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Consumers Seeking Marketplace Coverage Should Not Fear “Public Charge” Rule

November 15, 2018 at 4:30 PM

The Trump Administration’s proposal to radically change immigration rules relating to “public charge” determinations has understandably stoked fears about how applying for public benefit programs could affect peoples’ current or future immigration status. But with about a month left in the open enrollment period for the Affordable Care Act (ACA) marketplaces, consumers who are thinking about enrolling in a marketplace plan shouldn’t let this proposed change deter them.

The public charge rule that the Department of Homeland Security issued for public comment would make it much harder for many immigrants lawfully in the country to remain here and for many seeking legal entry to come. It directs immigration officials to reject applications from individuals who seek lawful permanent resident status, or seek to enter the United States, if they have received — or are judged likely to receive in the future — any of an extensive array of benefits tied to need, including Medicaid. Due, in recent months, to rumors that the rule was coming and reports about draft policies, families that include immigrants avoided or withdrew from a variety of public benefit programs even though they were eligible for them.

Although the proposed public charge requirements are complex and confusing, marketplace subsidies aren’t among the benefits that would drive a rejection of an immigration application under this proposed policy. And there are many reasons why families should consider applying on the ACA marketplaces before the December 15 deadline for both health coverage and subsidies that help reduce premiums and out-of-pocket costs.

Health plans available on the ACA marketplaces provide peace of mind to families by protecting them against catastrophic medical costs and financial harm if they’re injured or get sick. The plans offer a comprehensive set of essential health benefits (such as prescriptions and doctor visits, maternity care, and mental health treatment), and all enrollees get preventive benefits (such as annual checkups) at no cost.

Nor should families seeking to change their immigration status in the United States fear that immigration problems could arise if they apply for marketplace subsidies and are instead found eligible for Medicaid. While Medicaid is a program that could affect people’s immigration status under the proposed rule, and applying for marketplace subsidies can trigger eligibility screenings for Medicaid, that should not stop people from applying. The proposed rule specifies that using Medicaid benefits (other than to pay for long-term care in an institution such as a nursing home) would not factor into a person’s application for immigration status within the United States for 60 days after the rule is finalized, and the rule is far from being finalized.

All families that need health coverage, including those that include immigrants, should take advantage of the ACA marketplaces before open enrollment ends.


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