Health insurance coverage for legal immigrants in Massachusetts: Doing the right thing and the smart thing

Legal immigrants will enjoy the same rights to subsidized health insurance coverage as citizens of Massachusetts, thanks to a ruling by the Supreme Judicial Court. Although it will be painful for the state to fund the approximately $150 million hit to the budget, it's the right thing to do and also a smart thing.Massachusetts has achieved near-universal coverage thanks to its health reform law. Although health insurance costs are among the highest in the nation, Massachusetts can afford to have everyone in coverage. That's because Massachusetts has a modern, knowledge based economy with high wages, thanks largely to the state’s investment in education and infrastructure, and its open minded populace.Still, high and rising costs are a burden and universal coverage places a strain on the state's finances. In 2009 the state legislature shaved $130 million from the budget by going after an easy target: subsidies to legal immigrants.This was a bad idea for three reasons. First, it undermined one of the tenets of health reform: getting everyone into coverage. It's important to have everyone in the system so that providers don't have to deal with uncompensated care and residents don't miss out on services that could help them and make them more productive.Second, the system's costs should be addressed by improving value, performance and efficiency, not by kicking people out or weakening benefits. It's best for us to face up to the cost challenge and do something about its root causes, rather than foisting pain on vulnerable segments of the population.Third, it's vitally important that the state continue to be attractive to immigrants, who are crucial to the dynamism of the economy and the culture. Take a look around the state and the country as a whole and you'll find that immigrants are strong engines of economic growth. If I had to place a bet, I'd put my money on immigrants rather than the "top 1%" as the best job creators.So I'm glad to see Massachusetts doing the right thing, and the Supreme Judicial Court playing a constructive role in the process.