In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
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 will be published in the Federal Register later this week and will go into effect on October 15. The public charge rule will change 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. In addition, New York provided one example of how a state has engaged its assistors to help communicate potential implications of the rule.