Governor Mark Dayton signed legislation on Monday that restores $4.7 million in funding for some emergency, life-saving services for the sickest Minnesotans, regardless of their citizenship status.
The bill, which passed the Minnesota Senate unanimously, reverses some of the cuts made last year that left low-income legal and undocumented immigrants without a way to access chemotherapy and dialysis under the Emergency Medical Assistance program, even in a life or death health crisis. The program is funded through June of 2013.
However, the state’s Emergency Medical Assistance law still contains language that prevents undocumented immigrants from getting health care for other life threatening medical problems such as an organ transplants and long-term nursing care.
Despite the restrictions, supporters see the legislation as a victory.
“It’s rare for a major health care bill to pass with unanimous, bi-partisan support,” said Sen. Jeff Hayden, DFL-Minneapolis. “But in this case both Democrats and Republicans agreed that the state must at least provide a basic medical safety net available to everyone in Minnesota, even non-citizens.”
The cost of restoring Emergency Medical Assistance both for documented immigrants on the path to citizenship and for undocumented immigrants is covered, in part, by $11 million returned to the state from HMOs under new profit capping requirements.
“Every person needs to be treated with dignity and compassion. Economic class and legal status should not be a condition to save a human life,” said Sen. Patricia Torres Ray, DFL-Minneapolis. “I believe providing life-saving, emergency health care must be a top funding priority. What kind of society would allow a woman to die because she cannot afford dialysis? That’s not Minnesota.”
Added Sen. Hayden, “I’m glad that this important bill did not get bogged down by the debate over immigration. This is about restoring a basic human right in Minnesota, no matter who you are.”
Here are the exceptions now made in Minnesota law:
Sec. 29. EMERGENCY MEDICAL CONDITION COVERAGE EXCEPTIONS.
(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph (h), clause (2), the following services are covered as emergency medical conditions under Minnesota Statutes, section 256B.06, subdivision 4, paragraph (f):
(1) dialysis services provided in a hospital or free-standing dialysis facility; and
(2) surgery and the administration of chemotherapy, radiation, and related services necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and requires surgery, chemotherapy, or radiation treatment.
(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.
The law which was passed last year, much of which is still in place, is loaded with restrictions for undocumented immigrants.
Sec. 27. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
Subd. 4. Citizenship requirements.
(a) Eligibility for medical assistance is limited to citizens of the United States, qualified noncitizens as defined in this subdivision, and other persons residing lawfully in the United States. Citizens or nationals of the United States must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
(b) “Qualified noncitizen” means a person who meets one of the following immigration criteria:
(1) admitted for lawful permanent residence according to United States Code, title 8;
(2) admitted to the United States as a refugee according to United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title 8, section 1158;
(4) granted withholding of deportation according to United States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according to United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to United States Code, title 8, section 1153(a)(7);
(7) determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public Law 96-422, the Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the United States before August 22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation.
Beginning December 1, 1996, qualified noncitizens who entered the United States on or after August 22, 1996, and who otherwise meet the eligibility requirements of this chapter are eligible for medical assistance with federal participation for five years if they meet one of the following criteria:
(i) refugees admitted to the United States according to United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States Code, title 8, section 1158;
(iii) persons granted withholding of deportation according to United States Code, title 8, section 1253(h);
(iv) veterans of the United States armed forces with an honorable discharge for a reason other than noncitizen status, their spouses and unmarried minor dependent children; or
(v) persons on active duty in the United States armed forces, other than for training, their spouses and unmarried minor dependent children.
Beginning July 1, 2010, children and pregnant women who are noncitizens described in paragraph (b) or (e) who are lawfully present in the United States as defined in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation as provided by the federal Children’s Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision, a “nonimmigrant” is a person in one of the classes listed in United States Code, title 8, section 1101(a)(15).
(f) Payment shall also be made for care and services that are furnished to noncitizens, regardless of immigration status, who otherwise meet the eligibility requirements of this chapter, if such care and services are necessary for the treatment of an emergency medical condition
(g) For purposes of this subdivision, the term “emergency medical condition” means a medical condition that meets the requirements of United States Code, title 42, section 1396b(v).
(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of an emergency medical condition are limited to the following:
(i) services delivered in an emergency room or by an ambulance service licensed under chapter 144E that are directly related to the treatment of an emergency medical condition;
(ii) services delivered in an inpatient hospital setting following admission from an emergency room or clinic for an acute emergency condition; and
(iii) follow-up services that are directly related to the original service provided to treat the emergency medical condition and are covered by the global payment made to the provider.
(2) Services for the treatment of emergency medical conditions do not include:
(i) services delivered in an emergency room or inpatient setting to treat a nonemergency condition;
(ii) organ transplants, stem cell transplants, and related care;
(iii) services for routine prenatal care;
(iv) continuing care, including long-term care, nursing facility services, home health care, adult day care, day training, or supportive living services;
(v) elective surgery;
(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part of an emergency room visit;
(vii) preventative health care and family planning services;
(ix) chemotherapy or therapeutic radiation services;
(x) rehabilitation services;
(xi) physical, occupational, or speech therapy;
(xii) transportation services;
(xiii) case management;
(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
(xv) dental services;
(xvi) hospice care;
(xvii) audiology services and hearing aids;
(xviii) podiatry services;
(xix) chiropractic services;
(xxi) vision services and eyeglasses;
(xxii) waiver services;
(xxiii) individualized education programs; or
(xxiv) chemical dependency treatment.