Proposed Public Charge Regulation Causes Confusion in Clinics, Elsewhere

A Trump administration proposal to redefine what constitutes a “public charge” is making life challenging for low-income immigrants and the clinics and other providers to which they turn for Medicaid-covered health care.

The proposed regulation from the Department of Homeland Security would establish new criteria for determining whether a person is a “public charge,” based on their participation in certain public programs, and therefore in jeopardy of losing their legal immigration status.

Some Medicaid patients who come to clinics ask if receiving Medicaid-covered services might jeopardize their legal immigration status; others fail to keep appointments or forego seeking care out of fear of the future implications.  Clinic operators walk a fine line between trying to provide the care their patients need and deciding how to answer patients’ questions honestly but without causing undue alarm.  Some choose not to address the issue at all; others seek to answer patient questions but only when asked; while still others provide information about the situation without being asked – doing so, they realize, at the risk of scaring off some of those patients.

Meanwhile, some legal experts believe that a new standard, if adopted, would not be retroactive and consider Medicaid enrollment prior to the regulation’s adoption.

The result is confusion and concern among providers, legal immigrants enrolled in Medicaid, and advocates.

Last month NASH wrote to the Department of Homeland Security to convey its objections to the proposed legislation, expressing concern about its potential impact on private safety-net hospitals and the patients and communities they serve.

Learn more about the proposed regulation and the challenges providers face as they await a decision on whether it will be implemented in the Kaiser Health News report “Providers Walk ‘Fine Line’ Between Informing And Scaring Immigrant Patients.”