Public Charge Final Rule: Frequently Asked Questions
Patricia Boozang, Alice Lam, Allison Orris, and Elizabeth Dervan, Manatt Health
On August 14, 2019, the Department of Homeland Security (DHS) publisheda final rule, Inadmissibility on Public Charge Grounds. The rule makes significant changes to the standards DHS will use to determine whether an immigrant is likely to become a “public charge”—a person dependent on the government for support—which will have consequences for certain immigrants’ legal status.
In October 2019, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted awebinarabout the final rule, focusing in particular on how it could impact immigrants’ use of Medicaid and other health benefits. This document provides answers to frequently asked questions—including a number of questions raised during the webinar—about whom the rule will impact, what benefits are implicated by the rule, and how the rule might be administered.
Although the rule was originally scheduled to take effect on October 15, 2019, multiple preliminary injunctions issued by federal courts across the country blocked the rule last fall. A pair of decisions by the Supreme Court permitted the rule to go into effect nationwide on February 24. This document has been updated as of February 26, 2020 to reflect the most current information.
A range of policy proposals to cut federal Medicaid funding under consideration by Congress could profoundly reshape the Medicaid program. Although the specific details of these proposals have not yet been defined, many entities are actively analyzing the possible effects on state Medicaid enrollment and spending. This expert perspective highlights the national 50-state analyses of Medicaid cuts that have been released. SHVS will continue to regularly monitor published estimates and update this expert perspective.
The budget reconciliation process is continuing to move forward in Congress and includes developing proposals in the House to identify $880 billion in federal savings over the next ten years, the vast majority of which will need to come from Medicaid. To support states in informing and validating their own fiscal and program impact estimates of federal policy changes, Manatt Health has developed, with support and input from State Health and Value Strategies, a new toolkit providing national and state-by-state data on the potential impact of key cuts under consideration in Congress. This expert perspective provides an executive summary of the toolkit.
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.
