The Center’s staff enjoyed getting to visit with many readers of the policy update during this week’s statewide nonprofit conference. In today’s update, we share details on the state legislature’s (non)session this week and on a proposed new rule that could discourage some immigrants who receive services from nonprofits from accessing public benefits like SNAP and Medicaid. We also share resources that nonprofits can share with people in their community who are affected by the recent heightened immigration enforcement activities in North Carolina.
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NC General Assembly Reject Governor Stein’s Call for Special Session on Medicaid Funding |
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As background, on October 1, the NC Department of Health and Human Services (DHHS) cut rates for Medicaid providers, including many nonprofits. The cuts came after the NC Senate and NC House of Representatives were unable to agree on legislation to fully fund Medicaid for the current fiscal year. Specifically, DHHS: |
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Implemented a 3% rate reduction for providers of most services to Medicaid recipients;
- Implemented a 10% rate reduction for acute care hospitals, nursing homes, psychiatric residential treatment facilities, and research-based Behavioral Health Therapy/Applied Behavior Analysis services for people with autism;
- Implemented an 8% rate reduction for intermediate care facilities; and
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Reduced Medicaid administrative costs, including ending or reducing some contracts, halting some projects, and cutting back on compliance and quality assurance activities.
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Last week, a state court judge issued an injunction preventing DHHS from implementing rate cuts for providers of one type of service to children with autism. That ruling does not prevent rate cuts to other providers.
A variety of nonprofits and individuals receiving Medicaid benefits have shared with legislators the impacts of the Medicaid cuts on the lives of North Carolinians. Both the NC Senate and NC House of Representatives have unanimously passed bills (three bills for the House) to fully fund Medicaid, but the chambers have been unable to agree on whether to include other provisions in the Medicaid funding legislation.
Legislators are not expected to return to Raleigh for voting sessions on Medicaid – or on a broader state budget for FY2025-27 until sometime next year. |
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DHS Proposes New Public Charge Rule that Could Deter Immigrants from Receiving SNAP and Medicaid Benefits |
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On Wednesday, the U.S. Department of Homeland Security (DHS) formally published on the Federal Register a proposed regulation to make changes to the public charge rule that could discourage immigrants from using public benefits like the Supplemental Nutrition Assistance Program (SNAP) or Medicaid. Since the 19th century, American immigration officials have been allowed to deny visas to people who were deemed likely to be a “public charge,” meaning they would rely principally on government assistance. The public charge rule allows immigration officials to give greater weight to applicants' medical history, income levels, and dependency on public assistance in determining whether to grant lawful immigration status. The proposed new rule, which would likely take effect sometime in 2026, would rescind a 2022 rule that guaranteed that noncash public benefits like SNAP and Medicaid could not be considered in determining whether an individual would be granted lawful immigration status.
In 2019, DHS changed the public charge rule to take into consideration noncash benefits like SNAP and Medicaid. Many nonprofits expressed concerns that the 2019 changes to the public charge rule discouraged immigrants from using public benefits such as SNAP and Medicaid and caused disparate treatment of immigrant families who are at or near the federal poverty level. The public charge rule was revised in 2022 to disallow immigration officials from considering these noncash benefits, including benefits received by family members who are U.S. citizens. The proposed rule does not specify which noncash benefits would be considered when immigration officials review applications for lawful immigration status but instead would authorize DHS to develop its own policies and guidance. These DHS policies would not be subject to the regulatory review process. The new proposed rule is open to public comment through December 19.
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Nonprofits Can Protect their Organizations and People They Serve During Increased Immigration Enforcement in North Carolina |
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With immigration enforcement activity increasing in several parts of North Carolina over the past week, nonprofits are once again stepping up to support individuals and communities facing heightened fear and uncertainty. Organizations across the state are fortifying their response networks and providing community defense, legal help, mental health support, and reliable public information to counter rumors and keep families informed. Here are some resources nonprofits can share: |
The increased presence of Immigrations and Customs Enforcement (ICE) officials in Charlotte and the Triangle has also led to rallies and protests in support of immigrant communities. It is legal for nonprofits to participate in non-violent rallies and protests and engage in other types of advocacy activities. However, nonprofits should be aware that the federal government is prioritizing heightened enforcement of activities that are perceived as directly opposing ICE enforcement. In September, the U.S. Department of Justice published a memo aimed at preventing political violence against ICE. The memo concludes with a warning that “the Department of Justice will arrest and prosecute to the fullest extent of the law every person who aids, abets, or conspires to commit these crimes, whether through funding, coordination, planning, or other means.” This warning suggests that nonprofits and their staff, volunteers, and board members who are engaged in anti-ICE speech or activities could be subject to DOJ investigations and prosecution.
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