Trump’s alarming “Public Charge” rule attacks immigrants, threatening access to food and healthcare

The Trump administration greenlights rule despite massive public opposition

ALBUQUERQUE—Widespread, devastating impact looms as the Trump administration sidesteps Congress with “Public Charge” changes. The expanded “Public Charge” rule allows the government to deny permanent residency (green cards) and visa renewals to lawfully present immigrants who participate in basic need programs like Medicaid, housing assistance, and SNAP food assistance. The rule also adds specific requirements into the public charge test, including income, age, health and English proficiency. Advocacy groups condemn the new rule, which goes into effect October 15, 2019.

“Immigrant communities contribute so much to the cultural, civic, and economic fabric of our state and nation,” said Fabiola Landeros, a community organizer with El CENTRO de Igualdad y Derechos. “Once again the Trump administration is targeting our communities, persecuting the most vulnerable based on their economic status, and trying to minimize our political power. No family should be forced to choose between feeding their children or having access to medical care or risking family separation. In New Mexico, we value taking care of our families and neighbors. As Nuevo Mexicanos, we need to look for solutions to provide safety net services for our communities and we must fight back against Trump’s racist agenda by continuing to organize and building upon our legacy in New Mexico of supporting immigrant integration.”   

“The expanded public charge rule is an attack on all immigrants, including children and seniors who, like any working American, may need to access supplemental benefits at any point such as subsidized housing or food stamps,” said Kay Bounkeua, Executive Director of the New Mexico Asian Family Center. “The Asian population has a high rate of family sponsorships and limited English proficiency—the expanded testing will result in keeping families apart and undermine the strengths and contributions of a racially diverse community.”

Congress made many lawfully present immigrants eligible for basic needs assistance to promote economic stability. Historically, administrations of both parties have only considered receipt of cash benefits and institutional care as reasons to deny lawfully present immigrants visa renewals or to deny their application for permanent residency. 

“We have a shared responsibility to make sure no one in our community, especially children, go without basic needs,” said Teague Gonzalez, an attorney at the New Mexico Center on Law and Poverty. “Immigrants contribute exponentially more to our tax system that supports basic benefit programs than they draw in direct assistance. Trump’s new rule furthers a cruel and racist agenda meant to separate families and spread fear. It will turn the U.S. immigration system into a pay-to-play game that unfairly favors the wealthiest households.”

“We envision a vibrant New Mexico where all people—regardless of immigration status—can achieve their full potential and are treated with dignity and respect,” said Eduardo García, an attorney with the New Mexico Immigrant Law Center. “This harsh change in policy targeting immigrants goes against our core values. It is a tactic to spread fear among immigrants, discourage immigration, and harm immigrants by preventing them from having access to public resources. Further, this policy change and the ugly rhetoric behind it continue to fuel hatred, xenophobia, and racism against immigrants. Nonetheless, we will fight back and NMILC will provide guidance to people that need it.” 

“We are saddened by the Trump administration’s decision to force our country’s green card applicants to make an impossible choice between legally receiving public benefits and getting their green cards, both of which they need to succeed in our country,” said Tess Wilkes of the Santa Fe Dreamers Project. “The complexity of this rule change will discourage many eligible folks in the immigrant community from even applying for much-needed public benefits for themselves and their children, at a time when many of them already feel under attack.”

The proposed changes to public charge policy are already causing significant harm. Fear and confusion is creating a chilling effect, causing people to disenroll from programs and forgo benefits. The impact is far-reaching in New Mexico—nearly one in 10 New Mexicans is an immigrant, and one in nine have immigrant parents. Over 77,000 U.S. citizen children in New Mexico live with at least one immigrant parent and are in a family that receives basic food assistance. A Manatt Health analysis estimates that, across the country, as many as 26 million people and their families could be dissuaded from using public benefits under the proposed rule change. 

“The American spirit is rooted in the welcoming of the stranger into our communities—it is in the belief that all coming to our communities should be cared for and that everyone has the opportunity to be given the resources necessary to climb out of poverty and contribute to the community,” said James Gannon, CEO of Catholic Charities. “Throughout the history of this nation, the foreign born welcomed into our community have contributed to and strengthened the fabric of our nation, and participated in our national defense and advanced our society. Penalizing through an expansion of public-charge testing of immigrants will only lead to self-injury to the American society and our nation.” 

New Mexico stands to lose as many as 2,700 jobs and nearly $400 million in economic activity because eligible New Mexicans will forego federal benefits that flow directly into the state’s economy. Immigrant-led households in New Mexico paid $756.9 million in federal taxes and $394.3 million in state and local taxes in 2014.

