional Law, Equal protection of laws, Judicial review. Alien. Commonwealth Health Insurance Connector Authority. Words, "National origin," "Alienage."
CIVIL ACTION commenced in the Supreme Judicial Court for the county of Suffolk on February 25, 2010.
The case was reported by Cordy, J.
Wendy E. Parmet (Lorianne Sainsbury-Wong with her) for the plaintiffs.
Kenneth W. Salinger, Assistant Attorney General, for the intervener.
Carl Valvo for Commonwealth Health Insurance Connector Authority & another.
The following submitted briefs for amici curiae:
Mary M. Calkins, W. Keith Robinson, & Vid Mohan-Ram, of the District of Columbia, & Michael J. Tuteur for Irish Immigration Center.
Julie A. Su, Justin Ma, Daniel S. Floyd, Elaine Ki Jin Kim, & Minae Yu, of California, Meredith Higashi, of the District of Columbia, & Ami Gandhi, of Illinois, for Asian Pacific American Legal Center & others.
Victoria Pulos for Massachusetts Law Reform Institute & others.
Anthony D. Mirenda, Ara B. Gershengorn, Thomas Ayres, Katie Marie Perry, & John Reinstein for American Civil Liberties Union of Massachusetts.
Present: Ireland, Spina, Cordy, Gants, & Duffly, JJ.
This case involves four questions reserved and reported from the county court relating to the standard of review applicable to a statute that excludes aliens lawfully residing in the Commonwealth from participating in a public benefit program for which the Commonwealth receives certain Federal reimbursements. Commonwealth Care Health Insurance Program (Commonwealth Care) is a premium assistance program in which enrollees pay a portion of their health insurance premium based on a sliding scale with the remainder paid by the defendant Commonwealth Health Insurance Connector Authority (Connector). The plaintiffs are Massachusetts residents who either have been terminated from Commonwealth Care or denied eligibility solely as a result of their alienage. Specifically, the plaintiffs have brought a class action against the Connector alleging that exclusion from Commonwealth Care pursuant to an appropriation, St.2009, c. 65, § 31 (a), violates their rights under the Massachusetts Constitution. The statute eliminates the plaintiffs' eligibility for Commonwealth Care by adopting the same eligibility standards applicable to federally funded public benefit programs as set forth in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Pub.L. No. 104-193, as amended, codified at 8 U.S.C. §§ 1601-1646 (2006).
On the basis of stipulated facts and pursuant to Mass. R. Civ. P. 64(a), as amended, 423 Mass. 1410 (1996), a single justice of this court reserved and reported four questions:
We answer the first three questions in the negative and need not reach Question 4.
Facts. The following facts are taken from the stipulation of the parties accompanying the reserved and reported questions.
Commonwealth Care is a key feature of the Commonwealth's initiative to help all Massachusetts residents obtain and maintain health insurance coverage, as set forth in St.2006, c. 58. Portions of that statute, codified at G.L. c. 118H, establish Commonwealth Care with the declared purpose of "reducing uninsurance in the commonwealth." G.L. c. 118H, § 2. Commonwealth Care seeks to achieve this purpose by providing a structured premium assistance program under which enrollees pay a portion of premium for health insurance coverage with the remainder paid by the Connector. See G.L. c. 118H. Commonwealth Care enrollees are eligible for three plan types based on income levels ranging from 100% to 300% of the Federal poverty level. Total enrollment in Commonwealth Care as of June, 2010, was 160,318 and the Connector paid 100% of premium for 93,778 of those enrollees. Commonwealth Care premium assistance payments totaled $717 million in fiscal year 2010.
The original eligibility requirements for Commonwealth Care were set forth in G.L. c. 118H, § 3 (a), which provides that an individual may enroll if he or she has been a resident of the Commonwealth for six months, has household income below 300% of the Federal poverty level, is uninsured, and is not eligible for certain other State, Federal, or employer-subsidized health insurance programs. "Resident," for purposes of G.L. c. 118H, is defined, in part, as "a person living in the commonwealth... including a qualified alien... or a person who is not a citizen of the United States but who is otherwise permanently residing in the United States under color of law; provided, however, that the person has not moved into the commonwealth for the sole purpose of securing health insurance under this chapter." 3 G.L. c. 118H, § 1. Under the terms of its enabling act, therefore, Commonwealth Care is open to participation by lawful resident aliens, approximately 29,000 of whom were enrolled in the program as of August, 2009.
Both State and Federal funds support the provision of premium assistance payments on behalf of Commonwealth Care enrollees. Payments from State funds are made through the Commonwealth Care Trust Fund, established by G.L. c. 29, § 2OOO. This trust fund is credited with monies from a variety of sources including employer contributions (payable regardless of the immigration status of the employee), revenue from "free rider" surcharges, transfers from the Health Safety Net Trust Fund, revenue from "individual mandate" penalties, and a portion of cigarette tax revenues. The revenues earmarked for the trust fund have not heretofore covered the cost of Commonwealth Care so annual appropriations have been required from the Commonwealth's General Fund. See St.2010, c. 131, line item 1595-5819 (2011 appropriation of $702 million); St.2009, c. 27, § 119 (b) ().
Federal funds are provided through a Medicaid "demonstration project" pursuant to § 1115 of the Social Security Act, codified at 42 U.S.C. § 1315 (2006). In the demonstration project, Commonwealth Care expenditures made on behalf of federally eligible individuals are treated as expenditures under the Commonwealth's Medicaid plan and receive partial reimbursement from the United States. The reimbursement rate for federally eligible individuals is approximately fifty per cent of total expenditures but, pursuant to the American Recovery and Reinvestment Act of 2009, was increased to 61.59% in fiscal year 2010. Commonwealth Care receives no reimbursement from the Federal government in respect of expenditures made on behalf of federally ineligible individuals. Federal reimbursements for fiscal year 2010 were $419.6 million.
The Commonwealth initially permitted all residents, as defined in G.L. c. 118H, § 3, to enroll in Commonwealth Care whether federally eligible or not. In the absence of Federal reimbursement, the Commonwealth assumed 100% of the cost of providing Commonwealth Care subsidies to federally ineligible aliens. Due to the level of Federal reimbursement, at least two federally eligible residents (citizens or federally eligible aliens) could be enrolled in Commonwealth Care for the same cost to the State as one member of the plaintiff class. In 2009, the Legislature made certain changes to the eligibility requirements of Commonwealth Care in a supplemental appropriation for fiscal year 2010, St.2009, c. 65. Specifically, § 31 of that act (hereinafter, § 31) provides that:
To continue reading
Request your trial