Issue Briefs | Mar 25, 2022

Overview of the Public Charge Proposed Rule

Allison Orris, Alice Lam, and Daniel Weinstein, Manatt Health

On February 17, the Department of Homeland Security (DHS) released its 2022 notice of proposed rulemaking (NPRM) which would largely codify longstanding federal guidance regarding DHS’ authority to refuse a noncitizen’s application for admission or application for visa adjustment (including receipt of a green card) on grounds that they are “likely at any time to become a public charge.”

This issue brief provides an overview of key provisions of the 2022 NPRM and includes commentary to describe how the proposed rule differs from the 1999 Field Guidance, as well as how the proposed rule seeks to promote clarity and address the chilling effects caused by elements of the now-repealed 2019 Rule. Comments on the 2022 NPRM are due on April 25.

For those interested in strategies to help connect eligible individuals to affordable coverage, see the recently published issue brief Reshaping the Narrative on Public Charge to Reach Immigrant Populations That Need Affordable Health Insurance. 


Expert Perspectives

March 14, 2025

Recent Federal Marketplace Proposal Imposes New Requirements for States and Consumers

On March 10, 2025, the Centers for Medicare & Medicaid Services released a proposed regulation that makes several policy and operational changes to the Affordable Care Act Marketplaces and insurance rules. This expert perspective reviews provisions of the proposed rule to assess their impact on State-Based Marketplaces and state insurance regulators.

Medicaid Cuts and the States: Tracking State-Specific Estimates of the Impacts of Proposed Changes

Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, widely expected to reduce enrollment and federal Medicaid funding to states. A variety of state-level estimates have been released, which can be helpful for states as they consider how various policy proposals might impact their Medicaid programs. This expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update this expert perspective.