We all should have learned a lot of lessons from the COVID-19 pandemic. A few important ones involved the way our health care system treats immigrants. Such as:

• Many essential jobs in our economy, including those in agriculture, food processing and direct care, provided in both facilities and home settings, are filled by recent immigrants.

• Because some groups of immigrants are not eligible for programs like MaineCare, they came into the pandemic with the kinds of underlying conditions that made COVID much more dangerous.

• When large numbers of people get very sick, there are reverberations throughout the health care system and economy that affect everyone, whether they are sick or not.

Maine has a chance to act on these lessons by passing L.D. 718, sponsored by Assistant House Majority Leader Rachel Talbot Ross, D-Portland. It would end the exclusion of people from the MaineCare and the Children’s Health Insurance programs just because of their immigration status.

Current law carves thousands of newcomers out of these programs, and not just undocumented immigrants. Asylum seekers with work permits are denied coverage while they wait for action from the immigration courts that can take years.


People with permanent resident status – “green card” holders who are a step away from citizenship – are denied access to needs-based programs for five years.

Of course, no one is completely locked out of the American health care system. Hospitals and other providers are required to deliver emergency care to everyone who needs it, but preventive and follow-up care is provided on a cash basis for people without insurance.

That means that we all pay, because the cost of uncompensated care is factored into the prices charged to people with private insurance and is reflected in their premiums. It also means that we will pay for emergency heart surgery for an immigrant who is ineligible for MaineCare, but we won’t pay for the cholesterol-lowering drugs and primary care visits that could have prevented the emergency in the first place.

That’s not only cruel to the individuals who are affected, but also a waste of resources that could be used more productively.

Lawmakers are still waiting for a price tag on the bill, but it’s estimated to cost $7 million over two years. Gov. Mills has proposed policy changes that would partially lift the immigrant exclusion, adding coverage for pregnant women and people younger than 21. While we normally support compromises that make incremental progress, in this case halfway is not enough.

All the groups of immigrants who would be covered by this bill were eligible for the programs before 2011, when then-Gov. Paul LePage scapegoated these vulnerable families as part of a broader ideological attack on social welfare programs.


LePage and others claimed that it was unfair to help newcomers when so many native-born Mainers were in need. But LePage did not help those other Mainers gain health coverage. In fact, he vetoed legislation five times that would have expanded Medicaid eligibility to low-income working families. It took a referendum vote and Mills’ election in 2018 to finally get those people covered.

Restoring coverage for immigrant families would not create a new entitlement; it would just undo the damage done a decade ago. Leaving out some of the people who lost their coverage in 2011 would endorse, at least in part, LePage’s wrong-headed policies.

As COVID should have taught us, we all have a stake in each other’s health. Programs that keep people from getting sick and manage chronic conditions put downward pressure on everybody’s health costs, and make the people who are covered less likely to suffer a catastrophic – and expensive – health emergency.

Closing this coverage gap would give us a more humane health care system and one that uses our shared resources more efficiently. Lawmakers and Gov. Mills should find a way to make it happen before the Legislature finishes its business this month.

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