Advocacy Update

Feb. 28, 2020: National Advocacy Update


On Feb. 24, the "Inadmissibility on Public Charge Grounds" final rule became effective nationwide. The final rule gives the administration broad authority to consider non-cash benefits such as Medicaid (with some exceptions) and the Supplemental Nutrition Assistance Program (SNAP) in making public charge inadmissibility determinations for green card applicants. The AMA strongly opposed this rule in written comments arguing that, "including these vital medical and nutritional services as factors to be used in a public charge determination seeks to undermine the very concept of what these programs were created to do, and that is provide health care coverage and nutritional support to individuals, children and families in need."

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The AMA Litigation Center has joined state medical societies and medical specialty societies in filing briefs in a number of cases challenging the controversial new public charge rule and asking for preliminary injunctions to stop the change from going into effect while the courts consider whether the rule should be struck down permanently.

Each of these briefs asks the respective court to put or keep a preliminary injunction in place to prevent further harm and damage to immigrants' health. The cases include:

Casa de Maryland Inc. v. Trump. This case was on appeal to the 4th. U.S. Circuit Court of Appeals from the U.S. District Court for the District of Maryland.

City and County of San Francisco; County of Santa Clara v. U.S. Citizenship and Immigration Services. This case is on appeal to the 9th U.S. Circuit Court of Appeals from the U.S. District Court for the Northern District of California.

State of California v. U.S. Department of Homeland Security (DHS). This case is filed in the U.S. District Court for the Northern District of California. The case was joined with the City and County of San Francisco; County of Santa Clara case.

The AMA Litigation Center also joined the Washington State Medical Association and other physician organizations in filing a brief in State of Washington v. DHS that challenges the rule and asks for a preliminary injunction in the U.S. District Court for the Eastern District of Washington.

The AMA Litigation Center partnered, too, in a brief in the case—DHS v. New York—in which the U.S. District Court in Manhattan issued a preliminary nationwide injunction that blocked the rule from being implemented.

Learn more about the AMA's advocacy efforts related to the public charge.

A federal appeals court has ruled that the Trump administration can enforce a gag rule on physicians that will restrict them from providing complete information to patients about all of their health care options and providing appropriate referrals for care. AMA President Patrice A. Harris, MD, MA, released a statement strongly disagreeing with the ruling, saying that the AMA is disappointed by the court's decision, asserting that open conversations between patients and physicians are critical to the delivery of quality health care.

"This government overreach and interference demands that physicians violate their ethical obligations – prohibiting open, frank conversations with patients about all their health care options – if they want to continue treating patients under the Title X program," Dr. Harris said. "It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options."

The AMA will continue to monitor this case as it moves to the next stage.