“The vast majority of children in New Mexico–97%–are U.S.-born citizens. But that shouldn’t matter. Every child living in New Mexico, regardless of where they or their parents were born, deserves the healthcare, food assistance, and other benefits they’re eligible for and need in order to thrive,” said James Jimenez, executive director of New Mexico Voices for Children. “As with the family separations–which are still going on–this is an unconscionable and racist immigration policy that will have very negative, life-long consequences for children.”

“Punishing people for accepting help with food, housing, and medical care that they are eligible for, and have contributed tax dollars to, will have devastating and widespread effects on New Mexico’s communities,” added Gonzalez. “The expanded rule will push people further into poverty, separate families, and lead to overall worse health outcomes and higher rates of food insecurity in our state. We are already hearing from families who are afraid to seek help for their children.” 

For more information please see the following handouts in English and Spanish. People concerned about their benefits or immigration status should speak to an immigration attorney about the best route for families to take.
 

Memorial to expand home visiting services passed by Senate Public Affairs Committee

SANTA FE— A memorial establishing an advisory council to develop a plan for the statewide expansion of a Medicaid-financed home visiting system in New Mexico, will head to the Senate floor following a “do-pass” vote today in the Senate Public Affairs Committee. Home visiting programs provide support and critical assistance for families that range from health care to emotional and social supports at a crucial time in a child’s brain development. Senate Memorial 117, Medicaid Home Visiting Program Council, is sponsored by Senator Linda M. Lopez.

“Every child deserves the best start from birth. Nurturing our state’s youngest children is key to ensuring they grow up healthy and prepared to succeed in life,” said William Townley, attorney at the New Mexico Center on Law and Poverty. “We’re optimistic that the memorial will pass the Senate.”

If passed by the New Mexico Senate, SM 117 would convene a council of home visiting providers and heads of the Human Services Department, Children, Youth and Families Department, Department of Health, and the Children’s Cabinet to make recommendations for expanding home visiting across the state through Medicaid financing.

Research shows that home visiting helps establish a strong foundation for families so children can grow up healthier and parents can develop stronger parenting skills. Home visiting programs that currently exist in New Mexico provide a team of professionals to help families learn about healthcare, child development, and parenting skills. Other services can include screening mothers for postpartum depression, supporting breastfeeding, and connecting families to community activities.

Unfortunately, most New Mexican families do not have access to home visiting services. Most services are offered by private non-profits that cannot scale up to meet the large unmet need in the state.

“Offering education early in a child’s life is essential in helping families succeed,” said Townley. “It would be good for everyone in New Mexico if more families could access home visiting.”

Victory! Governor Moves to Stop Harmful Medicaid Cuts

VGreat news! Governor Michelle Lujan Grisham announced yesterday that her administration has asked the federal government to reverse harmful cuts in the Centennial Care 2.0 Medicaid waiver, regarding premiums, co-pays, and phasing out retroactive coverage.

With your support over the last two years, the New Mexico Center on Law and Poverty fought these drastic cuts along with other provisions in the waiver that would have reduced healthcare services for parents and caretakers living in deep poverty and New Mexico children’s ability to grow into healthy adults.

Every step of the way, we stood together to attend public hearings, share stories, make phone calls, and write comments. Our efforts worked! 

In response to our advocacy, the Human Services Department and federal government scaled back the cuts piece by piece in the past year. Governor Lujan Grisham’s decision now strikes down the last of them. Her decision aligns with our stance that these cuts would have caused thousands of low-income New Mexicans to lose healthcare coverage, shifted more costs to healthcare providers, and raised overall costs for our healthcare system and state budget.

Thank you to Governor Lujan Grisham and an especially big thank you to all of you for your advocacy to protect access to healthcare for low-income New Mexicans!

Governor reverses Medicaid cuts in Centennial Care 2.0 waiver

Advocacy efforts conclude in a victory for families


SANTA FE—Governor Michelle Lujan Grisham reversed serious cuts to New Mexico’s Medicaid program yesterday following two years of advocacy efforts by the New Mexico Center on Law and Poverty, community organizations, and healthcare providers. Under the Susana Martinez administration, New Mexico’s Human Services Department had proposed major cuts to healthcare services as part of the Centennial Care 2.0 waiver, many of which were approved by the federal Centers for Medicare and Medicaid Services in December 2018.  

The New Mexico Center on Law and Poverty led the efforts to fight the cuts that would have implemented premiums for some Medicaid patients, cut retroactive coverage, and instituted mandatory co-pays.

