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Federal and State Healthcare Policy Update New Proposed Rule: Public Charge Who is a Public Charge? An individual who is likely to become primarily dependent on the government for subsistence, as demonstrated by either the receipt of


  1. Federal and State Healthcare Policy Update

  2. New Proposed Rule: Public Charge

  3. Who is a “Public Charge”? An individual who is likely to become primarily dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense (U.S. Citizenship and Immigration Services)

  4. What is in the Proposed Rule? Traditional Earlier Leaked Final Proposed Versions Rule • Public Cash • Retroactive • Medicaid, Assistance Medicare • Medicaid, (e.g., SSI, Part D, CHIP, SNAP, TANF) SNAP, ACA, WIC, Housing • Long-term Head Start, assistance, Care Earned- energy income tax assistance credits, housing, • CHIP??? other federal, (still on the state & local table; benefits requesting comments)

  5. Current Proposed Rule Would Not Consider: § Disaster relief § Emergency medical assistance § Entirely state, local, or tribal programs § Education, child development, employment, and job training programs § Pell grants § Benefits received by active duty/reserve service member

  6. Anticipated Effects on Health § One million immigrants are expected to drop Medicaid (chilling effect) Increased ED use, uncompensated care costs § § Increased administrative burden on providers § Endanger maternal and infant health Heighten risk of infectious disease epidemics § Shift major health care costs from the federal § government to state and local governments

  7. In Opposition • National WIC Association • American Hospital Association • American Public Health Association (APHA) • Families USA • American Academy of Family Physicians • American Academy of Pediatrics • American College of Obstetricians & Gynecologists • American College of Physicians • American Psychiatric Association

  8. California Legislative Update

  9. Update from August: SB 1288 § Senator Connie Leyva (D-Chino) § Minimum nurse-to-patient ratios ü 1:1 in Operating Rooms ü 1:2 in ICUs ü 1:5 in General Med/Surge Units § Now: Corrective plans rather than monetary penalties for nurse staffing violations § Future: Up to $125,000 in penalties for violations

  10. Update from August: SB 910 § Bans issuing, selling, renewing, or offering “short- term” plans in CA starting January 1, 2019 § Senator Ed Hernandez (D-West Covina) § Already banned in New York § Maryland, Vermont, Hawaii just signed bills limiting short-term plans to three months § Support: Blue Shield of California, Kaiser Permanente § Oppose: Anthem Blue Cross

  11. SB 1152: Homeless Patient Discharge § Starts July 1, 2019 § Develop a written plan for coordinating services and referrals when discharging homeless patients § Maintain log of discharged homeless patients and their destination

  12. AB 3032: Maternal Mental Health § Hospitals must develop and implement maternal mental health program by January 1, 2020 § AB 2193 requires physicians to screen maternal mental health disorders starting July 1, 2019

  13. AB 2798: Hospital Licensing § CA Department of Public Health (DPH) to develop an automated application system by December 31, 2019 § CPH to approve hospitals’ application to modify, add, or expand service/program within 100 days of receipt

  14. AB 2679: Linen Laundry Process § Requires hospitals to adopt and implement modern linen laundry processing policy by January 1, 2020

  15. THANK YOU! Any other questions? helenjung@llu.edu or ihpl@llu.edu Let us know what topics you would like for us to cover next!

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