(Updated) Like other legal immigrants, Mohammed Khondoker saw part of his American dream vanish — then reappear in time for the holidays.
Khondoker arrived in New Haven from Bangladesh with his wife and baby daughter three years ago to live in “our dream country.” He’s here legally. He’s working. But the dream hit a bump on Dec. 1, when the Rell administration eliminated health insurance coverage for low-income adult legal immigrants who have lived in Connecticut less than five years.
Then Khondocker learned Monday that a Hartford judge, Grant H. Miller, overruled the state.
Miller ruled on Friday in favor of a suit filed by legal aid lawyers. Calling the cuts unconstitutional, he granted an injunction to stop the removal of the legal immigrants from a state insurance plan. The lawyers argued that the cut violated the equal protection clauses of both the state and federal constitutions. (Click here to read legal aid’s press release.)
Officials at the state Department of Social Services (DSS) Monday afternoon were taking steps to appeal the court’s ruling, according to spokesman David Dearborn.
“In the continuing budget crisis, the state made a decision to reduce this service,” Dearborn said. “When times were good, Connecticut stepped up to fund these benefits. Now, the administration and General Assembly have decided to cut back, in part because there are no federal subsidies to help us. DSS is responsible for implementing this part of the adopted state budget.”
Legal maneuvering aside, Mohammed Khondoker was celebratory.
“I’m feeling fantastic,” Khondocker said Monday upon hearing the news from a reporter. “I can’t explain how excited I am, because you know we can’t afford [to pay for health insurance on their own]. I love you, and have a Merry Christmas!”
Khondocker, who’s 34, has an accounting degree. (He declined to be photographed.) He works as a gas station attendant, with low wages that qualified the family to state-funded health insurance. Or it did, until Dec. 1.
He and his wife Thamina Begum, 33, who’s diabetic, were among almost 4,800 legal immigrants who lost their health coverage as part of broader state budget cutbacks.
The couple live with their daughters, Atika, who’s 4 and has been diagnosed with autism, and six-month-old Ryta, in a sparsely furnished apartment in a complex off Foxon Boulevard. The family won the lottery in Bangladesh for a special visa. For more than two years Khondocker has worked the gas station job in North Haven while Begum takes care of the children.
The family goes to the Fair Haven Community Health Center for routine medical care. They learned in a letter from the Connecticut Department of Social Services (DSS) that the parents were being terminated from a program called State Medical Assistance for Non-Citizens, or SMANC. The children would continue to be covered. The letter indicated those terminated could request an administrative hearing.
Those cut from the program are legal permanent residents between the ages of 21 and 65 who’ve been in the U.S. less than five years. The SMANC program is fully funded by the state. It was cut because the state is in the midst of a budget crisis. (A federal contribution for low-income legal immigrants’ health care doesn’t begin until they’ve been in the U.S. for five years.)
The cuts to SMANC were estimated to save $9.3 million this fiscal year and $9.75 million the following year, according to DSS spokeswoman Kathleen Kabara.
Kabara said the state decided to drop coverage for legal non-citizen immigrants in programs not also funded by the federal government, because of Connecticut government’s budget crisis. There were exceptions: People who are under 21 or pregnant would continue to receive coverage. The same went for legal non-citizen immigrants non-citizens who are under 21 years of age or pregnant; and for “non-citizens with refugee or asylee status; and other exempt groups,” including Cubans and Haitians, Amerasian immigrants, victims of human trafficking, and veterans and their spouses and dependents.
In error, some refugees were included in the original Dec. 1 cut-off. Kabara said that DSS reviewed the records of everyone who was terminated, found 41 refugees, and immediately reinstated them with Medicaid coverage retroactive to Dec. 1.
On Nov. 30, attorneys at Greater Hartford Legal Assistance filed the class action lawsuit, entitled Pham vs Starkowski . It sough an injunction to stop the termination of coverage and the reinstatement of all people dropped from coverage.
“The United States and Connecticut constitutions have certain things that are not legitimate on which to act, such as race,” said Nick Yorio, one of the attorneys who filed the lawsuit. “Aliens are another type of class entitled to special protection, because they are discreet and insular groups, and are shut out of the political process. They’re here legally but they can’t vote, but they pay taxes. When you see something like this, it has historically raised equal protection concerns, [because] one group is bearing the burden of loss of all their medical services in the name of budget savings for the general public.”
Hartford Superior Court Judge Miller agreed to fast-track the case. The final hearing took place on Dec. 9, just eight days after the suit’s filing.
“This is a difficult and unpleasant situation brought on by the state budget crisis,” DSS Commissioner Michael Starkowski wrote in a letter to social service providers. “I share your sensitivity about this matter, which presents difficulties to those people who lose their medical coverage. DSS as an executive branch agency has no choice but to administer this mandated change as expeditiously and effectively as possible.”
Victoria Restrepo (pictured) is the Khondoker family’s case manager at the Fair Haven clinic. She said that even with the cuts Begum would probably still be able to get her diabetes medication covered through RX Assist, a program funded by the pharmaceutical companies. And, she said, the family could continue coming to the clinic for care regardless of their ability to pay.
“We never turn anyone away. They can pay later,” she said, noting that the clinic uses a sliding scale.
But they can’t see any specialists without insurance coverage. So immediately upon receiving the letter from DSS, Khondoker canceled an eye appointment his wife had for this week.
“I can’t pay,” he said. “We are living hand to mouth.” He has applied to Yale Primary Care for coverage; he hasn’t heard yet if he and his wife will be accepted.
As for hospital coverage, Restrepo said people terminated from SMANC could apply for emergency services. But DSS would decide if the problem that sent them to the hospital is truly an emergency. If not, they would be billed.
In the letter that announced their termination, individuals were given information on other medical programs and how to apply for them. The options include the Charter Oak Health Plan for those 19 to 64 years old, which has reduced premiums for those earning up to 185 percent of the federal poverty level. “Assuming eligibility and premium payment, people who have lost SMANC coverage will be enrolled in Charter Oak retro[active] to Dec.r 1, 2009 or prospectively on Jan. 1, 2010,” Kabara wrote.
Yorio said there were two possible sources of medical assistance for those cut from SMANC. One was CONNPace, a program that helps pay for prescriptions, “but it includes co-pays and many of our clients could not afford that.” The other was the Charter Oak program, but it also has premiums and co-pays. “The base premium is $75 a month,” he said. “Our named plaintiff lives on $470 a month.” He said these options are not realistic financially for many members of the class. He added that under Rell’s proposed deficit mitigation plan, enrollment in Charter Oak would have been frozen, eliminating that as an option.
“My question is, if [I’m] a legal permanent resident, why did they cut me out?” said Khondoker. “It [health isurance] is a human right.” He said if the budget must be cut, “They can cut something else, but not health care.”