Taking Charge of the Public Charge
Wednesday, December 12, 2018
TAKING CHARGE OF THE PUBLIC CHARGE: Whatcom County Council stepped up last week with an active response to one of the more cruel and counterproductive stances of the Trump administration’s pogrom on immigration, adopting a resolution opposing changes to federal legislation that would reduce health, housing and other social service benefits for immigrant families.
In September, the Trump administration rolled out a proposal that would force an extremely difficult choice on many immigrant families—that their chances of remaining in the United States and lawfully employed here could be at risk if those families sought public benefits such as food assistance or essential health coverage provided through Medicaid, or even enrolling their U.S.-born children in Head Start or the Children’s Health Insurance Program (CHIP).
Under a new directive from the federal Dept. of Homeland Security, the proposal would overhaul how the government evaluates whether a would-be immigrant is “not likely to be a public charge” (a requirement of many visa categories and green card applications). Nationwide, more than 19 million—or one in four (25 percent) children live in a family with an immigrant parent, and nearly nine in ten (86 percent) of these children are citizens.
The DHS rule would expand the definition of “public charge” for immigration purposes and therefore prevent permanent legal residency for immigrants.
“The proposed ‘public charge’ definition places an impossible choice before immigrant families,” U.S. Senate Democrats wrote in response to the proposal. “If a migrant child falls ill, he may lose eligibility for a green card, and if a parent runs out of money to feed their family, the parent will become ineligible as well. This proposed rule will cause tremendous harm to the health and well-being of thousands of children, citizen and immigrant alike.”
The proposed change runs directly counter to Whatcom County’s 2013 call for a more compassionate community approach to public health-related services, which found that immigrant families often avoid seeking needed medical and social services—even police aid—out of fear of detention and deportation or loss of their permanent residency status.
“Whatcom County may face increased demands for assistance from immigrants and their families resulting from changes to the ‘public charge’ definition because fewer individuals will be able to access federal benefits such as Supplemental Nutrition Assistance Program, Section 8 housing vouchers and healthcare services,” Council noted in their resolution last week. Meanwhile, “Whatcom County administers federal programs, and changes to federal laws could impose burdensome new tracking and reporting requirements for local offices that administer these programs.”
Council committee chair Barbara Brenner, with support from Tyler Byrd, became fixated on the colorful issue of whether immigrants are legally in the country, but the distinction is academic when the subject is public costs associated with trauma, mental illness and communicable disease. These carry costs borne by local governments regardless of immigrant status. Moreover, the parsing undermines the very message of unconditional support from the social services and medical community to those seeking assistance.
The National Association of County and City Health Officials (NACCHO), representing the nation’s nearly 3,000 local governmental health departments, strongly opposes immigration policy that unfairly discriminates against immigrants with respect to education, employment, basic human rights, and social welfare.
“Our local public health departments are here to protect and preserve the health and well-being of the communities they support, especially the most vulnerable among us,” the organization noted in a press release. “Clearly, public health will be compromised if families are too afraid to access vital services, fearing the loss of permanent residency status.”
“Limited or reduced access to support programs will affect immigrant health, financial stability, and the healthy development of their children,” county health officials noted in comments to the proposed DHS rule.
“This deeply misguided policy will not ensure ‘self-sufficiency’ among immigrants, nor will it help hospitals, which will see a further rise in costs and frequency of emergency care that will result from the drop in use and accessibility of preventive services,” Sen Patty Murray commented on the proposed DHS rule. “In addition, this policy will have a significant impact on programs not implicated in the text of proposed rule. Immigrant families are likely to refuse services for which they are eligible out of fear of possible reprisal for using these services—leading to numerous adverse consequences for children and families’ educational outcomes, health, and general well-being. This policy will have a detrimental effect on the children of lawful immigrants and their future generations, further hindering their paths to success.”
When Congress expanded the definition of ‘public charge’ in 1996, it rejected a definition of ‘public charge’ that would have included food and health care assistance. Meanwhile, as documented by the American Academy of Pediatrics (AAP), children who receive essential preventive care and services through Medicaid and CHIP coverage have better health and educational outcomes later in life, as compared to eligible children who do not receive such coverage, she and other Senate Democrats noted in their comments.
“Expanding the definition of ‘public charge’ would therefore both ignore the legislative intent and undermine critical health care programs for children and their families,” they wrote.