May 27, 2018
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Discriminatory health care law deserves challenge

Hans Bruns

Sometimes it takes a single heart-rending personal story to get things moving to right a wrong. That is what’s going on in the case of a legal immigrant, Hans Bruns of Fort Fairfield.

Bruns has suddenly lost the state health benefits that have helped him survive the pain and suffering from a rare form of cancer. A letter from the Department of Health and Human Services informed him that his health care coverage had been reduced because of a law that Gov. Paul LePage had pushed through the Maine Legislature last year.

“I consider myself to be strong and able to bear a lot of pain,” he wrote in a court affidavit. “But on a scale of 1 to 10, my pain level is right now a 23. The pain is unbearable and I feel as though a knife is cutting my neck and a hammer is constantly beating my head when I walk.”

Without much notice, the Legislature last June adopted LePage’s proposal to impose a five-year waiting period for legal immigrants living in Maine to qualify for MaineCare, the state’s version of Medicaid. It was a provision in the biennial budget act and saved an estimated $3.9 million.

Bruns, 65, a German national, came to the United States in late 2007 as a legal immigrant. He settled in Maine in 2009 and began receiving MaineCare benefits in December 2010 after becoming disabled.

He was lopped off the rolls last October and was diagnosed with cancer in February. He has been getting charity care in Presque Isle but can’t get reimbursement for his prescriptions or for the cost of travel there from his home. He may need chemotherapy, radiation and possibly surgery.

Maine Equal Justice Partners and the American Civil Liberties Union of Maine Foundation have brought suit in his behalf against the Department of Health and Human Services. They seek an emergency injunction to restore benefits for Bruns and for an estimated 500 legal immigrants like him while the eligibility law is challenged in U.S. District Court in Bangor. They contend that the change in MaineCare eligibility violates the “equal protection” clause of the U.S. Constitution because it treats legal noncitizen immigrants differently from U.S. citizens.

Congress passed a law in 1996 setting the five-year waiting period for legal immigrants to get federal health care benefits. Congress permitted the states to pick up the benefits for new immigrants, and Maine and many other states did so. But Maine’s Legislature adopted the limitation last June.

Lawyers representing Bruns note that states have less flexibility than the federal government in making distinctions based on immigration status. The U.S. Supreme Court has held that Congress must have a “rational” reason to discriminate against legal immigrants, while a state must have a “compelling” reason. The lawyers cite cases holding that budget savings do not constitute a “compelling” reason.

LePage should act voluntarily to restore benefits to Bruns and others afflicted by the discriminatory law before a successful lawsuit may drag them into it.

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