Hospital groups: ‘Public charge’ rule could drive up costs 

The Trump administration’s proposed “public charge” rule could have significant healthcare consequences, according to two top hospital groups. 

The Department of Homeland Security has issued a proposed rule that would make it harder for legal immigrants to obtain visas or green cards if they’ve been on public assistance programs, including Medicaid and subsidies in Medicare Part D. 

But those changes, according to America’s Essential Hospitals, would likely push patients to avoid seeking care, and could especially harm facilities that treat large numbers of immigrants, including safety-net hospitals. 

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“By creating a strong disincentive to seek care, this rule would force people to forgo medical visits and medications until they are sicker and costlier to treat,” Bruce Siegel, president of AEH, said. “It would drive higher levels of uncompensated hospital care and, ultimately, higher costs for insured patients and taxpayers.”

In a statement, the American Hospital Association concurred with the concern the change would drive up costs.

"Forgoing care can exacerbate medical conditions leading to sicker patients and a higher reliance on hospital emergency departments. In turn, this could drive up costs for all purchasers of care," AHA CEO Rick Pollack said.

Secretary of Homeland Security Kirstjen Nielsen told Reuters in a statement the proposed rule follows federal law that requires immigrants show they can support themselves financially.

“This proposed rule will implement a law passed by Congress intended to promote immigrant self-sufficiency and protect finite resources by ensuring that they are not likely to become burdens on American taxpayers," Nielsen said. 

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