Refugees Sue Arizona|to Restore Medicaid


TUCSON (CN) — Arizona’s latest illegal attack on immigrants is to reduce their Medicaid benefits to “emergency only,” in violation of the Constitution and the Medicaid Act, refugees say in a federal class action.
     Lead plaintiffs Aita Darjee, a refugee from Nepal, and Alma Sanchez Haro, a battered woman who has lived in the United States for more than 20 years, are legal permanent residents who were transferred to “emergency only” medical care despite no change in their immigration status.
     “These are persons who really don’t have a lot of resources,” said their attorney Ellen Katz. “Many of these persons are refugees; they came to the United States for humanitarian reasons.”
     Katz’s clients sued Arizona Health Care Cost Containment System (AHCCCS) Director Thomas Betlach, on July 22.
     Depending on their legal status, some immigrants are eligible for full Medicaid coverage while others qualify for medical care only in emergencies. States need not participate in the Medicaid program, but if they do, they must abide by the federal Medicare and Social Security Acts.
     Arizona has been violating these laws for at least 18 months, by sending thousands of letters to poor immigrants, reducing their Medicaid coverage to emergency-only, the complaint states.
     The state admits this. When the refugees’ attorneys protested in an October 2015 letter to the state, “AHCCCS admitted it identified over 3,500 immigrants improperly transferred to emergency-only AHCCCS and reinstated these persons to full-scope AHCCCS,” according to the complaint.
     However, it continues: “The improper reductions of immigrant medical benefits from full-scope AHCCCS continue. As 2016 progressed, AHCCCS improperly reduced the medical benefits for some immigrants a second time.”
     As a result, “participants with significant medical conditions, including persons with diabetes, mental health conditions, asthma and high blood pressure, have been left without needed medical care.”
     One of them is Darjee, a 30-year-old Tucson resident who came to the United States with her family in 2011. As refugees, Darjee, her husband and their son became eligible for full AHCCCS benefits. A year later they became permanent legal residents and notified the state agency, which subsequently reduced their benefits to emergency-only.
     Their medical coverage was restored, but it was reduced again this month. Darjee’s husband, Dambar, has diabetes, high blood pressure and asthma.
     “They are very stressed over this situation,” the lawsuit states. “Plaintiff Darjee is especially worried about her husband.”
     Tucson resident Sanchez Haro, 48, received notice of her coverage reduction in April. A victim of domestic violence, in 2003 she received a special visa through the Violence Against Women Act, which made her eligible for full AHCCCS benefits. In 2015, she became a legal permanent resident and reported her change in legal status to the agency.
     Sanchez Haro, a diabetic who suffers from chronic depression and other illnesses, called AHCCCS for an explanation and was told the change occurred because she has been a permanent resident for less than five years.
     In 1996, Congress approved the Personal Responsibility and Work Opportunity Reconciliation Act in a push to overhaul the nation’s welfare system. The legislation included eligibility changes for immigrants, requiring them to live in the United States for five years before qualifying for public benefits.
     But the lawsuit notes that while immigrants who arrived in the United States after August 1996 must meet the five-year requirement, federal law exempts certain immigrants — such as the lead plaintiffs — and makes them eligible for full AHCCCS benefits.
     “These mistakes should not be happening,” Katz said. She said AHCCCS has the information it needs about her clients and the class, and presumably knows the law.
     The refugees seek class certification, declaratory judgment that AHCCCS is violating the Medicaid Act and the Due Process Clause of the Constitution, reinstatement of full Medicaid benefits, an injunction and costs of suit.
     Katz, with the William E. Morris Institute for Justice in Phoenix, is assisted by attorneys with the National Health Law Program in Los Angeles.
     AHCCCS officials could not be immediately reached for comment Tuesday.

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