If a regulation proposed by the Department of Homeland Security to redefine what constitutes a “public charge” is adopted, millions of people currently enrolled in the Medicaid and Children’s Health Insurance Program might choose to disenroll from those programs rather than risk losing their opportunity to obtain legal permanent resident status in the U.S.
The proposed regulation seeks to filter out of possible residency status individuals who might become public charges, or dependent on government programs, over time.
Under the proposed rule, individuals with lower incomes, a health condition, less education, and/or who are enrolled or likely to enroll in certain health, nutrition, and housing programs would face increased barriers to obtaining LPR [legal permanent residency] status.
The study notes that
Nearly all (94%) noncitizens who originally entered the U.S. without LPR status have at least one characteristic that DHS could potentially weigh negatively in a public charge determination.
To avoid losing eligibility for legal permanent residency status, the analysis suggests,
The proposed rule would likely lead to disenrollment from Medicaid and other programs among noncitizens who intend to seek LPR status as well as among a broader group of individuals in immigrant families, including their primarily U.S. born children.
How many people might disenroll from Medicaid, CHIP, and other programs is difficult to project but the study notes that
If the proposed rule leads to Medicaid disenrollment rates ranging from 15% to 35% among Medicaid and CHIP enrollees living in a household with a noncitizen, between 2.1 to 4.9 million Medicaid/CHIP enrollees would disenroll.
Reduced participation in Medicaid and other programs would negatively affect the health and financial stability of immigrant families and the growth and healthy development of their children, who are predominantly U.S.-born.
This, in turn, could lead to financial challenges for health care providers serving communities with large numbers of low-income patients, many of whom could be individuals who do not have permanent residency status. Some could seek to disenroll from Medicaid, or not to enroll if they qualify, leaving them uninsured if and when they need and seek medical care. This could prove especially challenging for private safety-net hospitals, which serve communities with large numbers of low-income patients and often serve communities with large numbers of immigrant residents as well.
Learn more about the proposed regulation and its implications for those it might affect and their health status in the Kaiser Family Foundation report “Estimated Impacts of the Proposed Public Charge Rule on Immigrants and Medicaid,” which can be found here.