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 Legislation and Policy

Public Comment Period Begins for Public Charge Proposed Rule
Last week the U.S. Department of Homeland Security (DHS) published a proposed rule, "Inadmissibility on Public Charge Grounds," in the Federal Register that would expand the types of federal benefits that DHS considers in determining if a person applying for his or her legal permanent residency (also known as a "green card") is likely to become a public charge. AMCHP previously released a statement about the expected impact of the proposed rule, citing concerns about families' decreased access to health care.

The proposed rule is open for public comment for 60 days from the date it was published in the Federal Register on Oct. 10. Comments may be submitted via the online docket on or before Dec. 10.

The proposed rule would expand consideration of public charge determinations to include the following federal programs that are currently excluded from such consideration: Medicaid, the Supplemental Nutrition Assistance Program, the Medicare Part D Low-Income Subsidy Program, and several housing programs. The proposed rule also seeks comment on adding the Children's Health Insurance Program (CHIP) to the list of programs considered during public charge determinations.

In its proposal, DHS identifies several possible consequences of the rule, including "worse health outcomes, including increased prevalence of obesity and malnutrition, especially for pregnant or breastfeeding women, infants, or children."

For further analysis of the proposed rule, see the Kaiser Family Foundation's fact sheet and issue brief on estimated impacts.

New Federal Bill Focused on Rural Maternal Health
Last week Sen. Heidi Heitkamp (D-N.D.) introduced legislation to improve maternal and obstetric care in rural areas, the Rural Maternal and Obstetric Modernization of Services (MOMS) Act (S. 3568). The bill would authorize $3 million dollars for each of fiscal years 2019-2023 to establish rural obstetric health collaborative improvement and innovation networks (CoIINs) through the Special Projects of Regional and National Significance (SPRANS) portion of the Title V Maternal and Child Health (MCH) Services Block Grant. This funding would be in addition to funds otherwise appropriated for the Title V MCH Services Block Grant. The bill would also: add a focus on maternal and obstetric care to existing federal telehealth programs; create a demonstration grant program to support training for rural maternal and obstetric care providers; and direct the Government Accountability Office to issue a report on maternal and obstetric care in rural areas.