Aliessa et al. v. Novello: N.Y. Law Restricting Immigrants' Eligibility for State Medical Aid Found Unconstitutional

IMMIGRANTS & PUBLIC BENEFITS

Health Care

ALIESSA ET AL. V. NOVELLO: N.Y. LAW RESTRICTING IMMIGRANTS' ELIGIBILITY FOR STATE MEDICAL AID FOUND UNCONSTITUTIONAL
Immigrants' Rights Update, Vol. 15, No. 4, June 29, 2001

New York's highest court has ruled that the state violated the U.S. and state constitutions when it denied state-funded Medicaid to certain immigrants who lost eligibility for Medicaid under the 1996 welfare reform law. The New York Court of Appeals in Aliessa, et. al. v. Novello held unanimously that a New York statute limiting immigrants' eligibility for the state's medical assistance program ran afoul of the equal protection clauses of the New York and U.S. constitutions, as well as the New York constitution's requirement that the state and its subdivisions provide for the aid, care, and support of the needy.

The statute in question, Social Services Law section 122, restricts immigrants' eligibility for New York's state medical assistance program by banning qualified immigrants who entered the United States on or after Aug. 22, 1996, from receiving program benefits for five years and limiting coverage for those permanently residing in the U.S. under color of law (PRUCOL) to persons who were diagnosed with AIDS or residing in certain residential care facilities on the date it was enacted. Prior to Section 122's 1997 passage, the New York medical assistance program provided benefits to all lawful permanent residents and persons who were PRUCOL who met the program's financial eligibility requirements.

The state adopted Section 122 in response to the 1996 federal welfare law, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). Title IV of the PRWORA made persons who are PRUCOL ineligible for Medicaid and imposed a five-year bar on the receipt of Medicaid benefits by most qualified immigrants who arrived in the U.S. on or after Aug. 22, 1996. However, the PRWORA also allowed states to provide state-funded benefits to persons whose immigration status made them ineligible for federal benefits, including people who are PRUCOL and qualified immigrants subject to the five-year bar.

The court considered several claims, first concluding that Section 122 violated the New York constitution's requirement that the state and its subdivisions provide for the "aid, care and support of the needy" and rejecting the argument that the provision of emergency Medicaid met the state's obligation. The court found that ongoing medical care is a basic necessity of life, explaining, "To allow a serious illness to go untreated until it requires emergency hospitalization is to subject the sufferer to the damage of a substantial and irrevocable deterioration in his health."

Next the court turned to the equal protection claims. The plaintiffs urged the court to apply strict scrutiny to its evaluation of Section 122 because the statute made distinctions between groups of people on the basis of immigration status. The state argued that Section 122 should be upheld if the state had a rational basis for its adoption, on the theory that its differential treatment of immigrants merely implemented federal immigration policy. The court concluded that the PRWORA's delegation to the states of the authority to distinguish between different classes of legal immigrants in administering their benefit programs violated Congress's constitutional obligation to establish a uniform, national system for regulating immigration. Since Congress had not acted with constitutional authority in delegating this power to the states, any immigration-based classification established pursuant to the delegation should be evaluated under the strict scrutiny standard generally applied to states' alienage classifications. The court applied the strict scrutiny standard and concluded that Section 122 violated the equal protection provisions of the state and U.S. constitutions.

Other states are not bound by a decision of a New York court. Nonetheless, they should take note of the court's conclusion that states violate the U.S. Constitution when they discriminate among classes of immigrants in the administration of their benefit programs. The Aliessa decision should prompt states to examine their benefit programs for immigration-based classifications, including programs that fail to draw down federal funds for immigrants after the five-year bar, and it may encourage more states to extend benefits to all lawfully present immigrants. The decision could also add momentum to efforts to make federal funding available to restore benefits to qualified immigrants subject to the five-year bar. Two bills that would partially restore benefits are currently before Congress. The Immigrant Children's Health Improvement Act of 2001 (ICHIA), S. 582, H.R.1143, would allow states to lift the five-year ban and provide health coverage to eligible, lawfully present pregnant women under Medicaid and to children under Medicaid and the State Children's Health Insurance Program. The Women Immigrants' Safe Harbor Act (WISH), H.R. 2258, would exempt battered immigrant women from the five-year bar and render them eligible for the major federal benefit programs.

Aliessa et al. v. Novello, __NY2d__, 2001 N.Y. LEXIS 140D (N.Y. Ct. App. June 5, 2001).