Protecting Access to Healthcare for Immigrant Communities
Public Charge Notice of Proposed Rule Making (NPRM)
On February 24, 2022, Department of Homeland Security (DHS) published the Public Charge Notice of Proposed Rule Making (NPRM) on the Federal Register, which was available for public comment until April 25, 2022.
The NPRM closely mirrors the 1999 guidance currently in place today. This means that under the proposed rule, DHS would redefine “likely at any time to become a public charge” as “likely to become primarily dependent on the government for subsistence.” Consistent with long-standing agency practice, DHS proposes to consider the following public benefits when making a public charge inadmissibility determination: Supplemental Security Income (SSI); Cash assistance for income maintenance under the Temporary Assistance for Needy Families (TANF) program; State, Tribal, territorial, and local cash assistance for income maintenance; and long-term institutionalization at government expense.
CPCA, in collaboration with the National Association of Community Health Centers (NACHC) and the Association of Asian Pacific Community Health Organizations (AAPCHO), created a comment letter from the community health center (CHC) perspective that CHCs and interested organizations can sign onto. In the letter, we ask that all state-funded programs be excluded from the public charge determination along with all Medicaid programs being removed from the rule, including long-term care. To see a copy of our letter please click HERE.
Supreme Court Hearing Impacting the Public Charge Rule
When the Biden administration took office, they declined to defend the Trump-era Public Charge rule in court and instead reinstated the 1999 guidance, which is in place today. As a result, Arizona is leading a coalition of 12 states in the hopes of gathering approval from the Supreme Court to represent the federal government in defense of the Trump-era rule. The oral arguments, which took place February 23, focused NOT on the merits of the public charge rule policy, but on whether these states could legally represent the federal government to defend the public charge Trump-era rule. The Supreme Court will issue an opinion on the case by the end of June
CPCA, along with our member La Clinica de La Raza, continues to be involved in litigation efforts to push against the Trump-era Public Charge rule. If the Supreme Court decides to allow states to defend the rule, we will be ready to push back through the courts. Additionally, given that the Biden administration released a proposed public charge rule on February 24, the rule may be finalized before the Supreme Court ruling, making it more difficult for states to revive the Trump-era Public Charge rule.
Mitigating the Chilling Effects of Public Charge
CPCA leads two external coalitions alongside its immigrant partners, the CA-PIF Outreach and Communications Workgroup under the CA-PIF efforts led by the California Immigration Policy Center (CIPC) and the National Health Center Immigration workgroup (NHCIW). The goal of these workgroups is to help align messaging and how folks speak about the Public Charge rule to patients and community members while also creating a space to share best practices, lessons learned and resources.
Through the efforts of the CA-PIF Outreach and Communications Workgroup, CPCA has been able to provide CHCs with resources to help answer questions from their immigrant patients related to health care access and public charge. Confusion around public charge and the grounds of becoming a “public charge” can lead immigrants and their families to disenroll from public assistance programs or refrain from using public services such as healthcare. To combat this, CPCA continues to work with the CA-PIF outreach and communications workgroup to focus on communications around the chilling effects. The workgroup continues to translate community facing documents and updates to existing training modules to provide the most accurate and accessible information to immigrant families. The training modules have been instrumental in educating advocates, service providers, and affected communities about the impacts of public charge. Additionally, CPCA continuously updates the immigration resources page to ensure that immigrants and their providers have access to the most up to date and accurate information.