Trump’s Public Charge Rule Change Represents an Impending Health Crisis

By Winn Periyasamy & Carlyn Cowen

On Monday, December 10th, the public comment period for the Trump administration’s proposed changes to the public charge rule will close, marking what could be a looming health crisis for hundreds of thousands of New Yorkers, and many more across the country.

On October 10, the Trump administration published their proposal to expand the “public charge” rule in the Federal Register. They propose broadening the definition of “public charges,” or immigrants who they believe will become dependent on government aid. The new definition would include applicants whose family income is lower than 125% of the federal poverty line or may need to use public programs crucial to population health – Medicaid, Medicare Part D low-income subsidies, SNAP, and housing assistance. The administration is also considering whether to add the Children’s Health Insurance Program (CHIP) as a public charge-applicable benefit.

Anyone deemed a public charge could have their green card applications denied – or even possibly be deported. Currently, only cash benefits or government-funded medical institutionalization carry this potential consequence. The Fiscal Policy Institute estimates that with this sweeping expansion, as many as 24 million people nationwide could be impacted by this proposed change.  This includes 2.1 million New Yorkers and 680,000 children – not all of who would face a public charge test but may withdraw from benefits for fear of jeopardizing their immigration status.

It’s increasingly clear that this administration will stop at nothing to attack immigrants, people of color, and low-income communities. Children and families will be disproportionately affected. We know that a child’s health and wellbeing is inextricably linked to that of their families’ – and to attack a parent’s access to these services is to attack their children’s health, citizen and non-citizen alike. In 2014, there were over 14 million Medicaid/CHIP enrollees living in a household with at least one noncitizen nationwide. Half of these enrollees were U.S. citizen children. Researchers estimate that if the proposed rule would lead to widespread disenrollment, as many as 4.9 million Medicaid/CHIP enrollees across the country could disenroll. Widespread health coverage losses, as well as reduced access to nutritious food and safe, affordable housing threaten immigrants’ ability to realize their full potential and thrive.

Many social services providers are already seeing this proposal drive immigrants away from benefits they need to live fully realized lives. Since February, senior adults have been coming into Chinese-American Planning Council (CPC) community centers to ask staff to withdraw them from their Supplemental Nutrition Assistance Program (SNAP) benefits – or starting and then stopping new applications for SNAP for fear of threatening their families’ immigration status. African Services Committee, a multiservice human rights agency based in Harlem offering assistance to 12,500 immigrants per year, tells of clients, both at risk for and living with HIV/AIDS, considering delaying starting life-saving medication in case it might impact their green card applications.

Misinformation and language barriers further complicate immigrants’ decisions. CPC staff have seen articles in Chinese-language newspapers telling their readers to stop using public benefits – and are seeing clients decline use of even WIC and subsidized child care benefits. These are both benefits these clients are legally eligible for – and which are not even in the current proposal. For staff, it is difficult to know how to encourage clients to keep life-saving benefits while also ensuring their safety. “What should I do – tell my client to move out of NYCHA and live on the street so she doesn’t get deported?,” asked one social worker.

The level of fear and anxiety over immigration status is so high that some immigrants are taking more extreme steps to avoid any visibility.  FPWA member agency Asian Americans for Equality runs after-school programs for immigrant youth in Flushing, Queens and they have seen a decline in participation because youth are afraid of being detained if they don’t go home right away.  AAFE has also heard of immigrant parents pulling their kids from school, for fear that they might be targeted by ICE or their immigration status might be reported to DHS.  In the climate that this administration has created, even schools are no longer trusted as institutions and safe environments.

As nonprofits working with and advocating for the rights of low-income immigrants and communities of color, FPWA and CPC urge everyone to fight this proposal. The public charge regulation has not officially changed, and the time to act is right now! Everyone can make their thoughts known by submitting your comments against the Department of Homeland Security’s proposal by December 10th. The law requires that such proposals are submitted for public comment – and that government officials must consider what the public has to say in deciding whether to approve this rule change. Visit the Protecting Immigrant Families Campaign to learn more. Our words have the power to change lives – and our government needs to hear us now.

Winn Periyasamy is a policy analyst at FPWA (formerly the Federation of Protestant Welfare Agencies), an anti-poverty, policy, and advocacy organization with a membership of more than 170 faith- and community- based service providers.

Carlyn Cowen is the Chief Policy and Public Affairs Officer, Chinese-American Planning Council, the nation’s largest Asian American social service agency, providing direct services to over 60,000 Asian American, immigrant and low-income New Yorkers each year.