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  • Washington Highlights

    DHS Issues Final Rule on “Public Charge”

    Jason Kleinman, Senior Legislative Analyst, Govt. Relations

    The Department of Homeland Security (DHS) Aug. 12 released the “Inadmissibility on Public Charge Grounds” final rule to establish new standards about which public benefits will be considered when legal immigrants seek to change their immigration status or enter the United States. The final rule will be effective Oct. 15.

    Under current law, the government considers whether individuals can support themselves financially when making immigration decisions. This rule expands the list of public benefits that can contribute to a person being determined to be a “public charge” to include Medicaid, public housing, and nutrition programs. Among the factors that will be heavily weighted against the immigrant are whether he/she has received or been certified or approved to receive one or more public benefits for more than 12 months in the aggregate within a 36-month period.

    After the agency released the proposed rule, the AAMC submitted comments urging DHS to not finalize the rule. The AAMC’s comments highlighted the negative impacts of the proposal, including an analysis that found that there could be a large “chilling effect” that may result in millions of individuals who are legally entitled to benefits being discouraged from accessing them for fear that they will trigger the public charge rule [see Washington Highlights, Dec. 14, 2018]. The agency received over 260,000 comment letters on the proposed rule, the vast majority of which opposed the rule.

    AAMC President and CEO David J. Skorton, MD, issued a statement expressing disappointment in the final rule. He noted, “Stable and continuous access to health care, food, and housing are vital to ensuring better health outcomes. Deterring access to programs for which an individual legally qualifies, such as Medicaid, will cause delays in seeking needed care. Along with the rule’s impact on food subsidies and housing support, this change will worsen existing health inequities and disparities, cause further harm to many underserved and vulnerable populations, and increase costs to the health care system overall, which will affect all patients.”

    The AAMC also joined the American Hospital Association, America’s Essential Hospitals, the Catholic Health Association of the United States, the Children’s Hospital Association, and the Federation of American Hospitals in a statement asking the administration to withdraw the rule. The statement adds, “This rule could undermine access to care for legal immigrants by discouraging the use of critical public programs like Medicaid. We are concerned that this could lead to delays in care that would negatively impact the health of the communities we serve.”

    The Department of Justice (DOJ) is responsible for prosecuting immigrants who are identified as public charges. It is anticipated that DOJ will conduct rulemaking to ensure that the standards applied in immigration court are consistent with the standards in the DHS rule.