Health Insurers Want Out of Legal Immigrant Eligibility Cases

A health insurer group wants the U.S. Department of Homeland Security to keep legal use of public health insurance programs out of immigration eligibility decisions.

America’s Health Insurance Plans AHIP) has filed a comment letter asking the department to continue to exclude use of those programs when deciding whether legal immigrants are likely to become “public charges,” or people who rely on government welfare programs to survive.

(Related: Trump Immigration Draft Leaves Out ACA Exchange Subsidies)

Keith Fontenot, AHIP’s new executive vice president of policy and strategy, wrote the letter, in response to draft public charge regulations that the Homeland Security Department released in September.

“The proposed rule is inconsistent with the nation’s goal of encouraging a healthier population,” Fontenot writes. “The proposed rule would discourage people from obtaining the health coverage they are legally permitted to receive.”

Any efforts to discourage people, including legal immigrants, from getting care are likely to make chronic health problems worse, increase the odds that uninsured people will end up in emergency rooms, and push doctors and hospitals to provide more uncompensated care, Fontenot writes.

The economic analysis in the September draft includes only a look at federal government costs related to immigration processes, Fontenot adds.

AHIP believes a complete analysis would show that the proposed rule could increase state health care spending, and also increase individual and group major medical premiums, Fontenot writes.

A Public Charge Primer

U.S. immigration laws and regulations already require would-be immigrants to show that they are unlikely to end up needing to use benefits from the government-funded programs that help the poor.

But immigration courts have been relying on a semiformal definition of the term “public charge” that was developed in 1999.

The U.S. Citizenship and Immigration Services (USCIS), an arm of the Homeland Security Department, posted draft regulations in September. Under the current rules, immigration courts look mainly at whether people seem likely to end up needing Medicaid nursing home benefits.