Opposing policies that threaten access to care and coverage

Anthony Barrueta
Anthony Barrueta
By Anthony Barrueta, Senior Vice President, Government Relations, Kaiser Permanente

Imagine for a moment a mother who moved to the United States from Guatemala to create a better life for her children. After years of hard work, she is now eligible to apply to become a permanent resident.

Unexpectedly she loses her job, and with it, her employer-sponsored health coverage. She has a heart condition that requires medication and ongoing monitoring from her doctor, which would be nearly impossible to afford without health coverage.

Her doctor tells her she’s eligible to enroll in Medicaid, but she’s scared. She heard that under a new rule, her participation in the program would threaten her application for permanent resident status.

What should she do? What would you do?

A new policy threatens access to affordable care and coverage for legal immigrants

A rule finalized today by the Department of Homeland Security will make situations like this a reality for millions of immigrants who reside in the U.S. legally. The so-called public charge rule expands the criteria used by DHS to determine whether a person is likely to rely on public assistance through programs like Medicaid, food stamps, or housing assistance.

In December 2018, we submitted comments to DHS urging the agency to withdraw the proposed rule, and we joined dozens of advocacy groups to publicly voice our opposition. We outlined our concern that this proposal would require people to avoid care and coverage for which they are eligible, leading to families missing out on preventive care and vaccinations and relying on emergency rooms when they get sick.

A notable exclusion in the final rule is that Medicaid benefits received by children under age 21 and pregnant women will not be considered in public charge determinations. Low-income people receiving subsidies to defray the cost of prescription drugs through Medicare Part D are also excluded. This is a change from the proposed rule and a testament to the importance of raising our voices through the public comment process.

We’re committed to protecting the health of all people in our communities

At Kaiser Permanente, we are concerned by any loss of access to care and coverage. This rule directly affects our providers’ ability to deliver that care and coverage — especially to some of the 1 million people across our regions enrolled in Kaiser Permanente Medicaid programs.

We also recognize that excellent medical care alone is not enough to create healthy communities; the social, economic, and environmental determinants of health play a significant role. That’s why we’re working to create health-promoting physical, social, and economic environments by partnering with community groups and clinics to enroll eligible people in nutrition assistance programs, and why we support investments in safe, stable, and affordable housing.

We’ll continue to monitor this rule as it is challenged in the courts. And we won’t stop advocating for access to affordable, high-quality care and coverage on behalf of all who reside in our communities.

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