Final Public Charge Rule Threatens Access to Healthcare for Immigrant Families

This Monday, the Department of Homeland Security (DHS) released a final rule entitled “Inadmissibility on Public Charge Grounds” – the latest in a barrage of policy and regulatory shifts that endanger access to care for millions of people living in the United States. As a healthcare system that believes healthcare is a human right, Howard Brown Health denounces this final rule and stands with the individuals and families that are being targeted under this administration.

This final rule, which may go into effect on October 15, 2019, changes the requirements for many immigrants to enter the United States and affects the process of becoming a permanent resident. Based on the final rule, most immigrants applying for permanent residency must provide evidence showing that they are not likely to become a “public charge” – or someone what will seek access to social services and benefits. Although not new, previous determinations of a person being considered a potential public charge were based on two types of benefits. The first was whether an applicant for permanent residency used services for cash assistance – such as Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI) – and the second was whether an applicant was likely to need long-term, government-paid nursing care.

Under this final rule, which is estimated to affect approximately 10 million immigrants, DHS will now consider Medicaid and income-based Medicare Savings programs for Medicare beneficiaries as additional factors in the public charge consideration. This means that DHS will soon be able to use healthcare an immigrant has accessed through Medicaid as a factor in their public charge considerations. This administration is forcing immigrants to make a terribly inhumane choice – seek healthcare and risk permanent residency or avoid accessing care and preventative services to have a better chance of staying with your family and community.

Millions of other immigrants who are not affected by the rule will nonetheless be discouraged from essential healthcare, welfare, and public safety services, fearing that their contact with any government office might jeopardize their legal status in the country and the security of family members (citizen and non-citizens) who are their dependents. The chilling effect on immigrant families by this rule and others like it will harm public health and safety for millions.

Howard Brown Health will continue to provide care to all who need it – including immigrants and their families. Our community is stronger when all its members are able to receive the care they need and deserve.


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