Vt. lawmakers resolve immigrant health care issue

By Dave Gram
Forbes, May 3, 2011

MONTPELIER, Vt. (AP) -- Vermont Senate negotiators dropped an amendment to bar illegal immigrants from coverage under a new state health care program, delivering a victory Monday evening to human rights activists who had rallied repeatedly at the Statehouse to demand the change.

Instead, the three senators serving on a House-Senate conference committee suggested studying the issues surrounding providing health care to an estimated 1,500 to 2,500 undocumented farmworkers in the state, as well as others in Vermont illegally. Their House counterparts readily agreed to the proposal.

The fight over coverage for illegal immigrants was a late-session storm in otherwise smooth sailing for the centerpiece of Gov. Peter Shumlin's legislative agenda: a publicly financed, universal health care system that had broad support from Shumlin's fellow Democrats who control both houses of the General Assembly.

After the Senate last week adopted the amendment proposed by Sens. Randy Brock, R-Franklin, and Richard Sears, D-Bennington, activists with the Health Care is a Human Right Campaign of the Vermont Workers' Center, who had been providing strong grass-roots support for the health reform measure, turned on the senators.

Brock continued to defend his amendment Monday night, arguing that it is in keeping with federal law, and that if Vermont wants the federal permissions it needs to pursue its envisioned health system reform, it can't flout federal immigration law.

"It's clear we need a federal immigration policy that makes sense, and we need a guest worker program," Brock said. "But it's also clear that Vermont cannot and should not provide insurance coverage to people who are not here lawfully."

Brock is not on the conference committee, and the senators who are showed their willingness to jettison his and Sears' amendment under pressure from the activists.

Sen. Claire Ayer, chairwoman of the Senate Health and Welfare Committee and the leader of the Senate conferees, read from proposed legislative findings that pointed out apparent contradictions in federal law:

"Federal law requires certain health care providers to provide emergency treatment to all individuals, regardless of immigration status. Federal law prohibits coverage of undocumented immigrants through Medicaid and through the Exchange," a new health insurance marketplace that the Vermont bill calls for setting up, in keeping with the federal health care law passed last year, the proposed findings said.

The Senate proposal called for asking the Green Mountain Care Board, which already is to conduct several other studies to get the state ready for universal health care, to add the immigration issue to its list.

House conferees quickly agreed.

"The human rights perspective certainly is a worthy one," Rep. Michael Fisher, D-Lincoln, vice chairman of the House Health Care Committee and a member of the conference committee, said in an interview shortly after Monday evening's session. "There's also financial issues that warrant our attention, and legal ones."


Activists decry exclusion of undocumented workers from Vermont's H.202

By Anne Galloway, May 2, 2011

An undocumented Mexican migrant worker named Javier wouldn’t give his full name or say what county he lives in for fear of deportation. In spite of his apprehensions, however, he stood in front of the Statehouse on Sunday and told a crowd of May Day activists that the health care reform bill they had worked hard to support included a provision that discriminates against undocumented workers. Javier’s remarks were translated by an interpreter.

“This amendment appears to be a discriminatory act to exclude us from the health care proposal,” Javier told the crowd.

Javier, who has farmer’s lung, said he would not be able to receive medical attention if H.202 passes because he would not be able to afford to pay for his care out of pocket. Doctors have suggested that he undergo testing because they suspect he has fibrosis. Javier said the expense makes further diagnosis impossible.

The Vermont Farmworker Solidarity Project and the Vermont Workers Center has organized a lobby day today to pressure lawmakers to reverse the amendment, which they say runs counter to the fundamental principles of health care for all. They are also holding a press conference on the Statehouse steps to make their case to reporters at noon on Monday.

About 1,500 to 2,000 undocumented dairy workers from Mexico are employed by Vermont farmers and they are credited with helping to keep the dairy industry solvent at a time when few Vermonters are willing to work on farms.

Universal health care means universal, David Karindler, an organizer with the center, said.

“This is the first time such hateful language has been put in legislation,” Karindler said. “We’re all about inclusion in this state. This is the first time exclusion has become part of a bill. This is about undocumented people flocking to the state. Why would they flock to a place with no housing and no jobs?”

