The American College of Emergency Physicians (ACEP) urges the Department of Homeland Security to reconsider the “Public Charge” rule, which would give immigration officials broad discretion to consider a person’s use of Medicaid and other public benefits when making immigration determinations.
Emergency physicians care for all patients who come to the emergency department who believe that they could be experiencing a true medical emergency, regardless of ability to pay or immigration status, consistent with the federal Emergency Medical Treatment and Labor Act (EMTALA) and the Prudent Layperson Standard. However, policies that discourage any person from seeking necessary care and services create the potential for worsening of a medical condition, and potentially even an avoidable death.
"This approach would not eliminate the need for that care. It simply delays it until the patient’s condition becomes an emergency, and potentially untreatable,” said ACEP President L. Anthony Cirillo, MD, FACEP.
ACEP is concerned that confusion surrounding the rule will cause individuals to avoid not just emergency care, but even preventive care, chronic disease management, and other medically necessary services even when they remain eligible to receive them.
The Administration estimates that approximately 1.2 million people will disenroll from or avoid enrollment in Medicaid, CHIP, SNAP, and other public benefit programs because of the rule. This loss of coverage would increase uncompensated care, worsen emergency department crowding and threaten the sustainability of the emergency care safety net that all people in this country rely upon during a medical emergency.
