Homeland Security proposed rule would lead to legal immigrants foregoing healthcare

Photo by John Moore/Getty Images

WHAT HAPPENED

In a rule proposed by the Department of Homeland Security on Saturday, legal immigrants in the United States may be denied "lawful permanent residency" if they seek Medicaid or other public assistance, Politico reported. 

WHY IT MATTERS

The political motivation behind such a move aside, providers are lambasting the rule because of its effect on beneficiaries who receive Medicaid, Medicare Part D subsidies, and other benefits. It jeopardizes their health and, according to America's Essential Hospitals, threatens the stability of hospitals.

Without access to care via Medicaid, healthcare costs will not decrease. Instead, they will turn into uncompensated care, with costs shifting to providers and state governments, according to Linda Rosenberg, president and CEO of the National Council for Behavioral Health.

THE BIGGER TREND

Hospitals have borne the cost of uncompensated care for years, but because patients now have higher deductibles and greater out-of-pocket costs, hospitals can no longer write-off unpaid bills.

Also, incentives for value-based care, particularly from the government, promote wellness and a proactive approach to health, such as controlling infections and managing chronic diseases.

The rule works against this incentive, likely reversing the public health gains of the last several decades in areas such as vaccinations, control of infectious diseases, and access to healthier foods, said Barbara McAneny, MD, president of the American Medical Association.

ON THE RECORD

"By creating a strong disincentive to seek care, this rule would force people to forgo medical visits and medications until they are sicker and costlier to treat. It would drive higher levels of uncompensated hospital care and, ultimately, higher costs for insured patients and taxpayers," said Bruce Siegle, president and CEO of America's Essential Hospitals.

"The American Medical Association believes every individual deserves timely, accessible, quality healthcare, nutrition and housing," McAneny said. 

THEIR TAKE

Existing law already bars undocumented immigrants from Medicaid and other public assistance and requires green card holders to wait five years before enrolling in Medicaid and Medicare.

"Under long-standing federal law, those seeking to immigrate to the United States must show they can support themselves financially," DHS Secretary Kirstjen Nielsen said by statement. "This proposed rule will implement a law passed by Congress intended to promote immigrant self-sufficiency and protect finite resources by ensuring that they are not likely to become burdens on American taxpayers."

The rule has a 60-day comment period.

OUR TAKE

Denying legal immigrants equal access to Medicaid and other critical safety-net programs will have a negative effect on the health of these families and on hospitals.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com