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

October 13, 2021

ACA Marketplaces Well-Positioned for Strong 2022 Open Enrollment Season

With the Patient Protection and Affordable Care Act’s (ACA’s) ninth open enrollment period (OEP) set to launch in less than a month, the ACA Marketplaces are seeing record enrollment numbers with more generous subsidies, new carrier competition, and a relatively stable rating environment. At the same time, there is uncertainty with the trajectory of the COVID-19 pandemic and medical costs trending upward as the economy recovers, albeit at an uneven pace. These trends have made for a challenging rate review process in the 47 states plus the District of Columbia (D.C.) that conduct their own ACA rate reviews of carrier-proposed rates using federal review standards. State announcements of 2022 rates have trickled out at a slower pace than in prior years, and it is likely that many states will not publish their approved rates until the beginning of open enrollment. As always, state rate results vary widely and, even within states, there often are substantial variations among carriers and across different regions in geographically diverse states. With these caveats, this expert perspective highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.