Why Thousands of Undocumented Children Deserve Comprehensive MassHealth Coverage

And yet, these bragging rights, oddly enough, could make lawmakers complacent. Indeed, such impressive coverage rates sometimes mask small but important gaps that urgently need to be filled.

Example: Over 30,000 children and young adults without legal status are only eligible for limited health coverage through safety net programs. A pending invoice in the Legislative Assembly would extend full MassHealth coverage to all eligible children and young adults under age 21, regardless of immigration status.

Currently, these young people typically have coverage with limits, such as a $200 annual cap on prescription drugs; no access to home care, which is important for children with complex disabilities; no coverage of durable medical equipment such as wheelchairs and feeding tubes; no coverage of glasses or other visual aids, among other limitations.

“If you are an undocumented child, you have access to some safety net services and some preventative care – like you can go to your annual visit with a doctor and to the emergency room, but there are strict caps on services. mental health services,” said Suzanne Curry, director of behavioral health policy at Health Care for All, which advocates for the bill.

Ruth Gomez has a son, Dylan, 8, who is among the population with limited medical coverage under MassHealth because they lack legal status. Dylan is blind (he was born without eyes), partially deaf and has severe developmental disabilities. He needs Gomez’s help for almost all of his basic functions. Gomez told me in an interview that she can’t work because she’s Dylan’s primary caretaker.

“His coverage only includes the essentials: emergency services, certain medications, etc.” said Gomez, who lives in Everett. “But we don’t have access to occupational therapy or physiotherapy. He was prescribed medication to control his excessive drooling. But it costs $400 per month. We can’t afford it. So we have to do without it. »

Nine other states, including Connecticut, Maine and Vermont, and Washington, DC, have taken similar steps to expand their Medicaid programs to cover children regardless of immigration status.

The policy was recommended by the Massachusetts Health Equity Task Force. Created by the Legislative Assembly in the summer of 2020 to address racial inequalities exposed by the COVID-19 pandemic, the group has published “A Blueprint for Health Equity” a year ago with recommendations to target these health disparities. The task force called attention to the limited MassHealth coverage that undocumented children and youth currently receive as a “major barrier to health equity.” Passage of the bill “will make a significant difference to the health and well-being of this underserved population,” the task force members wrote.

The main issue in expanding MassHealth coverage is resources. MassHealth already represents a large part of the total state budget: 36% for fiscal year 2022. But its share drops to 22% if only state dollars are counted. In other words, the program is partially funded by the federal government — in fact, the federal government covers more than half the cost of MassHealth, according to a guidance note from the Massachusetts Budget and Policy Center. Health Care for All estimates that passage of the bill will cost about $110 million, which at a time when the the coffers of the state are overflowing with cashthat’s not a lot to ask.

Consider the long-term impact of denying improved health coverage to this young population. Finally, “this [cost] reveal . . . maybe in schools or even in the juvenile justice system. It takes a long time to see a return on investment in health care, including pediatrics in general,” Curry said.

From a health equity perspective, the Legislature should extend coverage to undocumented children like Dylan through the passage of the Legislation on coverage for all children, as Bill is known. It is also smart policy to invest in their health care now to avoid much greater costs in the future.


Marcela García is a columnist for the Globe. She can be contacted at marcela.garcia@globe.com. Follow her on Twitter @marcel_elisa and on Instagram @marcel_elisa.

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