TAKE ACTION: Comment here by Monday, March 2 at 2 pm PT/5 pm ET to oppose the proposal to nix automatic coverage renewals for low-income enrollees.
Changes to Public Charge Effective Now
Despite the many legal efforts to stop the “public charge” rule from taking effect, both the final Department of Homeland Security and the interim final Department of State public charge rules will be implemented on February 24 for all visa and adjustment of status (“green card”) applications submitted on or after that date. The last of the nationwide injunctions preventing the Dept. of Homeland Security rule from going into effect was stayed by the U.S. Supreme Court on January 27. This means the new public charge criteria will be used while the cases make their way through courts to be heard on the merits.
For more information on the impact of public charge on health care and benefits, see here. For “know your rights” materials including who is subject to the public charge test, see here and here.
Monday February 24 was a national “teach-in” day organized by the Protecting Immigrant Families campaign. There are multiple local events scheduled to help combat the fear and confusion in the community:
Monday, February 24: Seattle OIRA and Northwest Immigrant Rights Project (NWIRP) presented a training intended for “non-attorney” service providers who assist immigrant and refugee communities. FREE, watch the FB live event here.
Tuesday, February 25, 11am–noon, webinar: Public Charge 101 hosted by the national Protecting Immigrant Families campaign. Free, register here to attend.
Wednesday, March 4, 7:30am-9am, Perkins Coie (1201 Third Ave. Suite 4900, Seattle 98101 or remote access): CLE presentation for the Washington State Society of Healthcare Attorneys, “Public Charge” Rule: Impacts on Health and Healthcare. FREE and open to the public, register here to attend.
Tuesday, March 17, 11am-12:30pm, webinar: Public Charge updates from the Immigration Legal Resource Center, mainly intended for legal service providers. FREE, register here to attend.
Wednesday, March 18, 6pm-8pm, Peter Kirk Community Center (352 Kirkland Ave, Kirkland 98033): King County Immigrant and Refugee Commission providing an overview of public charge and health access for immigrants. FREE and open to the public.
Proposal to nix automatic coverage renewals for low-income enrollees
We are very concerned to see the Administration’s proposed rules to govern activities in health insurance marketplaces, including the Washington Health Benefit Exchange (2021 Notice of Benefit and Payment Parameters). One problematic proposed change seeks to prohibit automatic renewals of coverage for low-income enrollees whose premium tax credit (PTC) covers all of the premium. Any enrollee who doesn’t provide updated financial information would automatically be billed for the full premium amount. In 2019, 1.8 million people were automatically re-enrolled in coverage, including about 270,000 persons who were enrolled in a plan with zero premium after application of PTCs. HHS requests comment on whether these changes should apply to Federal and State exchanges.
The National Health Law Program summarizes impacts of the proposed rule and offers a portal for you to comment here. Comments are due Monday, March 2 at 2 pm PT/5 pm ET.
TAKE ACTION: Comment here by Monday, March 2 at 2 pm PT/5 pm ET to oppose the proposal to nix automatic coverage renewals for low-income enrollees.
Reviving Block Grants once again: a new attack on Medicaid
Yet again, the federal administration is trying to disrupt the Medicaid program through administrative action, this time by trying to entice states to apply for block-granted funding. Block grants would provide states with a low and finite amount of federal funds, turning the Congressionally designated open-ended, federal-state entitlement program on its head. The block grant guidance issued in January by the Department of Health and Human Services allows states to cap funding for Medicaid – a program that has been shown to improve the health and financial security of enrollees while also improving state budgets. The guidance provides states authority to cut coverage and benefits for people with Medicaid through a waiver.
States operate their Medicaid programs within federal minimum standards and a wide range of state options in exchange for federal matching funds that are available with no limit – i.e., an entitlement. The state entitlement funding structure means the federal government pays its share of however much a state spends on health care. So, if a state has unexpected health care costs such as public health emergencies (e.g., Zika and coronavirus), responding to a natural disaster, or an economic downturn — the federal government continues to support the state. Block grants are problematic because they provide states with a low and finite amount of federal funds, and when states exceed that amount, the state must bear the costs or cut back on coverage. This means fewer dollars available for the most vulnerable populations in the state as well as harm to the state budget, rural hospitals, and state health insurance coverage.
The legality of these waivers is questionable. The National Health Law Program’s Jane Perkins said, “This is just one more example of the Trump administration attempting to explode the Medicaid Act that Congress has written. The document issued today by CMS appears to re-write bedrock provisions of Medicaid, an activity which is beyond the scope of CMS’s power. Only Congress is tasked with making these changes. Our legal team is carefully investigating the enforcement and litigation options at this time.”
On February 6th, the US House of Representatives passed Resolution 826 – “Expressing disapproval of the administration’s harmful actions towards Medicaid.” See this FAQ, here and here for more information.
President’s Proposed Budget Takes an Axe to Health Care Funding
The President’s budget is yet another attack on health care. It would eliminate $1 trillion in funding for Medicaid and the ACA over the next decade, causing millions of people to lose coverage. The president would also cut $180 billion over ten years from basic food assistance (SNAP), shrink assistance for people with disabilities, and eliminate some low-income housing programs.
See here and here for more information about the full scope and impact of the proposed cuts.