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What We’re Reading: DACA Immigrant Obamacare Eligibility; New Medicaid Rule for Home-Based Care; HHS Finalizes Nondiscrimination Rules

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A new federal rule will enable thousands of immigrants in the Deferred Action for Childhood Arrivals (DACA) program to obtain health care through the Affordable Care Act; a forthcoming CMS rule is expected to lower home-based care wait times and raise caregiver wages; the HHS Office for Civil Rights has finalized 2 rules that strengthen the ACA’s health care discrimination ban.

Immigrants With DACA Protections Will Be Eligible for Obamacare

US officials recently announced a new federal rule that will enable thousands of immigrants in the Deferred Action for Childhood Arrivals (DACA) program to obtain health care through the Affordable Care Act (ACA), according to The New York Times. HHS Secretary Xavier Becerra said that DACA recipients are much more likely to be uninsured than the general US population. This is because the more than 500,000 immigrants with DACA protections have been ineligible for benefits, like federal health insurance programs. However, this HHS regulation set to take effect in November would grant those with DACA protection health coverage access under the ACA, as well as provide them with work permits. US officials estimate that about 100,000 uninsured people could obtain health insurance through this new federal rule.

New Medicaid Rule to Lower Home-Based Care Wait Times, Raise Caregiver Wages

A forthcoming CMS rule is expected to lower home-based care wait times and raise caregiver wages, according to Stat. The new rule brings changes to various Medicaid programs, including managed care delivery systems, but one of the most notable changes applies to the home and community-based services industry (HCBS). Under this rule, CMS will require home-based care providers to use 80% of the Medicaid reimbursements they receive toward caregiver compensation. Providers have up to 6 years to comply with this new rule, but states have the option to offer “hardship exemptions” and offer small providers a lower threshold than the 80% mandate. This rule was prompted in part by worker shortages that led to long home-based care wait times; one estimate found nearly 700,000 Americans on home-based care wait lists since 2016. Consequently, CMS noted that it hopes the new rule will stabilize the industry and help caregivers, many of whom are people of color and immigrants.


HHS Finalizes Nondiscrimination Rules, Focuses on LGBTQ+ Protections

The HHS Office for Civil Rights (OCR) has finalized 2 rules that strengthen the ACA’s ban on all gender- and sex-based discrimination in health care organizations or any HHS grant program, according to PatientEngagementHIT. The first final rule released on April 26 protects members of the LGBTQ+ community, strengthening section 1557 of the ACA, which provides nondiscrimination protection based on color, race, sex, age, disability, and national origin. Other protections established include the requirement for providers, health insurers, and others to be clear with patients about their rights, including language assistance and accessibility accommodations; this also extends to telehealth. OCR Director Melanie Fontes Rainer said this final rule is in direct response to patient stories about facing discrimination in their health care. Additionally, a second rule unveiled on April 30 extended 1557 nondiscrimination requirements to HHS grant programs.

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