Finch v. Commonwealth Health Insurance Connector Authority

461 Mass. 232
CourtMassachusetts Supreme Judicial Court
DecidedJanuary 5, 2012
StatusPublished
Cited by13 cases

This text of 461 Mass. 232 (Finch v. Commonwealth Health Insurance Connector Authority) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Finch v. Commonwealth Health Insurance Connector Authority, 461 Mass. 232 (Mass. 2012).

Opinion

Cordy, J.

In this case, we apply strict scrutiny to a legislative appropriation that denied State subsidies for the purchase of health insurance to a category of noncitizen immigrants lawfully residing in the Commonwealth (qualified aliens). Under the appropriation, subsidies provided by the Commonwealth Care Health Insurance Program (Commonwealth Care) were made available only to individuals eligible for federally funded public benefit programs, as set forth in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Pub. L. No. 104-193, as amended, codified at 8 U.S.C. §§ 1601-1646 (2006), thereby excluding qualified aliens residing in the country less than five years. On a reservation and report from the county court, we determined that this appropriation discriminated on the basis of alienage and national origin, both suspect classifications, and that it therefore should be subjected to strict scrutiny. Finch v. Commonwealth Health Ins. Connector Auth., 459 Mass. 655, 668-678 (2011) (Finch). We remanded the matter to the county court. Id. at 679. The plaintiffs moved for partial summary judgment, seeking a declaration, pursuant to Mass. R. Civ. P. 56 (a), 365 Mass. 824 (1974), that the appropriation violates the principles of equal protection in the Massachusetts Constitution. The single justice again reported the matter to the full court.

The Attorney General was allowed to intervene on behalf of the Commonwealth, and she asserts that the limiting language [234]*234incorporated into the appropriation does not violate the equal protection provision of the Massachusetts Constitution, because it advances the compelling interest of furthering the national immigration policies expressed by Congress in PRWORA. We reject the Commonwealth’s proffered justification for two reasons. First, in applying the standard of strict scrutiny the court is required to consider the statute’s actual purpose, rather than relying on a hypothetical justification. Here, exclusively fiscal concerns, which the Commonwealth concedes are not, on their own, adequate to survive strict scrutiny, motivated the legislative enactment. Second, the strict scrutiny doctrine imposes rigorous procedural requirements on a State, to ensure that legislation is narrowly tailored to further a compelling interest. The Commonwealth made no attempt to comply with those requirements, and the policies and findings of fact expressed by Congress in PRWORA do not furnish a compelling interest for discrimination by the Commonwealth in its entirely State-run program. Consequently, we conclude that the limiting language of the appropriation cannot stand, and we remand the matter to the single justice with instructions to grant the plaintiffs’ motion for partial summary judgment.

1. Background. The following recitation is abridged from our discussion in Finch, supra at 657-661, which in turn drew from the joint stipulation of facts.

Commonwealth Care is a State-initiated program, enacted in 2006, that provides structured premium assistance for low-income Massachusetts residents. Enrollees pay a portion of premium for health insurance coverage, with the remainder paid by the defendant Commonwealth Health Insurance Connector Authority (Connector). See generally G. L. c. 118H. The Connector administers Commonwealth Care.

Both State and Federal funds currently support the provision of premium assistance payments on behalf of Commonwealth Care enrollees. Federal funds are provided through a Medicaid “demonstration project” pursuant to § 1115 of the Social Security Act, codified at 42 U.S.C. § 1315 (2006). In the demonstration project, Commonwealth Care expenditures made on behalf of individuals eligible for Federal benefits are treated as expenditures under the Commonwealth’s Medicaid plan and receive partial reimbursement from the Federal government. [235]*235Commonwealth Care receives no reimbursement from the Federal government in respect of expenditures made on behalf of federally ineligible individuals.

PRWORA, enacted by Congress in 1996, sets forth an intricate scheme for determining whether aliens are eligible for Federal benefits. Broadly speaking, “qualified alien[s]” include lawful permanent residents and certain other categories of noncitizens, such as refugees or recipients of asylum. See 8 U.S.C. § 1641(b). Qualified aliens may then be divided into those who are eligible for Federal benefits and those who are federally ineligible. Generally, qualified aliens are eligible for Federal benefits, such as Medicaid, only if they have lived in the United States for five years, 8 U.S.C. § 1613(a), or if they fall into specified categories with respect to refugee status, veteran status, or national origin. See 8 U.S.C. § 1612(a); 8 U.S.C. § 1613(b), (d); Finch, supra at 658 n.3, 677.

The Commonwealth initially permitted all eligible residents, as defined in G. L. c. 118H, § 1, to enroll in Commonwealth Care. The category “residents” included qualified aliens, even those ineligible for Federal benefits. Id. In the absence of Federal reimbursement, the Commonwealth assumed one hundred per cent of the cost of providing Commonwealth Care subsidies to federally ineligible aliens.

In 2009, the Legislature made certain changes to the eligibility requirements of Commonwealth Care. These changes were enacted in a two-part supplemental appropriation for fiscal year 2010. St. 2009, c. 65, § 31 (appropriation). Section 31 (a) of the appropriation (§31 [a]) excluded all aliens who are federally ineligible under PRWORA from participation in Commonwealth Care.3 Simultaneously, § 31 (b) of the appropriation [236]*236(§31 [6]) permitted the establishment of a new entity, the Commonwealth Care Bridge program, which provided a form of health insurance continuation to individuals previously covered by Commonwealth Care but who lost eligibility as a result of § 31 (a).4 Approximately 29,000 legal immigrants lost premium assistance benefits as a result of § 31 (a). The plaintiffs are individuals who either have been terminated from Commonwealth Care or have been denied eligibility solely as a result of their alienage.

2. Discussion.5 a. The Legislature’s actual purpose. To pass strict scrutiny, a law “must be narrowly tailored to further a legitimate and compelling governmental interest and must be the least restrictive means available to vindicate that interest.” Finch, supra at 669, quoting Commonwealth v. Weston W., 455 Mass. 24, 35 (2009). We apply the same analysis under strict scrutiny in cases arising under the State Constitution as Federal courts apply when analyzing cases under the Federal Constitution. Commonwealth v. Weston W., supra at 30 n.9, and cases cited.

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Bluebook (online)
461 Mass. 232, Counsel Stack Legal Research, https://law.counselstack.com/opinion/finch-v-commonwealth-health-insurance-connector-authority-mass-2012.