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State lawmakers consider removing immigration status as a barrier to MaineCare

Ari Snider
Maine Public
Hussein Yasari sits in a common room at his apartment building in Biddeford. Yasari, originally from Iraq, has lived in Maine for nine years but does not qualify for MaineCare based on his immigration status as an asylum seeker. He said some months, he has to decide between paying for his medical bills or buying food.

On a recent morning, Hussein Yasari settled himself into a chair in a common room at his apartment building in Biddeford.

Yasari is from Iraq, where he worked as an imam in Baghdad before moving to the U.S. nine years ago. Now in his seventies, he moves slowly and walks with a cane. Yasari said he struggles with a number of health conditions, including diabetes, joint pain, and deteriorating eyesight.

But, speaking in Arabic through an interpreter, he said his asylum case is still pending - making him ineligible for MaineCare.

"I talked to a doctor and I need a surgery for both my eyes. But when they know that I don't have MaineCare they canceled," Yasari said.

Even when he is able to get care, Yasari said cost is a major burden, and he's sometimes forced to decide between paying his medical bills and buying food.

"Yes, would I pay my bills, or eat?" Yasari said. "I have to eat."

Yasari can't enroll in MaineCare due to a rule put in place by former Governor Paul LePage that bars certain immigrants, including asylum seekers - from accessing the program - even if they meet the income eligibility guidelines.

Two years ago the legislature partially rolled back that rule to exempt those who are 21 or under or pregnant. A new bill introduced by Democratic House Speaker Rachel Talbot Ross would remove immigration status as a barrier for all income-eligible residents.

One group pushing for the bill is the New Mainers Public Health Initiative in Lewiston. Executive Director Hibo Omer said without health insurance, many of her clients put off seeking medical attention until an issue becomes unbearable.

"They keep it to themselves until they can't, you know, control that pain," she said, "It's mind boggling, very sad."

At that point, Omer said, many people end up in the emergency room. She said that’s generally much more expensive than addressing an ailment earlier through preventative care, burdening the patient and the healthcare system as a whole.

In addition to the health impacts, Omer said it’s a matter of fairness to immigrant residents who are working and paying taxes.

"They work into the system, and they are taxpayers, and they don't benefit from the taxes that they are paying," she said.

Ari Snider
Maine Public
Hibo Omer is the executive director of New Mainers Public Health Initiative, one of the organizations urging the legislature to pass LD199. Omer said removing immigration status as a barrier to MaineCare is a matter of fairness to immigrants who are working and paying taxes in Maine.

Some immigrants who don’t qualify for MaineCare rely on free care programs offered through certain hospital systems.

But Megan Brewer, medical director and family physician at B-Street Health Center in Lewiston, said that's no substitute for full health insurance, especially when it comes to the cost of prescription drugs.

Brewer said some of her patients can't afford to buy medication and she will sometimes pay for a one-time prescription out of her own pocket.

"They're rare but not that rare, circumstances where somebody really, like, does not have the resources," she said. "I feel like a human being morally obligated to give $20."

Brewer said removing immigration status as a barrier to MaineCare would alleviate a huge amount of stress for her patients, help her clinic provide better care, and benefit public health over all.

"To me, it's like not a political issue, but sort of like sustaining our health care systems and, and public health," she said.

Democrats on the Health and Human Services Committee voted last week to recommend the bill be included in the state budget.

But the proposal is drawing opposition from Republicans. State Representative Kathy Javner, ranking Republican on the Health and Human Services Committee, said in a statement that “Our top priority should be to ensure that Maine’s most vulnerable citizens, particularly those with disabilities, the homeless, and elderly residents on a fixed income, are cared for," and that the bill would “increase the tax burden on Maine’s working poor at a time of unprecedented cost of living increases.”

But Hussein Yasari, the retired imam from Iraq, said getting access to MaineCare would have a major positive impact on his life.

"So this will bring joy and relief that I can finally do the surgeries for my eyes, also [it] will help me financially," he said.

But for now, after a recent fall that sent him to the emergency room, Yasari said he’s facing another month of choosing between paying his medical bills and buying food.

The health and human services committee will take public testimony on the bill on March 28th.

Language interpretation service for this story was provided by Ali Al-Mshakheel.