“We owe a huge thanks to Governor Lujan Grisham for reversing these harmful measures and to the advocates and families who fought tirelessly over the last two years for the health and wellbeing of all New Mexicans,” said Abuko D. Estrada, supervising attorney at the New Mexico Center on Law and Poverty. “Piece by piece, we’ve successfully fought the cuts in the Centennial Care 2.0 waiver that would have led to thousands of families losing healthcare coverage and shifted an unfair burden of costs to healthcare providers and the healthcare system.”  

The governor’s rejection of the waiver is the latest in a series of positive actions the new administration has taken to improve the health and wellbeing of New Mexicans. Since taking office, Lujan-Grisham has set forth plans to reach uninsured New Mexicans who are eligible for Medicaid but not enrolled and help them apply. The governor has also been publicly supportive of bills, currently working their way through the legislature, that would open up a Medicaid Buy-in option for New Mexicans who do not otherwise have access to affordable healthcare coverage.

Investment in home visits invests in our future

By William Townley, New Mexico Center on Law and Poverty Healthcare Attorney
(This op-ed appeared in the Albuquerque Journal)

Every parent knows that having a new child is incredible and wonderful, but also one of the most stressful endeavors anyone can ever hope to undertake. In New Mexico, about 27,000 children are born each year. Many of these newborns are the sons and daughters of first-time parents who are just embarking on a lifetime full of joys and the greatest of challenges.

Every child deserves the best start from birth. We know that the earliest years of our children’s lives are the most important in their social, emotional and cognitive development. Nurturing our youngest children is key to ensuring they grow up healthy and prepared to succeed in life.

But parenting is hard. And it can be especially daunting for parents who have little in resources.

Home-visiting programs can be of great help to new families, providing support and critical assistance that ranges from health care to emotional and social supports at a crucial time in a child’s brain development. 

This legislative session, our leaders have an opportunity to expand Medicaid-funded home visiting to more families statewide. Services that more New Mexicans could access include checking on the development and health of the child, screening mothers for post-partum depression, supporting breastfeeding, and connecting families to community activities.

New Mexico is already moving forward with a pilot home-visiting program for Medicaid eligible families in Bernalillo County starting in January 2019. Curry and Roosevelt counties will join the pilot later in the year. 

This pilot will implement two different models of evidence-based home visiting, Parents as Teachers and Nurse-Family Partnership, which have been found to produce higher educational and health outcomes for children. Both models measurably reduce birth complications, infant emergency medical care episodes, as well as incidence of child abuse and neglect, and successfully encourage young parents to pursue higher education and job training.

There has never been a more opportune time to invest in our children. The pilot program leverages federal funding to cover about 70 percent of the costs. If our Legislature expanded the program, our state would be able to leverage the same percentage and New Mexico could offer home visiting programs at a fraction of what it would otherwise cost the state.

For every dollar we invest in home visiting, New Mexico can save between three dollars and six dollars in remedial costs. Home visiting establishes a strong foundation for families where children can grow up healthier and safer, and parents can develop stronger parenting skills for the years to come.

We call on our governor-elect and state lawmakers to expand Medicaid-funded home visiting to all New Mexican families. We ask that you pick up the phone and do the same.

Doña Ana unanimously backs ‘Medicaid Buy-in’

County Commissioners moved by local support and statewide momentum

DONA ANA COUNTY—The Doña Ana Board of County Commissioners after hearing testimony from New Mexico Together for Healthcare family leaders who live in Doña Ana County, unanimously passed a resolution on Tuesday in favor of continuing the state’s efforts to shape a healthcare solution that would open up Medicaid for any New Mexican to buy into—regardless of their current Medicaid eligibility.

“Before I had Medicaid, I didn’t have insurance, and I was turned away when I went to the doctor,” said Maria Burciaga, a Doña Ana county resident and Strong Families New Mexico healthcare advocate. “I once saved $1500 to partially pay for a necessary treatment, but was told I could not get seen until I had the full amount, which was $4000. The expansion of Medicaid allowed me to access healthcare and get that treatment. We need to continue to pursue the Medicaid Buy-in to give even more access to even more people.”

Burciaga is part of NM Together for Healthcare, a family-driven, multi-racial campaign working statewide to provide healthcare access that is affordable to all New Mexicans.

Family leaders have been working tirelessly, reaching out to policy makers and building support in communities across New Mexico. ince July, six resolutions in support of studying a Medicaid Buy-in option have passed unanimously in local counties and city governments as well in sovereign nations across the state.

Community members, state and local experts and policymakers have become more interested in this innovative plan since the bipartisan passing of the Medicaid Buy-in memorials in the New Mexico House and Senate during the 2018 legislative session.

