{"id":4171,"date":"2019-01-16T07:15:09","date_gmt":"2019-01-16T13:15:09","guid":{"rendered":"https:\/\/wwwqa.cencalhealth.org\/?p=4171"},"modified":"2023-03-24T00:11:51","modified_gmt":"2023-03-24T05:11:51","slug":"trump-tax","status":"publish","type":"post","link":"https:\/\/wwwqa.cencalhealth.org\/news\/2019\/01\/trump-tax\/","title":{"rendered":"Providers Walk \u2018Fine Line\u2019 Between Informing And Scaring Immigrant Patients"},"content":{"rendered":"

Some doctors and clinics are proactively informing patients about a proposed policy that could jeopardize the legal status of immigrants who use public benefit programs such as Medicaid. Others argue that because this \u201cpublic charge\u201d proposal isn\u2019t final \u2014 and may never be adopted \u2014 disseminating too much information could create unnecessary alarm and cause some patients to drop benefits. (Heidi de Marco\/KHN)<\/span><\/p>\n

By Ana B. Ibarra \/ California Healthline<\/p>\n

While the Trump administration decides whether to adopt a controversial policy that could jeopardize the legal status of immigrants who use public programs such as Medicaid, doctors and clinics are torn between informing patients about the potential risks and unnecessarily scaring them into dropping their coverage or avoiding care.<\/p>\n

\u201cWe are walking a fine line,\u201d said Tara McCollum Plese, chief external affairs officer at the\u00a0Arizona Alliance for Community Health Centers<\/a>, which represents 176 clinics. \u201cUntil there is confirmation this indeed is going to be the policy, we don\u2019t want to add to the angst and the concern.\u201d<\/p>\n

However, if immigrants do come to a clinic wondering whether using Medicaid can affect their legal status, trained staff members will answer their questions, she said.<\/p>\n

Other providers prefer to prepare their patients proactively in case the proposal is adopted. At Asian Health Services, a clinic group that serves Alameda County, Calif., staff members pass out fact sheets about the proposed changes, provide updates via their patient newsletter and host workshops where patients can speak to legal experts in several Asian languages.<\/p>\n

\u201cWe can\u2019t just sit back and watch,\u201d said CEO Sherry Hirota. \u201cWe allocate\u00a0resources<\/a>\u00a0to this because that\u2019s part of our job as a community health center \u2014 to be there not only when they\u2019re covered, but to be there always,\u201d even when that coverage is in jeopardy, she said.<\/p>\n

The\u00a0proposed \u201cpublic charge\u201d rule<\/a>, which is awaiting final action by the U.S. Department of Homeland Security, would allow the federal government to consider immigrants\u2019 use of an expanded list of public benefit programs including Medicaid, CalFresh and Section 8 housing as a reason to deny lawful permanent residency \u2014 also known as\u00a0green card status<\/a>. Medicaid is the state-federal health insurance program for low-income people.<\/p>\n

Currently, people are considered public charges if they rely on cash assistance (Temporary Assistance for Needy Families or Supplemental Security Income) or need\u00a0federal help<\/a>\u00a0paying for long-term care.<\/p>\n

Should the rule go into effect, it could force patients to choose between health care and their chance at a green card, McCollum Plese said. \u201cAnd most people will probably not take the services,\u201d she said.<\/p>\n

The rule would not be retroactive, meaning it wouldn\u2019t take into account past use of public benefits like Medicaid, according to legal experts.<\/p>\n

But health centers and medical providers know that if they tell patients about it now, they risk scaring some of them into premature decisions about their benefits, including dropping coverage.<\/p>\n

Some\u00a0immigrant patients already are skipping medical appointments<\/a>\u00a0out of fear stoked by the proposed rule, providers and advocates report.<\/p>\n

\u201cFor now, our focus has been on correcting misinformation, not necessarily raising awareness among those who haven\u2019t heard about the potential changes,\u201d said Erin Pak, CEO of\u00a0KHEIR Center,<\/a>\u00a0a clinic group with three locations in Los Angeles. \u201cThis is a proposal that thrives on fear and misunderstanding, so we wanted to be thoughtful about how and when to engage patients on the issue, given that nothing has passed into law.\u201d<\/p>\n

The Department of Homeland Security is reviewing\u00a0more than 200,000<\/a>\u00a0comments from the public before it issues a final rule. It\u2019s possible the department won\u2019t adopt the rule at all, legal experts say.<\/p>\n

At KHEIR Center, the patient population is predominantly Korean immigrants, a group that is highly aware of the proposed public charge rule because of the coverage it has received in Korean-language media, according to Kirby Van Amburgh, the center\u2019s director of external affairs.<\/p>\n

Other groups served by the clinic, such as Latino and Bengali immigrants, have asked few questions, she said.<\/p>\n

Trained staff address patients\u2019 questions one-on-one, and hand out a\u00a0fact sheet<\/a>\u00a0when needed.<\/p>\n

Last month, L.A. Care health plan, which covers more than 2 million Medicaid enrollees in Los Angeles County, hosted a public charge webinar for about 180 providers. David Kane, an attorney at Neighborhood Legal Services of Los Angeles, led the webinar and urged doctors to tell concerned patients that nothing has changed yet, and that most immigrants would not be affected.<\/p>\n

He also explained that if the federal government adopts the rule, it would not be effective immediately. There would most likely be a 60-day grace period before the changes take effect, Kane said. After that, implementation could be further delayed in court.<\/p>\n

John Baackes, CEO of L.A. Care, who has been critical of the public charge proposal, said his organization offered the webinar because of the estimated 170,000 legal immigrants on his plan who could potentially be affected.<\/p>\n

\u201cI think we\u2019ve got to let people know what could come, and try to give them more accurate information so that they don\u2019t act imprudently,\u201d he said. To do that, \u201cwe have to stay current.\u201d<\/p>\n

<\/div>\n

Ana B. Ibarra:\u00a0<\/span>aibarra@kff.org<\/a>,\u00a0@ab_ibarra<\/a><\/p>\n

<\/div>\n

This\u00a0KHN<\/a>\u00a0story first published on\u00a0California Healthline<\/a>, a service of the\u00a0California Health Care Foundation<\/a>.<\/p>\n

Kaiser Health News<\/a>\u00a0(KHN) is a national health policy news service.
\nIt is an editorially independent program of the\u00a0Henry J. Kaiser Family Foundation<\/a>\u00a0which is not affiliated with Kaiser Permanente.<\/p>\n","protected":false},"excerpt":{"rendered":"

Some doctors and clinics are proactively informing patients about a proposed policy that could jeopardize the legal status of immigrants who use public benefit programs such as Medicaid. Others argue that because this \u201cpublic charge\u201d proposal isn\u2019t final \u2014 and may never be adopted \u2014 disseminating too much information could create unnecessary alarm and cause […]<\/p>\n","protected":false},"author":1,"featured_media":4177,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"categories":[5,7],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/4171"}],"collection":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/comments?post=4171"}],"version-history":[{"count":4,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/4171\/revisions"}],"predecessor-version":[{"id":4197,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/4171\/revisions\/4197"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/media\/4177"}],"wp:attachment":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/media?parent=4171"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/categories?post=4171"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/tags?post=4171"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}