Oregon health care legislation would declare an "emergency"

The Immigration and Nationality Act of 1952 organized the variety of statutes governing U.S. immigration law into one body of text. Once the INA was enacted, it was codified under Title 8 of the United States Code (Aliens and Nationality). Section 1182 (Inadmissible aliens) includes the following text:

Any alien who, in the opinion of the consular officer at the time of application for a visa, or in the opinion of the Attorney General at the time of application for admission or adjustment of status, is likely at any time to become a public charge is inadmissible.

The public charge rule creates a self-sufficiency hurdle for applicants for admission to the United States: Aliens unable to care for themselves are deemed inadmissible. Use of the term in federal legislation can be traced back to the Immigration Act of 1882, which stated:

If on such examination there shall be found among such passengers any convict, lunatic, idiot, or any person unable to take care of him or herself without becoming a public charge, they shall report the same in writing to the collector of such port, and such person shall not be permitted to land.

Notwithstanding its inclusion in U.S. immigration law, the public charge standard has lacked a formal statutory definition. The Trump administration remedied this deficiency by publishing an Inadmissibility on Public Charge Grounds final rule in August, but court challenges delayed its implementation. The final rule, which went into effect nationwide on February 24, disqualifies individuals who received public benefits for more than 12 months, in total, within any 36-month period.

A breach of discipline in Oregon

Maintaining such a policy requires foresight and strength. Awareness of the long-term implications of one's decisions must override immediate feelings of empathy. An ability to say “no” in the face of the world's impassioned pleas is required. It seems that in Oregon, emotional weakness and feeblemindedness prevail.

On February 14, only ten days before U.S. Citizenship and Immigration Services began to implement the public charge rule, the Oregon House of Representatives passed a bill that would prevent nonprofit hospitals from requiring patients to apply for Medicaid before they are screened for charity care programs or other forms of financial assistance.

House Bill 4029 is Oregon’s response to the public charge rule, which would in most cases disqualify applicants for permanent residence who have received Medicaid benefits. That could discourage people who might, one day, apply for a visa or permanent residence, from accessing medical care, if the only way they can pay is through Medicaid.

The provision of subsidized medical care by the state of Oregon would create a partial “end-run” around federal efforts to remove the existing inducement to immigrate for people who are not self-sufficient.

Thanks to the Trump administration's final rule, this incentive would now — should the Oregon legislation be enacted — have to come from voluntary charitable donations, instead of government tax revenues. That qualification would disappear if hospitals are reimbursed by the state for their charity care expenses; often such reimbursements come in the form of tax credits.

A declaration of emergency

House Bill 4029 would prohibit nonprofit hospitals and their affiliated clinics from requiring patients to apply for government benefits before providing charity financial assistance. The bill was prefiled for the 2020 session of the Oregon State Legislature by Representative Andrea Salinas, a Democrat from Lake Oswego.

Before joining the Oregon House of Representatives in September 2017, Andrea Salinas was a lobbyist for public employee unions SEIU Local 503 and AFSCME Council 75, and other left-leaning groups.

The final section of HB-4029 makes this alarming declaration, to urge the immediate taking of effect by the bill, upon enactment:

This 2020 Act being necessary for the immediate preservation of the public peace, health and safety, an emergency is declared to exist, and this 2020 Act takes effect on its passage.

In addition to forbidding nonprofit hospitals from requiring patients to apply for government subsidies before they are screened for or provided financial assistance, the legislation would place limits on the amounts they could be charged.

Patients whose household income is not more than 200 percent of the federal poverty guidelines would have their charges “adjusted” down by 100 percent. Patients whose household income is between 200 and 400 percent of the federal poverty guidelines would have their charges adjusted on a sliding scale, which would reach a minimum 25 percent discount at the high end of the income scale.

HB-4029 has advanced to the Oregon Senate

On February 14, the bill was passed by the House of Representatives with 41 Aye votes and 11 Nays. After moving to the Senate it had its first hearing. On February 20 a hearing was held on HB-4029 by the Senate Committee on Health Care. The committee voted 3-1 to approve the proposal on February 24.

Disclaimer: Information on this website is not legal advice.