A Medicaid Buy-in plan would allow New Mexicans who are currently not eligible for Medicaid the option to buy into an affordable healthcare coverage plan that leverages Medicaid.

With more than 180,000 New Mexicans without health insurance, including over 25,000 Doña Ana County residents, a Medicaid Buy-in plan could substantially lower uninsured rates by utilizing the already popular and successful Medicaid model. Medicaid already covers over 830,000 New Mexicans, including over 104,000 Doña Ana County residents.

“I’m really passionate about this campaign because in 2014 I had kidney stones and couldn’t afford the surgery I needed, until I was able to access Medicaid. Without Medicaid, I would have had to take out a loan to cover the expenses and I would have gone into debt,” said Burciaga. “Having Medicaid has helped me to address my healthcare issues, and everyone should be able to afford to do this.”

The Doña Ana Board of County Commissioners will include this resolution in their legislative requests for the upcoming 2019 session and share the resolution with state legislators.

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NM Together for Healthcare is a statewide, multiracial campaign of families and community organizations working together to strengthen healthcare access in New Mexico, supported by Strong Families New Mexico, Partnership for Community Action, New Mexico Center on Law and Poverty and Health Action New Mexico. For information, visit http://nmtogether4health.org/ or email nmtogether4healthcare@gmail.com.

Proposed Medicaid cuts would force New Mexicans to go without healthcare

ALBUQUERQUE—New Mexico’s Human Services Department proposed cuts to Medicaid would hurt families and violate federal law, said the New Mexico Center on Law and Poverty in comments submitted yesterday on the department’s Centennial Care 2.0 waiver proposal.

“Everyone needs access to healthcare coverage,” said William Townley, an attorney with the New Mexico Center on Law and Poverty. “But HSD’s proposed cuts to Medicaid would force many New Mexican families to go into debt or simply drop coverage. That’s bad news for all of us. We know that when people go without healthcare, it’s much harder for them to maintain their financial stability, be productive in the workforce, or continue their education.”

HSD’s proposal imposes new patient premiums on low-income adults living just above the poverty line. Research has shown that these fees will cause thousands of New Mexicans to lose healthcare coverage. For many low-income families, the proposed increase to $10 a month is prohibitive and would force them to choose between healthcare and other necessities like food, housing, and transportation.

Hospital bills are especially devastating for families on limited income, often ranging from $10,000 to over $100,000. Yet, HSD’s proposed cuts would also phase-out retroactive coverage, which pays for a Medicaid eligible person’s hospital and medical bills incurred up to three months before signing up for Medicaid. Phasing out retroactive coverage would put New Mexico’s families in jeopardy of severe medical debt and force healthcare providers to shoulder increased uncompensated care costs.

New Mexicans have voiced overwhelming opposition to HSD’s proposed cuts to Medicaid. Throughout the entire Centennial Care 2.0 waiver application process, patients, providers, stakeholders, researchers, advocates and community members were nearly unanimously opposed to these changes.

HSD’s proposed Medicaid cuts also violate federal law. The Centers for Medicare and Medicaid Services (CMS) can only approve waivers of federal Medicaid requirements that are listed under Section 1115 of the Medicaid Act. Provisions that govern cost-sharing, such as premiums, and retroactive coverage are outside of Section 1115, meaning CMS lacks legal authority to waive such requirements. CMS has not yet approved the regulatory changes proposed in HSD’s new regulations.

The Center’s comments can be found here: http://nmpovertylaw.org/wp-content/uploads/2018/10/NMCLP-Comment-on-HSDs-Medicaid-Cuts2018-10-25.pdf

 

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The New Mexico Center on Law and Poverty is dedicated to advancing economic and social justice through education, advocacy, and litigation. We work with low-income New Mexicans to improve living conditions, increase opportunities, and protect the rights of people living in poverty.

 

HSD to Hold Hearing on Medicaid Cuts Wednesday

SANTA FE—New Mexico’s Human Services Department will hold a hearing on the serious cuts the Medicaid program faces in the Centennial Care 2.0 waiver proposal on Wednesday, October 24 in Santa Fe.

The waiver proposal imposes new excessive patient premiums on low-income adults living just above the poverty line. These fees will cause thousands of New Mexicans to lose healthcare coverage. The proposal would also phase out retroactive coverage, which is a protection that pays for a Medicaid eligible person’s hospital and medical bills incurred up to three months before signing up for Medicaid. Phasing out retroactive coverage would put New Mexico’s families in jeopardy of severe medical debt and leave healthcare providers with additional uncompensated care costs.

