The Proposed Public Charge Rule is Terrible Policy


The Trump Administration wants us to believe that its revised “public charge” rule, penalizing lawful immigrants for utilizing noncash benefits such as Medicaid, SNAP (food stamps), and Section 8 vouchers, will be good for America.  Nothing could be further from the truth.  If enacted, this rule will make America sicker and poorer.


Under this proposal, immigrants who are lawfully enrolled in many noncash benefit programs will run a high risk of being deemed “public charges” if they try to adjust their status, making it nearly impossible for them to remain in the country.  Never mind that these immigrants are entitled to these programs, or that their children – many of whom are U.S. citizens – depend on them for housing, food, and health care.  The real aim, un-American to its core, is to encourage immigrants to leave the country, and to discourage others from coming here in the first place.  Even immigrants who have never used these benefits will find themselves at risk if government bureaucrats conclude they might need such assistance at any point in the future.


As a community health center that has served the primarily low-income Latino neighborhoods on Chicago’s Southwest side for nearly 15 years, Esperanza Health Centers knows well the people who will be caught in the crosshairs of this policy.  For many of our patients, friends, neighbors, and families, the choice will be between keeping their families fed, housed, and healthy, or adjusting status and facing possible deportation.  It will be a decision between seeking a healthier, most stable future for their children, or being forced to leave the country and abandoning those children to an unconscionable limbo.


And it is not just these individual tragedies that make the proposed rule so cruel.  If this policy is enacted, the health of the entire nation will suffer. 

Ample research demonstrates that access to public benefits has a positive impact on long-term health and well-being for everyone. Children who have access to Medicaid and SNAP are less likely to develop serious health problems, like diabetes and heart disease (they’re also more likely to finish high school).  Kids with access to health care are more likely to get vaccinated, protecting the entire community’s health.


By contrast, this rule will leave communities less protected.  Increasing numbers of people will choose not to enroll in Medicaid, given the risk to themselves and their families (a process that’s already begun).  And studies show that high rates of uninsured individuals reduce the quality of health care for everyone, as emergency rooms, emergent care centers, and other health facilities become strained to meet the increased demand.  In other words, coercing legal immigrants to go without Medicaid means your local hospital or health center will be less able to take care of you. 


And as legal immigrants disappear from the Medicaid roles, fewer immigrant children will be immunized.  Fewer adult immigrants will get their annual flu shots or pneumococcal vaccines.  Our collective defense against communicable diseases plummets, and illnesses rise in every community.  Last year’s 80,000 flu-related deaths, the highest in four decades, will become the new wished-for norm.


It’s not just the health of the nation that is at risk.  While the Administration claims that this new policy will save taxpayer money, the evidence to the contrary could not be clearer.  With fewer immigrants able to adjust their status and receive work authorization, our nation’s tax base will suffer.  Immigrants contribute more than $11 billion annually through payroll taxes to the Medicare program alone.  Even the conservative Cato Institute has debunked the Administration’s assertions, calculating that for each $1.00 the new rule purportedly saves, taxpayers will have to pay $1.46.


Legal immigrants are not a drain on the public benefits system.  To the contrary, they contribute more in taxes than they draw in services.  Every lawfully employed immigrant is a net economic gain to the country.


But preserving the nation’s health or shoring up its finances has never been the Administration true intent, despite claims to the contrary.  Toward the end of the proposed regulation’s heartless 400-plus pages, officials readily acknowledge the dire consequences that will likely follow:


•             Worse health outcomes, especially for pregnant or breastfeeding women, infants and children

•             Increased use of emergency rooms and urgent care as a method of primary health care

•             Increased prevalence of communicable diseases

•             Increased rates of poverty and housing instability

•             Reduced productivity and educational attainment


That’s right.  The people who crafted this rule knew full well the shameful legacy it will leave behind. This is beyond irresponsible stewardship.  It is a cruel attack against the health of all Americans and a wanton assault on the bedrock values of our country.