UC Health Executive Vice President John D. Stobo, M.D., issued the following statement today (Oct. 10) in response to the U.S. Department of Homeland Security's (DHS) proposed rule to expand the definition of “public charge”:

UC Health is concerned that the Department of Homeland Security’s proposal to change the definition of “public charge” may adversely affect public health. As a consequence of expanding the definition to include people on Medicaid who use non-emergency services, some Medicare beneficiaries who qualify for help purchasing their prescription drugs and families in need of CalFresh nutrition benefits, legal immigrants may forgo or delay medical services out of fear that seeking such help could jeopardize their applications to extend their stay, change their status or gain permanent residency. This is not only unjust, but could also create significant public health risks, adversely impact health professionals in the workforce, and increase unreimbursed costs for safety net hospitals.

UC Health is worried about the health of individuals and communities. If implemented, the change will create an environment in which individuals who are legally entitled to services may avoid seeking care, potentially allowing treatable conditions, including communicable diseases, to advance. This could lead to increased use of emergency rooms and drive up uncompensated care costs to all hospitals, which will ripple throughout the entire health care system.

Additionally, UC Health is one of the state’s largest training grounds for new physicians and health professionals entering the workforce. Hands-on patient care, especially in underserved communities, and innovative medical progress rely on talented individuals from around the world. UC Health fears the proposed rule will hinder our ability to attract, support and retain the personnel necessary throughout the care continuum to fulfill our mission.    

UC Health, which is comprised of five leading academic medical centers across California, includes 12 public hospitals that disproportionately serve low-income and elderly patients. UC Health’s hospitals form the core of California’s health safety net and are among the state’s leading providers of complex care to Medicaid and Medicare enrollees.

By considering receipt of non-emergency Medicaid and Medicare prescription drug assistance, food stamps, housing vouchers and other benefits in public charge determinations, the proposed rule could affect the health of our communities in many ways. The University of California system is conducting a thorough analysis of the proposed rule to determine the broad impact it would have on our university communities and those we serve.