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.
To maximize efforts to maintain coverage, state Medicaid agencies and Marketplaces can now leverage digital channels as part of their overall outreach and communications efforts. Rapidly evolving changes in consumer media consumption habits as well as shifts in digital channels, and the ability to leverage data sources, enables granular audience targeting and efficient use of resources. These can be incorporated into an overall integrated outreach and education campaign to maximize renewals and coverage retention.
Individual-level data on race and ethnicity collected within the Medicaid program and in other state agencies is greatly influenced by federal guidance. This expert perspective summarizes the proposed revisions to the federal standards for collecting race and ethnicity that are currently out for comment, and provides considerations for states interested in submitting comments.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, three states—Iowa, Minnesota and Utah—have a public data dashboard. SHADAC will update this expert perspective as additional dashboards go live.
