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NCCHCA Statement on Public Charge Rule

Friday, October 12, 2018

Contact: Ben Money, CEO
(919) 469-5701
North Carolina Community Health Center Association
4917 Waters Edge Drive, Suite 165
Raleigh, North Carolina 27606

On October 10th, 2018, the Trump Administration posted a proposed rule that would broaden the definition of “public charge”—a designation used to determine whether an immigrant applying for legal permanent residence status or admission to the United States should be granted that status.  The expanded public charge proposal is cause for profound concern among Community Health Centers (CHCs) and the 28 million patients they serve. The North Carolina Community Health Center Association fears the proposal will impose additional barriers – real and perceived – to services immigrant families need to maintain their health and the public health and well-being of the communities in which they reside.

Many patients served by health centers work in service sector jobs requiring close interaction with others.  Imposing barriers and disincentives for this population to seek preventive and primary health care services would have a negative impact on local businesses and economies and could make it more difficult to control communicable disease outbreaks. Since women make up 80 percent of all single-parent households, women are at an increased risk of being determined a ‘public charge’ based on their household size. Children are at an increased risk of being determined a public charge due to their age and greater likelihood of accessing receipt of public benefits such as Medicaid and food stamps.  Children would be at additional risk if CHIP was added to the list of services that make someone a public charge; therefore The North Carolina Community Health Center Association also asks that participation in the Children’s Health Insurance Program not be considered in the determination of public charge.

The Community Health Center mission is to provide cost effective, quality health care in areas where economic, geographic, or cultural barriers limit access to affordable health care services. We recognize the importance of population health and the role that access to affordable health care plays in maintaining and improving the health of communities, as well as empowering individuals to engage in employment and strengthen our state’s economy. This rule, if enacted as written, would likely prevent individuals from accessing services that are important for their health and well-being as well as that of the community of which they are a part. Expansion of the public charge rule is expected to decreased participation in Medicaid, the Supplemental Nutrition Assistance Program, the Medicare Part D Low-Income Subsidy Program, and housing programs. Such reductions would contribute to more uninsured individuals, less control of communicable diseases, and negatively affect the health and financial stability of communities.

This proposed rule works against our efforts to improve the health and economic well-being of everyone in North Carolina. We ask that the Administration reconsider this effort immediately and work with us to maintain access to preventive and primary care services for Community Health Center patients their communities.

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