The idea is poor public policy, critics say, and racist if it ends up hurting children of color, even unintentionally. The governor's defenders say tough choices must be made.

01:00 AM EST on Friday, March 31, 2006

BY ELIZABETH GUDRAIS
Journal State House Bureau

PROVIDENCE -- Advocates at the State House yesterday assailed the governor's proposal to end state-paid health insurance for children of undocumented immigrants. The idea, they said, is bad public policy at best, and at worst, racist.

"It's racist if the outcome . . . is hurting people of color," Gladys Gould, a Providence resident speaking on behalf of Jobs with Justice, said. "Whether or not it's intentional, that's the outcome."

Under Governor Carcieri's proposal, the state would stop paying for health insurance for an estimated 3,000 children whose families have household income below 250 percent of the federal poverty level, or $40,225 a year for a family of three, but whose parents cannot prove they are in the United States legally.

Providence resident Jaime Mendez also said Carcieri's proposal would disproportionately affect the state's Hispanic population. (Nationally, 78 percent of illegal immigrants come from Latin American countries, according to the Pew Hispanic Center.)

"If these budget cuts go through," Mendez told House Finance Committee members, "I would like you to come to these communities . . . and say to people, 'You're sick? Too bad.' "

Undocumented immigrants might not be citizens, but they are taxpayers, Wilfrid Ordonez, a community organizer for Progreso Latino, said.

Because many have payroll taxes withheld from their checks, and all pay sales tax, "none of them are, or can be, freeloading off of the system," Ordonez said in written testimony. "They are, in fact, subsidizing our social programs like unemployment, disability insurance, Social Security. . . . "

Ronald A. Lebel, Carcieri's director of human services, said the governor agonized over the cuts to social services.

"At the end of the day," Lebel said, "the governor looked at the $300-million deficit and had to make some tough decisions."

When Carcieri unveiled the proposal at a news conference last month, he said of the reasons behind his recommendation: "I want to take care of Rhode Islanders. We can't take care of the rest of the world's problems."

The governor has said that Rhode Island's generous social-service programs encourage people to move here from other states. Rhode Island is one of just six states that provide comprehensive health coverage for undocumented children. Besides Rhode Island and the District of Columbia, Massachusetts, Florida, Michigan, New York and Washington also provide such coverage. Nine other states provide limited coverage -- for instance, a restricted benefit package compared with coverage for citizen children -- Lebel said.

Those who argued to retain the children's coverage said they're not worried if Rhode Island stands out among the states. The RIte Care program has become a model for the nation, they said. The most recent U.S. census data showed Rhode Island had the second lowest percentage of uninsured children in the nation, falling behind Vermont. Just 5.8 percent of Rhode Island's children younger than 19 are uninsured, compared with 11.4 percent nationally.

The state will save a projected $4 million next fiscal year by discontinuing health coverage for undocumented children. However, Edward J. Quinlan, president of the Hospital Association of Rhode Island, said state residents will end up footing the bill one way or another -- either through higher premiums for commercial insurance or through state reimbursement to hospitals for uncompensated care.

Hospitals "will not turn away all of the individuals that are going to be tossed off the rolls of RIte Care," Quinlan said. "We can't. We won't. We never have."

Yesterday's hearing unfolded against the backdrop of a U.S. Senate debate on immigration. The Senate is weighing competing proposals for dealing with the estimated 11 million immigrants who are illegally in the United States.

One bill would create a guest worker program, and ultimately give the immigrants citizenship as long as they hold jobs, pass criminal background checks and pay taxes, among other requirements. Another would focus on enforcement. The U.S. House has already passed a bill to tighten border security and criminalize the aiding of undocumented immigrants, but Congress is not expected to send any immigration legislation to President Bush until after the November election, the Associated Press reported.

As it turns out, Carcieri's proposal would affect not only undocumented immigrants, but some who are in the United States legally as well.

The governor would accomplish the cut by deleting a section of state law that mandates RIte Care coverage for poor noncitizen children "without regard to the availability of federal financial participation."

In practical terms, that means the state would end coverage for children who are not among those the federal government deems eligible for Medicaid.

Even if noncitizen children are here legally -- for instance, as part of a family of refugees -- the federal government imposes a five-year waiting period for Medicaid eligibility. Currently, Rhode Island offers those children RIte Care as long as their families don't exceed the income cap, but the state receives no federal reimbursement for coverage provided to children who've been here less than five years.

Kate Brewster, director of the Poverty Institute at Rhode Island College, noted that Carcieri was among the dignitaries who welcomed Liberian president Ellen Johnson-Sirleaf to Rhode Island last week. There are an estimated 10,000 to 15,000 Liberians in Rhode Island, including many who came here fleeing civil war.

Carcieri's presence alongside those immigrants at last week's reception was "ironic," Brewster said, "when we're talking about taking away the most basic health care for their kids."

egudrais@projo.com / (401) 277-7045