HLA's Immigrant Health Care Access Initiative addresses the many substantial health care barriers facing immigrants with low income. Throughout Massachusetts, the uninsurance rate among immigrants is improving with the help of our work and others’, but remains much higher than for U.S. citizens. Also, repressive immigration enforcement policies prevent immigrants from seeking care.
HLA lawyers represent immigrants in low-income situations improperly denied health insurance enrollment and refused coverage for specific services. We also provide expert consults for health care and social service providers trying to help immigrants receive the care they need.
HLA’s lawyers improve health care access for immigrants through community outreach and policy advocacy as well. We visit community-based organizations to hear about difficulties immigrants face obtaining health care and deliver presentations on immigrants’ rights in the health care system. HLA also established an Immigrant Health Care Access Coalition to coordinate policy advocacy and community organizing among organizations interested in health care for immigrants.
Medical-Legal Partnership for Immigrants (MLPI)
Health Law Advocates’ (HLA) Medical-Legal Partnership for Immigrants (MLPI) tackles immigration status as a social determinant of health. The MLPI helps immigrant patients access needed care while generating considerable return on investment for the providers who care for them. Many immigrant patients are uninsured or underinsured, which results in higher acuity and poorer health outcomes. To fill these gaps, medical providers often use their own resources to care for these patients. HLA partners with medical providers to ensure their immigrant patients can establish eligibility and enroll in the best insurance coverage available to them. We address fears of possible negative consequences for enrolling in public benefits by providing accurate, up-to-date advice to both staff and patients. Also, given the federal government’s current mass deportation efforts, we help providers develop policies and procedures to prepare for the possibility of immigration enforcement actions at their facilities.
The Need
Immigrants have significantly higher rates of uninsurance than U.S. citizens in Massachusetts. Census data from 2022 shows that 8.92% of immigrants living in Massachusetts (49,500 people) are uninsured, compared with 2.14% of citizens (136,500 people). Strikingly, this number of uninsured does not include immigrants enrolled in MassHealth Limited, which provides coverage only for emergency services. Therefore, even more immigrants are underinsured and cannot access primary, preventative, or specialty medical services that they need.
Many immigrants are uninsured or underinsured even though they are eligible for comprehensive coverage. This happens for numerous reasons. MassHealth representatives are poorly informed about the complex eligibility rules around immigration status, and MassHealth’s computer system sometimes fails to correctly categorize applicants’ immigration documentation. Furthermore, health care providers and certified application counselors are often unfamiliar with all the nuances of MassHealth eligibility for noncitizens.
Problem-Solving Intervention
HLA’s MLPI collaborates with medical providers to ensure that immigrant patients can access the best health insurance coverage available to them. Our lawyers possess specialized expertise at the intersection of health law and immigration law that allows us to quickly identify whether patients have a pathway to improved coverage. Sometimes a brief consult with HLA is enough to assist medical providers with their patients’ enrollment in better coverage. However, legal representation is often required to ensure coverage upgrades.
Strengthening immigrants’ access to care reduces health disparities, improves health, safety, and financial stability, and reduces the stress and fear that immigrant patients experience when interacting with the health care system. HLA has achieved powerful outcomes such as these for thousands of immigrant clients, including hundreds of patients referred by our MLPI partners.
We anticipate that immigrant communities will rapidly become more concerned with interacting with government programs, such as MassHealth, given the incoming federal Administration’s rhetoric and past policies. HLA’s MLPI team will continue to counsel immigrants and their caregivers on new and applicable federal and state laws regarding participation in public benefits to help our clients make informed decisions.
If you have any questions about the MLPI, please contact Andrew Cohen, Director/Lead Attorney, HLA’s Access to Care and Coverage Practice: acohen@hla-inc.org.
Watch "Liana's Story"
In the 1940s, Liana survived the siege of Leningrad. Years after her daughter, Marina, emigrated to America to pursue a PhD, Liana left Russia and joined her daughter outside Boston. When Liana's insurance didn't cover services she needed to recover after a very bad fall, HLA stepped in to advocate for her right to health care.
This video premiered at HLA's 24th Benefit Breakfast in November 2019.
Liana's Story from Tira Khan, Sugarhouse Media on Vimeo.
Finch v. Connector Authority (2012)
The Initiative builds on HLA's historic class action lawsuit Finch v. Connector Authority which vindicated immigrants’ constitutional right to equal protection and secured health insurance for tens of thousands of low-income immigrants in Massachusetts. In the Finch case, the Massachusetts Supreme Judicial Court (SJC) unanimously deemed a state law barring 40,000 low-income immigrants from a state insurance program unconstitutional. In the first, and highly critical, phase of the Finch case the SJC ruled that the statute in question was subject to the highest level of judicial scrutiny because it discriminated against our clients.
The Immigrant Health Care Access Initiative is supported by the Massachusetts Legal Assistance Corporation, the Blue Cross Blue Shield of Massachusetts Foundation, the Nord Family Foundation, Jill Block and Wade Rubinstein, the Clowes Fund, the Massachusetts Bar Foundation, and the Herman and Frieda L. Miller Foundation.