immigrants did not violate the equal protection clauses of the United States Constitution and the Connecticut State Constitution.
The state funded program had provided coverage for immigrants who were ineligible for federally funded Medicaid. The court found that the elimination of a program which only applied to immigrants did not treat immigrants differently from citizens. Hong Pham v. Starkowski, — A.2d —-, 300 Conn. 412, 2011 WL 1124005 (Conn. Apr. 5, 2011). Greater Hartford Legal Aid represented the plaintiffs.
In 1996, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act. The Act barred immigrants who have legally resided in the United States for less than five years from receiving Medicaid coverage (the “five year rule”). 8 U.S.C. § 1613. Connecticut responded by creating a program called State Medical Assistance for Non-Citizens (SMANC). Public Acts, Spec. Sess. June, 1997, No. 97-2 § 146 (Spec. Sess.P.A.97-2), codified as amended at General Statutes (Rev. to 2009) § 17b-257b. SMANC provided medical coverage to immigrants who would have been eligible for Medicaid if not for the five year rule that Congress had adopted.
However, in 2009, the Connecticut legislature passed Spec. Sec. P.A. 09-5, § 64 (“§ 64”), which ended SMANC and left immigrants subject to the five year rule without access to SMANC or federal Medicaid.
Connecticut also restricted eligibility for SAGA-medical, a state medical assistance program designed to provide medical coverage for certain groups of indigent individuals who could not receive federal Medicaid assistance. The Connecticut legislature passed Spec. Sess. P.A. 09-5, § 55 (“§ 55”). This law restricted eligibility for SAGA-medical to those who did not meet the categorical eligibility requirements for federal Medicaid. Recent immigrants who were categorically eligible for Medicaid could not participate in SAGA-medical.
The plaintiffs were the class of legal immigrants residing in Connecticut who had resided in the United States for less than five years who would otherwise be categorically eligible for federal Medicaid. They sued Connecticut’s Commissioner of Social Services claiming that the laws excluding them from Connecticut’s state programs violated the equal protection clauses of the US Constitution and the state constitution. The district court held that the state laws violated the Equal Protection Clause of the US Constitution, not addressing the state constitution.
The Connecticut Supreme Court unanimously reversed and held that Connecticut’s laws did not violate equal protection. Section 64 did not violate equal protection because SMANC had never been available to citizens, and therefore ending SMANC did not involve a legislative decision to provide benefits to citizens that it was not providing to non-citizens. The court rejected the argument that by participating in federal Medicaid but ending SMANC, it was providing benefits to citizens that it was denying to a class of non-citizens. It wrote, “the equal protection clause does not require the state to treat individuals in a manner similar to how others are treated in a different program by a different government.” Furthermore, “the state’s treatment of individuals within SMANC cannot be compared to the state’s treatment of individuals within the separate federal Medicaid program, which is governed and funded substantially by a different government.” The state did not have an obligation to provide benefits to the plaintiffs that Congress had revoked.
Even though the state legislature changed the eligibility requirements for SAGA-medical to exclude the plaintiffs’ class, the court held that § 55 also did not violate equal protection. The court found that § 55 excluded the plaintiffs from SAGA only on the grounds that they met the categorical eligibility requirements for federal Medicaid, not on the grounds of the plaintiffs’ citizenship.
Because the court found that neither § 64 nor § 55 discriminated on the basis of alienage, and because the plaintiffs had not argued that the statutes would fail rational basis scrutiny, the court upheld the statutes as constitutional.
The court also rejected the plaintiffs’ arguments that § 64 and § 55 violated § 20 of the Connecticut constitution because the laws did not discriminate on the basis of alienage and the statutes passed rational basis scrutiny.