In 2006, the Massachusetts legislature created Commonwealth Care, a health insurance premium assistance program for low-income residents, including lawfully-residing aliens. Commonwealth Care is supported by both state and federal funds. Federal funding is provided via a Medicaid demonstration project pursuant to 42 U.S.C. §1315, so that Commonwealth Care is partially reimbursed by the federal government for payments made on behalf of individuals eligible for Medicaid. Legal aliens who have resided in the United States less than five years are ineligible for federal benefits, such as Medicaid, under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), 8 U.S.C. §1613(a). In other words, the Commonwealth of Massachusetts assumes responsibility for 100% of the premium assistance provided to legal aliens who do not meet PRWORA’s eligibility requirements.
Karen Breda. "Denial of Health Insurance Premium Assistance to Legal Aliens Violates Equal Protection Provision of Massachusetts Constitution." American Bar Association TIPS Insurance Regulation Committee Newsletter (2012): 9-10.