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Health Updates for Jan. 31, 2020

Public Charge

On Jan. 30, 2020  the U.S. Citizenship and Immigration Services (USCIS) announced it will implement the Inadmissibility on Public Charge Grounds final rule on Feb. 24, 2020. The final rule will apply only to applications and petitions postmarked (or submitted electronically) on or after Feb.24, 2020 and  will only consider federal Medicaid, SNAP or federal housing benefits received after Feb. 24, 2020. It will post updated forms and instructions related to the new public charge rule during the week of Feb. 3, 2020. (The final rule is still enjoined in Illinois, but the nation-wide injunction was lifted Jan 27, 2020).

Protecting Immigrant Families –MA is planning a webinar soon, and meanwhile is asking interested people to submit their questions in advance here

For attorneys: PIF-MA will provide a public charge training in early March specifically for attorneys representing immigrants who could be subject to the rule after Feb 24, 2020. Contact or to sign up for this training. 

We have updated  MA  flyers on Public Charge and Nutrition Programs & Public Charge and Health Programs

The litigation is on-going on an expedited track. Our litigation tracker along with other links and resources on public charge are posted here:

Stay informed. Fight fear with facts. 

Medicaid Block Grants

On Jan. 30, 2020 the Centers for Medicare and Medicaid Services (CMS) issued guidance encouraging states to apply for 1115 waivers to block grant Medicaid funding at the state level. There is a good summary of the proposal from Kaiser Health News here:

In objecting to proposals to repeal the ACA and replace Medicaid with block grants in 2017, Governor Baker  recognized the danger the block granting poses for the states. He wrote then:

“While we strongly support maintaining and increasing flexibility for states (such as through existing Section 1115 waiver authorities), proposals that suggest states be provided with more flexibility and control must not result in substantial and destabilizing cost shift to states. We are very concerned that a shift to block grants or per capita caps for Medicaid would remove flexibility from states as the result of reduced federal funding. States would most likely make decisions based mainly on fiscal reasons rather than the health care needs of vulnerable populations and the stability of the insurance market.”


In 2018, CMS issued  guidance encouraging states to submit 1115 demonstrations to impose work requirements in Medicaid. Some states took CMS up on the offer only to find these demonstrations blocked by the courts. 

While MA advocates will have to be vigilant, let’s hope MA officials are too smart to fall for the bait of “increased flexibility” to cut benefits and legal protections for Medicaid beneficiaries. 

Fiscal Accountability proposed rule comment deadline Feb 1, 2020

And while CMS is all about increased flexibility for state Medicaid programs to restrict access to health coverage, it has proposed a highly technical rule that will restrict state flexibility to fund the non-federal share of costs of the Medicaid program.  The extended comment deadline on the proposed rule is tomorrow Feb 1, 2020. 

A good summary of the rule and what’s at stake for states is here:

While the details of this rule get into realms with which most beneficiary advocates are unfamiliar, we can weigh in on the importance of Medicaid and the harm to beneficiaries if state funding mechanisms are restricted. Community Catalyst has produced this template for comments. MLRI’s comments were filed today and attached. 


Temporary Census Work

 MLRI has a new Q & A on how MassHealth treats temporary census earnings.

File Attachment: 
PDF icon MLRI_fiscal_NPR_comments_Jan3120.pdf42.69 KB