On January 5, 2012, the Massachusetts Supreme Judicial Court, the state's highest court, held unconstitutional a state law that excluded certain immigrants from eligibility for subsidized health coverage under that state's "Commonwealth Care" program. Finch v. Commonwealth Health Insurance Connector Authority, 459 Mass. 655, 946 NE 2d 1262, aff'd, SJC-11025 (MA Jan. 5, 2012). At issue in Finch was a legislative appropriation that denied state subsidies for the purchase of health insurance to noncitizen immigrants residing lawfully in Massachusetts. The appropriation financed the Commonwealth Care Health Insurance Program, otherwise known as "Commonwealth Care." Commonwealth Care was established in 2006 to provide premium assistance for health insurance to low-income Massachusetts residents. This program was supported equally by state and federal funds. The challenged appropriation required Commonwealth Care to limit subsidies only to individuals eligible for federally funded public benefit programs as set forth in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), 8 USC ¶¶1601-46. PRWORA essentially excludes from eligibility for federal benefits anyone who has resided in the country for less than five years.
The plaintiffs in Finch were FNs who had either been denied eligibility for assistance under Commonwealth Care or had been terminated from that program. They asserted various equal protection claims under the federal and state constitutions. Relying exclusively on the Massachusetts constitution, the Finch court found that the challenged appropriation could not withstand the strict scrutiny analysis that Massachusetts requires to uphold laws that make distinctions based on alienage. As a result of this decision, Massachusetts now must pay the full amount for those FNs who are not eligible for Commonwealth Care under PRWORA because the federal government is not legally permitted to match these funds.