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Association Comments on Public Charge Proposed Rule

In a Dec. 10 letter to the Department of Homeland Security (DHS), America’s Essential Hospitals urged the agency to exclude use of crucial health programs as a factor in public charge determinations.

The letter was sent in response to a proposed rule to expand the list of programs considered in a public charge determination to include nonemergency Medicaid benefits and low-income subsidies for Medicare Part D beneficiaries. The proposed rule also would introduce new income requirements for individuals seeking entry or a green card, along with other changes to how public charge determinations are made.

In its comments, America’s Essential Hospitals pointed to the negative ramifications for essential hospitals and their patients, including:

  • deterring millions of vulnerable people from seeking health care due to a chilling effect;
  • straining hospital budgets and local and state economies;
  • undermining public health efforts as individuals refuse to seek care;
  • undercutting existing laws that determine eligibility for public benefits; and
  • creating additional burden on providers and state and local agencies.

The association also encouraged DHS not to include the Children’s Health Insurance Program (CHIP) in public charge determinations. The proposed rule does not include CHIP, but DHS solicited feedback on adding the program to the list of considered benefits.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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