On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (the ARP), a wide-ranging package of health care and economic measures responding to the coronavirus pandemic. The ARP includes a broad expansion of the Affordable Care Act’s (ACA) main health insurance subsidy, the premium tax credit (PTC), the first major expansion of the health care reform law since its passage. This piece highlights the policymaking considerations that states must account for in light of the PTC expansion and uncertainty about future federal action. A key theme that emerges is that states will benefit from approaches that give them the flexibility to adjust policies year by year as the federal landscape develops.
Final Public Charge Rule: Analysis and Potential Implications
On September 3, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar on the public charge final rule, facilitated by experts at Manatt Health. On August 12, the Department of Homeland Security (DHS) issued a final version of its public charge rule, which changes how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers. Speakers highlighted the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits, as well as communications and messaging.
Please note that the slide deck has been updated as of February 24,2020. Although the rule was originally scheduled to take effect in October 2019, multiple preliminary injunctions issued by federal courts across the country temporarily blocked the rule. As a result of decisions by the Supreme Court, the rule will go into effect nationwide on February 24, 2020.