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Immigrant Eligibility for Publicly Funded Health Care Benefits - CHANGES OCTOBER 15, 2019

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Posted: 06 Mar, 2009
by Cathy Roberts (Empire Justice Center)
Updated: 04 Oct, 2019
by Valerie Bogart (New York Legal Assistance Group)

AUGUST 2019 ALERT - Trump Administration Finalizes "Public Charge" Rule Changes - Going Into Effect Oct. 15, 2019

On Monday August 12, 2019, the Department of Homeland Security finalized a rule that dramatically expands the "public charge" immigration policy.  The changes will apply only to applications that are postmarked or submitted electronically on or after October 15, 2019.   They change the definition for deciding whether an immigrant  who receives Medicaid or other government benefits is considered a "public charge" -- which can result in denial of Lawful Permanent Resident status (green card),  denial of an extension of a non-immigrant visa,  deny a change  of non-immigrant status (e.g., from a student visa to an employment visa), or deny admission to the U.S. 

 Please see these fact sheets and web sites of national organizations for more information about these rules:


​​​​​​​A few take aways - but see more in the fact sheets and websites above: 

  • Certain immigrants --such as refugees, asylees, survivors of domestic violence, Temporary Protected Status (TPS), and other protected groups --are not subject to public charge determinations and are not  affected by this proposed rule.  Public charge is also not a consideration when lawful permanent residents (green card holders) apply to become U.S. citizens.   

  • Before, only receipt of cash assistance (public assistance and SSI) and Medicaid for nursing home care were considered in determining who is likely to become a "public charge."   The  rule will now also include these new benefits, but only when received after Oct. 15, 2019:

    • Medicaid (federally funded only - see note below re  State PRUCOL Medicaid in NYS)(with limited exceptions for pregnant women and children and emergency Medicaid for undocumented immigrants) -   The rule will not consider treatment of an emergency medical condition as constituting a public charge. 

    • Supplemental Nutrition Assistance Program (SNAP);

    • Housing assistance, such as public housing or Section 8 

  • Medicaid in NYS --  (Correction 8/27/19) Immigrants who are not Lawful Permanent Residents but who reside in NYS with the knowledge and acquiescence of the government are  eligible for considered PRUCOL and are eligible for state-funded health insurance. See this article.   
    • Many PRUCOL immigrants are in the Essential Plan, not in Medicaid.  The Essential Plan covers most health benefits but not long-term care. The Essential Plan will not be considered in the public charge determination. 
    • Since the Essential Plan does not cover long-term care, seniors and people with disabilities who are PRUCOL and who need long-term care must receive Medicaid instead.   While  receipt of STATE-funded Medicaid alone will not be counted in the public charge determination, people receiving home care or other long-term care services may still be denied based on the totality of their circumstances.  Under the new rules, having a serious health condition and no private insurance or means for support weighs heavily against an applicant.     See  New York State of Health Medicaid and Public Charge QAs (8/16/19).  
  • Medicaid and other  benefits received by an immigrant's family members will not be considered (though since many people won't know that, there will be a chilling effect deterring many family members from receiving crucial health, income, housing and food assistance). 

  • The rule will not be retroactive. This means that benefits -- other than cash assistance or long-term care at government expense -- that are used before the rule is final and effective will not be considered in the public charge determination.

FOR HELP:  CONTACT THE  New York State New Americans Hotline for a referral to an organization to advise you.    212-419-3737   See this link about the NYS Office for New Americans.
 
Monday-Friday, from 9:00 a.m. to 8:00 p.m.
Saturday-Sunday, from 9:00 a.m. to 5:00 p.m.

Or call toll-free in New York State at 1-800-566-7636

*************************************************************************************

New York's Exchange Portal: A Gateway to Coverage for Immigrants, published 9/14/15, by Empire Justice Center reviews current rules on eligibility and describes how immigrants can access health care through NYSof Health portal, including for emergency care for those who are undocumented and not PRUCOL.   

The Community, Migrant & Homeless Health Center Handbook on an IImmigrant Eligibility for Publicly Funded Health Care Benefits written by Empire Justice Center's senior staff attorney Barbara Weiner, in collaboration with CHCANYS (the Community Health Care Association of New York State) and the Immigrant Eligibility Coverage Workgroup, is available here. (LINK WILL BE UPDATED)

Click here for an interactive Marketplace eligibility questionnaire, designed to help enrollment assistors and consumers better assess their potential eligibility for Marketplace coverage based on immigration status, age and income. This questionnaire is not an official assessment of eligibility. To receive an official determination of eligibility contact the New York State of Health Marketplace at http://www.nystateofhealth.ny.gov or 1-855-355-5777

  • This tool was created jointly by the Children's Defense Fund - New York, the Empire Justice Center, and the Community Service Society through their work in the Health Care for All New York coalition.

Note - please see 2013 updates re PRUCOL status for people applying for or granted DACA status in this article.

Also read
item Medicaid for Immigrants who are Not Permanent Residents (Do Not have "Green Cards")-- PRUCOL and Temporary Non-Immigrant Eligibility
item Emergency Medicaid in New York State - Limited Medicaid Coverage for Undocumented Immigrants
item The Language Access Resource Center - Empire Justice Center
item Temporary Protected Status (TPS) and Public Health Insurance
item Empire Justice Center Reports on Immigrant Access to Health Care in NY's Health Insurance Exchange
item Know Your Rights: NYLAG Webinars on Medicare and Medicaid -

Also listed in
folder Medicaid -> Immigrant Access

External links
http://www.wnylc.com/health/client/images/icons/article_out.svg https://protectingimmigrantfamilies.org/
http://www.wnylc.com/health/client/images/icons/article_out.svg http://www.chcanys.org/clientuploads/__2019/HCS/NYSOH_Public_Charge_Assistor_QAs_Final_081619_.pdf
http://www.wnylc.com/health/client/images/icons/article_out.svg https://www.newamericans.ny.gov/Hotline/hotline.html
http://www.wnylc.com/health/client/images/icons/article_out.svg https://www.clasp.org/publications/fact-sheet/impact-trumps-public-charge-rule-select-states

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