Federal Regulatory Actions Threaten the Health of Low-Income Californians
Federal regulatory activity over the past year has continued to target immigrants and low-income households. These proposed or final policies — including public charge, changing the poverty measure inflation factor, and requiring immigration status verification for households receiving housing assistance — fundamentally erode and disincentivize receipt of public services that are critical for the health and well-being of the nation’s most vulnerable populations. California’s local plans are concerned about the harmful impacts these three sweeping policies will have on their beneficiaries and the communities in which they live.
See below for summaries of these proposed or final rules and LHPC’s comment letters on each.
Public Charge Final Rule Dissuades Immigrants from Seeking Necessary Care
Under the public charge rule, the federal government may deny legal permanent resident status or deny entry into the U.S. based on a determination of whether the individual is likely to become a public charge. While this has been a longstanding policy, the Department of Homeland Security’s Final Rule — effective Oct. 15, 2019 — drastically expands what is considered in public charge determinations.
Definition. Public charge means an
immigrant who receives one or more public benefits for more
than 12 months in the aggregate within any 36-month period.
Medicaid considered a public benefit.
Therefore, receipt of the benefit will be considered a negative
factor during public charge determinations.
Exceptions. The Final Rule includes
exceptions to considering Medicaid in public charge
determinations. Notable exceptions include:
- Receipt of emergency Medicaid
- Medicaid benefits received by individuals under the age of 21
- Medicaid benefits received by a woman during pregnancy and during the 60-day period postpartum
- Services or benefits funded by Medicaid but provided under the Individuals with Disabilities Education Act
Other benefits to be considered.
Other federally funded benefits that will be considered in
public charge determinations include Supplemental Security
Income, cash assistance, food stamps and housing
Read LHPC’s comment letter on the public charge proposed rule.
Proposed Rule Regarding Changes to Poverty Measure Inflation Factor Would Shrink Eligibility for Public Programs
In May, the President’s Office of Management and Budget released a request for comment regarding potential changes to the methodology for calculating inflation that is applied annually to the poverty threshold, or the Official Poverty Measure (OPM). Namely, the federal Administration is considering changing from its longstanding use of the Consumer Price Index (CPI) for all Urban Consumers to chained CPI.
Summary of chained CPI. Unlike the
CPI for all Urban Consumers, chained CPI assumes that consumers
generally change their purchasing behaviors to switch to lower
cost goods when the cost of comparable goods rise at different
rates. Experts have longstanding concerns about the accuracy of
chained CPI for low-income and elderly households.
- Impact of Chained CPI on the OPM. It is anticipated that the OPM will grow at a slower rate if chained CPI is adopted. In 2013, when the federal Administration last contemplated changing the OPM inflation factor, the Congressional Budget Office estimated that the chained CPI would result in an average of 0.25 percentage points less than annual adjustments to the OPM using the CPI.
Use of the OPM by the U.S. Department of Health and
Human Services (HHS). Changing the inflation
measure applied to the OPM could have significant impacts on
eligibility for public programs. Each year, HHS publishes
poverty guidelines that dictate eligibility for dozens of
federal programs using the inflation-adjusted poverty
Federal programs that use the HHS poverty
guidelines. Medicaid, the Children’s Health
Insurance Program (CHIP), Head Start, the Supplemental
Nutrition Assistance Program (SNAP), the National School Lunch
Program, and many state and local programs use the HHS poverty
guidelines to determine eligibility guidelines.
- Request for comment on the Federal Register
Read LHPC’s comment letter on the poverty measure inflation factor proposed rule.
Proposed Rule Requiring Verification of Eligible Status for Households Receiving Housing Assistance Could Spur Increase in Homelessness
The U.S. Department of Housing and Urban Development (HUD) proposed rule requires every member of a household that receives federal housing assistance to verify his or her legal immigration status for the household to receive any subsidy or assistance.
Existing process. Current rules
require that financial assistance to mixed households be
prorated based on the number of eligible individuals in the
family. Therefore, total household assistance is calculated by
the number of confirmed eligible individuals in the
- Change to affirmative verification. All members of a household will be required to provide verification of eligible immigration status. Households that currently receive prorated assistance based on the number of verified citizens or eligible non-citizens (“mixed households”) in a household would no longer receive this assistance if even one member of their household does not affirmatively verify eligibility.
Impact on children. Nationally, over
55,000 citizen children living in mixed households may face
eviction as a result of the proposed rule. California families
and children would be disproportionately impacted, as the HUD
analysis estimates that 37 percent of mixed families receiving
housing assistance live in our state.
Impact on homelessness. The HUD
analysis acknowledges that homelessness could be an impact of
the rule, particularly in tight housing markets. This would be
particularly problematic for California households, where
vacancy rates are at a 30-year low.
- Proposed Rule on the Federal Register
Read LHPC’s comment letter on the verification of eligible status proposed rule.