CITING the legal advice of the Office of the Attorney General, Gov. Ralph DLG Torres on Tuesday vetoed a “recycled” bill that proposes to establish a Rota Medical Subsistence Allowance Program.
Authored by Sen. Teresita Santos, Senate Local Bill 22-1 is similar to S.L.B. 21-2, which she introduced in the 21st Legislature. It proposed to form a medical assistance allowance review board that will create rules regarding eligibility for assistance.
It was vetoed by the governor because, according to the attorney general, it violates the separation of powers doctrine and the Health Insurance Portability and Accountability Act, and it also lacks rationale in requiring voter registration for eligibility.
S.L.B. 22-1, which was passed by the Rota Legislative Delegation on June 16, 2021, has the same intent as S.L.B. 21-2, but it addresses the issues raised by the governor in his veto last year.
Instead of creating a review board, the new bill would allow the Rota Health Center director to form a terminally ill patients evaluation committee, which will decide who qualifies as “terminally ill” patients.
In his veto message on Tuesday, the governor said he commends the Rota delegation’s intent to provide additional assistance to the island’s terminally ill patients.
However, the governor said, “similar to the case in S.L.B. 21-2, as advised by the attorney general, several legal issues arise from the enactment of this bill, which warrants my disapproval once again.”
He said these legal concerns are the following:
• The durational residency requirement violates the Equal Protection Clause. The bill provides that “patients who are residents of Rota for a period of at least one year immediately preceding the date of this Act may apply for medical subsistence allowance.” This language, the governor said, “runs afoul of the Equal Protection Clause, which prohibits states from enacting strict residency requirements.” If challenged, the durational residency requirement in the bill must survive scrutiny under the Equal Protection Clause. The governor said it is unlikely that the residency requirement will be upheld as the local bill does not provide any rationale for the requirement.
• The local bill is beyond the delegation’s constitutional authority. The governor noted that S.L.B. 22-1 directs the Rota Health Center to designate five staff members to evaluate and certify whether a patient is terminally ill to receive the medical subsistence allowance. The listing would be provided to the mayor of Rota. This interferes with the jurisdiction of the Commonwealth Healthcare Corp. and the inter-island medical referral services. The delegation, the governor said, cannot override CHCC’s authority over the Rota Health Center. He added that the local bill if enacted is unenforceable if it contravenes Commonwealth law.
• The consent to release information must be voluntary. Saying that the local bill mandates a patient consent to release his or her name to the mayor for the purpose of requesting, the governor added that it fails to articulate a compelling reason for receiving the allowance. The right to privacy is protected by Article I, Section 10 of the Commonwealth Constitution and the federal statute commonly referred to as the Health Insurance Portability and Accountability Act.
