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The “Public Charge” Rule: How Will It Affect Immigrants’ Health Care and the Safety Net?

November 28, 2018

~ From our colleagues at the Commonwealth Fund ~


Earlier this fall, the U.S. Department of Homeland Security (DHS) proposed a rule that would result in Medicaid coverage affecting an immigrant’s status as a ‘public charge.’ The new rule could negatively influence DHS’s determinations when immigrants are entering the country or applying to extend their stay, change their visa status, or secure a green card.

In a new post on To the Point, Allison Orris, April Grady, and Cindy Mann of Manatt Health report that by disrupting coverage for millions of people, the so-called public-charge rule would also reduce Medicaid support for health care providers and drive up uncompensated care costs. According to Manatt analysis, an estimated $17 billion in Medicaid and Children’s Health Insurance Program spending on hospital payments would be at risk if the new policy takes effect.

Safety-net health care providers and providers in communities with large immigrant populations will be particularly hard-hit, the authors write, affecting not only their fiscal health but their ability to serve the broader community.

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