Frequently Asked Questions | Feb 26, 2020

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) published a 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 a webinar about 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.


Expert Perspectives

January 20, 2021

Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations

The rollout of vaccines designed to end the coronavirus (COVID-19) crisis has begun in earnest across the United States. Currently, each state is responsible for determining how to allocate, distribute, track, and report its vaccine allotment from the federal government, although the federal government is expected to take on a larger role under a new Biden administration. Since the beginning of the pandemic, Black, Indigenous, and other people of color have been disproportionately impacted by both higher risks of infection and poorer health outcomes, and many are concerned that an inequitable or inefficient distribution of the COVID-19 vaccine may further widen health inequities among these populations. One way to help ensure the equitable administration of COVID-19 vaccine is to track vaccine administration disaggregated for key subpopulations, such as gender, race and ethnicity, and geography (e.g., urban vs. rural). This expert perspective reviews the data states are currently publicly reporting related to vaccine administration and provides an interactive map that explores the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography. The expert perspective also discusses what current data sources states are using to provide this information and provides an overview of options states can consider to collect information about the administration of COVID-19 vaccine in populations via survey data.

January 19, 2021

2022 Notice of Benefit & Payment Parameters: Implications for States

On November 25, 2020, the U.S. Departments of Health & Human Services (HHS) and Treasury released the proposed 2022 “Notice of Benefit & Payment Parameters” (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on several provisions that have implications for state oversight of insurance markets and the state-based marketplaces. Comments on the proposed rule are due by December 30, 2020.