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Public Charge Rule Raises Concerns about Access to Health Care and Other Family Supports

August 15, 2019

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'Public charge' refers to a person who is considered primarily dependent on the government for public assistance, such as health care, food and housing assistance, etc. Click To Tweet

This week the Trump Administration released a new immigration rule that radically changes the policy that determines how certain immigrants become permanent residents. The new Department of Homeland Security rule, which goes into effect on October 15, will now link an individual’s immigration status to their income and their use of public benefits, such as health care, food and housing assistance and other public programs. Health and social services advocates, and groups across the country are reacting strongly against the new rule because of its apparent bias against individuals who are low or moderate income – without regard to life circumstance and the many ways in which immigrants contribute to the economic and social vitality of our communities.

Given the REACH Foundation’s mandate to improve health among all people who reside within our service area, regardless of nationality, citizenship or socio-economic status, we decry the threatening effect of this new rule and join other foundations and community leaders in calling for Congress to reverse this policy.

Of particular concern to REACH, the Kaiser Family Foundation recently predicted “decreased participation in these programs would contribute to more uninsured individuals and negatively affect the health and financial stability of families and the growth and healthy development of their children.”

The new rule represents a massive change in current policy. It targets individuals who are lawfully present in the United States and are seeking to become permanent residents by allowing immigration officials to judge residency applications based on the applicant’s use, or possible future use, of public benefits that are tied to need, such as health coverage or food assistance. Use of these public benefits can be used to deem a person a “public charge” – a designation indicating the applicant is less deserving of permanent residency based on the likelihood that the person will need public assistance immediately or at some future point.

Under the current rule, cash assistance and nursing care can be considered in the public charge test. With the new rule, the public charge definition has been broadly extended to include most Medicaid programs, Supplemental Nutrition Assistance Program (SNAP) benefits; housing vouchers and other aid; and Medicare for seniors. It also weighs income in the determination, setting a bias against those who do not have wealth.

The new changes will not be used by immigration officials until October 15.

This latest action will also sow fear and amplify mistrust of government and public institutions in our country. It will cause people to avoid seeking health services and taking advantage of health and other basic benefits that help individuals as they work to support their families. It will create harm within households as families are forced to make decisions about how they stay together and how to support their children and extended family members.

In reviewing the new standards, the Migration Policy Institute has projected that the new rule will cause a significant share of the nearly 23 million noncitizens and U.S. citizens in immigrant families using public benefits to disenroll.

There has already been a strong outcry and calls for reversal of the rule. The Administration chose to release this plan despite overwhelming opposition among the more than 260,000 comments submitted. Across the country and in the Kansas City metro area, service providers for immigrants are working to understand the implications for their clients and how to support them. Communities Concerned for Immigrants and Refugees, a local community learning and action network, is considering how local nonprofits can best help their constituents.

As legal experts and advocates converge, we encourage our partners to become informed about the policy and be aware of how this announcement will affect the individual and local health and well-being of our community. At REACH, we believe this policy stands in direct conflict with the expressed values of our nation. We join with others calling for its reversal.

For more information, check out the resources below:


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