The Senate amendment to H.202, the universal health care bill, limits access to the state’s insurance exchange, which goes into effect in 2013, and Green Mountain Care, the single-payer system which could be implemented as early as 2014, to Vermont residents. Under the provision, individuals in the exchange are “reasonably expected to be during the time of enrollment, a citizen or national of the United States or a lawfully present immigrant in the United States as defined by federal law.”

The amendment is based on federal requirements under the Affordable Care Act, which restricts access to the state’s health care exchanges to legal residents of the United States. The Brock-Sears amendment would make it illegal for the state to provide federal funding for care through the exchanges. As it stands now, Medicaid money cannot be used to provide health care for undocumented residents. Legislative lawyers are re-evaluating the legal repercussions of the language in the amendment, according to Senate President Pro Tem John Campbell, D-Windsor.

“I doubt people are going to be moving up here,” Campbell said. Vermont already has more generous Medicaid benefits than those offered by other states and that fact hasn’t led to an influx of people to moving here, he said.

Senate Democrats voted overwhelmingly for the amendment in a 22-8 vote after Sen. Claire Ayer announced that the Senate Health and Welfare Committee had reviewed the amendment and took no position on it. Ayer later voted for the amendment, along with Sen. Tim Ashe, P/D-Burlington, and because they were called on first to vote (the roll call is given in alphabetical order), one observer speculated that this signaled a green light to other Democrats in the chamber. Campbell also voted yes.

James Haslam posted a statement about the vote on the left-leaning blog Green Mountain Daily last week that sparked a fierce debate in which the word “racist” emerged.

Campbell said there was some confusion in the Senate about the amendment. For that reason, he asked Shumlin administration lawyers to review the language and they gave senators the go-ahead.

“It came down a lot of things happening last week,” Campbell said. “This was not something on anyone’s radar until we saw the amendment with the assurance of certain individuals. You put faith and trust in that. If it’s determined to be a mistake, then as far as I’m concerned I’ll take the heat on that go ahead and change it. I don’t think Dick Sears or Randy Brock are racists or trying to be Arizona-like in their development of the law.”

Campbell described the provision as belt-and-suspenders legislation – essentially a restatement of the federal law.

Activists question why the amendment is necessary if it’s part of the federal law.

Karindler said Sen. Randy Brock, R-Grand Isle-Franklin, went out of his way to redefine what a resident was.

“It was strategic in its divisiveness,” Karindler said. “To suddenly frame things around undocumented workers seemed calculated.”

Peg Franzen, president of the Vermont Workers Center, said she thought the Senate debate on the amendment got confusing.

“We’re hoping people understand what it actually means,” Franzen said. “It actually refers to Green Mountain Care, which would not be set up until 2014 or 2017.”

Freshman Sen. Philip Baruth, D-Chittenden, who voted against the amendment, said it’s unfortunate that the attention is focused on the amendment when Senate Democrats evinced, “hard core serious unity” around support for H.202.

“I’m discouraged that this one stray amendment is now the story as though it’s indicating fractures in Democratic lines,” Baruth said. “It’s a shame. Instead of a victory lap we’re now in a simulated crisis. I don’t think it’s a crisis. It’s a bump and we will fix it. I hope people who voted for this will get a chance to vote for (the amendment) without it. There are people who did yeoman’s work on this bill who are being unfairly demonized in some quarters. It’s a shame all around that a victory lap morphed into something far less positive.”

Rep. Mark Larson, D-Burlington, and chair of the House Health Care Committee, said lawmakers will likely re-examine the amendment as part of a larger review of the legislation during the conference committees, which take place on Monday starting at 10 a.m., 1 p.m. and 4 p.m.

Larson is also dismayed by the turn of events.

“My focus is on trying to create a health care system that works for our state and I don’t want to get into a focus on whether my senate colleagues are racist or not,” Larson said. “I appreciate why people are upset about the amendment and the significance the issue has in terms of whether all people will be covered by Green Mountain Care. I also understand that national immigration policy isn’t very helpful at this point.”

In the past, Vermont used state dollars to cover health care costs for undocumented farm workers, according to Larson. Under federal rules, Medicaid money can’t be used. That policy would carry through under Green Mountain Care, Larson said, because part of the funding for the single-payer system would come from Medicaid. The state would have to come up with an alternative funding source. Currently, farmers, federal health centers and volunteer groups help workers with care, though in some cases health care providers end up shifting the cost to other patients.