Biden rule eases access to healthcare for immigrants

President Joe Biden’s administration has published a new rule designed to ensure that noncitizens can access healthcare services without harmful immigration consequences.

The Department of Homeland Security said Thursday it will not penalize noncitizens who try to utilize health-related benefits, including most Medicaid benefits and the Children’s Health Insurance Program.

Advocates for the rights of immigrants cheered the move, and federal healthcare leaders said the policy makes sense to protect public health more broadly.

U.S. Health and Human Services Secretary Xavier Becerra said in a statement that the rule is a step in protecting noncitizens, and all Americans.

“People who qualify for Medicaid, CHIP, and other health programs should receive the care they need without fear of jeopardizing their immigration status,” Becerra said in a statement. “As we have experienced with COVID, it’s in the interest of all Americans when we utilize the health care and other services at our disposal to improve public health for everyone.”

The Biden administration has reversed the policy implemented by former President Donald Trump’s administration.

Trump’s policy made it more difficult for noncitizens to become legal residents. The Biden administration said the Trump policy deterred people from pursuing health benefits because they were frightened of jeopardizing their immigration status.

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The Urban Institute conducted a study which found that one in five immigrant adults in families with children avoided public benefits in 2020 due to concerns about their immigration status. Immigrants most frequently reported they didn’t seek food assistance, Medicaid and CHIP benefits.

The final rule applies to noncitizens requesting admission to the U.S. or applying for legal permanent residence, or a “green card”, the Biden administration said.

There are about 22 million noncitizens in the United States, according to estimates by the U.S. Census Bureau. Roughly four in 10 (42%) of undocumented immigrants lack health insurance, the Kaiser Family Foundation says.

The new rule takes effect Dec. 23, 2022. The health and human services department said the rule doesn’t allow more people to enroll in Medicaid, CHIP or other programs, but clarifies federal policy regarding recipients of benefits.

Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, said the agency will work to ensure all qualified recipients have access to federal healthcare programs.

“This final rule reinforces a core principle of the Biden-Harris Administration: that healthcare is a right, not a privilege, and no one should be deterred from accessing the care they need out of fear,” Brooks-LaSure said in a statement.

Melanie Fontes Rainer, acting director of the HHS Office for Civil Rights, said in a statement Thursday that federal laws “require that all people be afforded fair and just decisions when applying for health benefits and other supplemental government services, free of bias, stigma, and discrimination.”

“Today’s rule sets up safeguards to help ensure that people with disabilities and older adults who are not U.S. citizens can access health care without fear,” Rainer said.

The Trump administration factored in Medicaid, housing and other benefits to determine if immigrants seeking to stay in America were likely to become a “public charge,” or dependent on the government for assistance. Critics derided the policy as a wealth test for immigration and said it kept immigrants from accessing health benefits for fear of jeopardizing their status.

The federal government moved away from the Trump policy after Biden took office. Still, immigration and public health groups said the Biden administration’s new policy is significant.

Jeremy McKinney, president of the American Immigration Lawyers Association, said the new rule will help ensure those who are eligible get healthcare.

“Research and anecdotal evidence showed us that the public charge regulation caused such fear among immigrants who sought to legally apply for a green card that many chose to forego health care and vital economic support,” McKinney said in a statement. “Family members eligible for assistance didn’t receive that help because of deep concern that it would mean an end to their American Dream. These changes to simplify and de-mystify the rule will truly change lives across our nation.”

While advocates welcomed the step, some, including the Migration Policy Institute, said the federal government will need to employ a strong educational effort to ensure immigrants know they can access healthcare and other needed services. The outreach effort should incorporate messengers trusted by immigrant communities, including local leaders and nonprofit organizations.

A coalition of 21 attorneys general from around the country filed a letter supporting the Biden administration’s policy.

California Attorney General Rob Bonta said in April, “Public programs are a key part of supporting the well-being of our neighborhoods. Our immigrant communities should know that they can and should access them if they are in need. During this pandemic in particular, we’ve seen firsthand that — no matter where you come from — our health and safety is interconnected.”