WHAT:
HSD Hearing on the Centennial Care 2.0 Waiver Proposal

WHEN:
9:00 a.m -12:00 p.m., October 24, 2018

WHERE:     
Rio Grande Conference Room, Toney Anaya Building, 2550 Cerrillos Rd, Santa Fe, NM 87505

WHO:
William Townley, attorney at the New Mexico Center on Law and Poverty and other groups against the waiver
HSD staff
Public Comment

McKinley County Commission unanimously supports innovative ‘Medicaid buy-in’

Community need and widespread support inspired commission

GALLUP–The McKinley County Commission, after hearing powerful community testimony, on Tuesday unanimously passed a resolution in support of the state’s work to develop and implement an innovative plan to allow New Mexicans the opportunity to buy-in to the proven, trusted Medicaid healthcare system.

“With more than 16,000 McKinley residents still uninsured,” said Christopher Hudson from the McKinley Communities Health Alliance “We need to support innovative ideas that will help everyone in our communities get the health care they need. A Medicaid buy-in program is a great option to make quality care affordable and accessible.”

In the 2018 Legislative Session, both the House and the Senate passed memorials calling for the Legislative Health and Human Services Committee to explore the policy and fiscal implications of offering a Medicaid Buy-in plan to New Mexico residents.

By allowing McKinley County residents to buy-in to Medicaid for their health coverage, a state program would reduce uncompensated care for doctors and hospitals and would also save much-needed funding in the county’s indigent care funds.

“I know how hard it can be to access health care,” said McKinley County resident and Strong Families New Mexico healthcare advocate Althea Yazzie. “I’ve had to fight with insurance providers to get help to pay for my medications, my transportation, and my rheumatologist appointments. Being sick is hard. Getting better shouldn’t be. I’m proud of our county for supporting Medicaid buy-in.”

In addition to sharing the resolution with legislators to show the county’s support for a Medicaid buy-in plan, the resolution also adds Medicaid buy-in to McKinley County’s legislative priorities, meaning the county will work directly with legislators to advance the program.

Court finds management problems prevent HSD from fixing food and medical benefits applications

ALBUQUERQUE—A federal court found that lack of leadership and accountability in the New Mexico Human Services Department prevents it from fixing entrenched problems in food and medical benefit administration.

In a ruling issued late yesterday, U.S. District Court Judge Kenneth Gonzales set a series of deadlines for HSD compliance with court ordered reforms and required the appointment of knowledgeable subject matter experts in supplemental nutrition assistance program (SNAP), Medicaid, and eligibility for families that include immigrants in the department’s Income Support Division.

“We’re very hopeful that this ruling will lead to much needed changes in the department’s leadership,” said Sovereign Hager, managing attorney at the New Mexico Center on Law and Poverty. “For there to be permanent improvement in administration, the Human Services Department leadership must have expertise and management abilities that give front line workers the tools they need to ensure New Mexicans can get food and medical assistance. HSD is still not processing applications in time, leaving too many children and families unable to access basic necessities.”

In September 2016, Judge Gonzales held the HSD Secretary Brent Earnest in contempt for failing to remove barriers to assistance for eligible families. The court appointed a Special Master to monitor and make recommendations to the department.

Despite court orders and the expertise provided by the Special Master, HSD continues to improperly deny eligible New Mexicans food and medical assistance and does not provide timely information about case decisions. Each month the department develops a backlog of unprocessed cases, a large share of phone calls go unanswered, and workers are not accurately trained on the requirements for processing food and medical assistance applications.

In his ruling yesterday, the judge agreed with the Special Master’s January 2018 report finding that the current HSD management team lacks the sufficient “knowledge, skills, and abilities” necessary to ensure families receive information about their cases and get the assistance they need to eat and see the doctor.

The judge also found that the Income Support Division Director demonstrated “woefully” little knowledge of the court ordered changes to improve processing food and Medicaid applications despite the significant impact they had on the division’s mission and work.

The judge was also troubled by the ISD Director’s lack of knowledge of standard memoranda issued by her division, training procedures, and her admitted failure to speak with the Regional Operations Managers on how to address improving timeliness and efficiency.

“We hope the state will make the management changes that will end the need for such extensive oversight through the courts,” said Hager. “New Mexicans who are going through significant hardships shouldn’t have to fight with the state to get the food and medical care they need.”

Center attorneys working on the Deborah Hatten Gonzales v. Brent Earnest lawsuit include Sovereign Hager, Gail Evans, and Maria Griego. Civil rights attorney, Daniel Yohalem is lead counsel on the case.

The court’s ruling can be found here: http://nmpovertylaw.org/wp-content/uploads/2018/04/Doc.-836-Memorandum-Opinion-and-Order-2018-04-05-00000003.pdf