Trump Administration’s New Regulation Could Cripple Health Care Providers’ Ability to Serve their Communities

Trump Administration’s New Regulation Could Cripple Health Care Providers’ Ability to Serve their Communities

OAKLAND, CA, September 24, 2018 – The California Association of Public Hospitals and Health Systems (CAPH) is deeply concerned about the regulation released over the weekend by the Trump Administration that would make it harder for immigrants who access public services to become lawful permanent residents.

“This regulation is a misguided departure from current policy that could severely weaken public health care system providers’ ability to care for their patients. It could force families and communities to live in fear and avoid accessing needed health care services,” said CAPH President and CEO Erica Murray.

The proposed regulation issued by the Department of Homeland Security would expand the definition of public charge, a term that can be used to deny an immigrant from gaining legal permanent status because they would be deemed likely to use essential public services. Under the proposed regulation, “public charge” would be expanded to include a broad list of public services, including Medicaid (called Medi-Cal in California), housing subsidies, food vouchers, and help for low-income seniors to afford prescription drugs. Public charge previously only considered cash assistance and government-funded institutionalized long-term care.

The proposed policy change has not yet been posted to the Federal Register. Once it is, the public will have 60 days to comment. The Administration cannot enforce the policy until at least 60 days after the final rule is published.

CAPH represents California’s 21 public health care systems that disproportionately serve low- income patients and communities. Together, these systems are the core of the state’s health care safety net, delivering care to all who need it, regardless of ability to pay or circumstance. Though just 6% of all health care systems in the state, California’s public health care systems serve more than 2.85 million patients a year, provide 11.5 million outpatients visits annually, and operate more than half of the state’s top-level trauma and burn centers. California’s public health care systems operate in 15 counties where more than 80% of Californians live. They provide 35% of all hospital care to Medi-Cal beneficiaries and 40% of hospital care to the remaining uninsured in the communities they serve.

Low-income families rely on public health care systems across California for preventive, primary, specialty, and surgical care. Although public health care system providers are trying to assure patients of their safety when they arrive for services, many are avoiding care out of fear of the potential consequences for their immigration status. An expanded public charge definition will only exacerbate this unfortunate and unhealthy situation.

“Our health care systems are focused on keeping patients healthy and well, providing an array of needed services to improve their well-being,” said Murray. “The proposed changes would hurt providers’ ability to care for patients and create safe spaces for them to maintain good health.”