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.
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    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.
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    Medicaid considered a public benefit.
    Therefore, receipt of the benefit will be considered a negative
    factor during public charge determinations.
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    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
 
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    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
    assistance.
 - Resources
 
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.
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    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.
 
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    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
    threshold.
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    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.
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    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
    household.
 - 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.
 
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    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.
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    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.


