Rally to protect families at the Boston Statehouse. (Daniel Frost/for Community Catalyst)
Immigrant families remain the target of unjust policies that threaten their access to health care services and increase the fear of family separation. One of these latest attacks is the proposed changes to the public charge policy. If approved, it would have detrimental effects on the health and well-being of immigrant families, particularly for children. You can take action to push back against this harmful policy by submitting a public comment by December 10, encouraging the Trump Administration not to make the proposed changes to the public charge rule.
Previously, an individual was considered a “public charge” if they were found to be “primarily dependent on public benefits,” including only cash-assistance programs and long-term institutional care. The proposed rule re-defines “public charge” as an individual who “receives one or more public benefits,” and broadens the benefits considered to include: Most forms of Medicaid, Medicare Part D premium and cost sharing assistance, the Supplemental Nutrition Assistance Program (SNAP) and housing assistance. The proposed rule also expands the categories of immigrants subject to the rule to include those seeking to extend or change their visa, individuals seeking entry to the U.S. and those applying for legal permanent residency (or a “green card”). Therefore, this rule would subject many immigrants and their families to potential denial of the immigration status they are seeking for using critical public health programs, even if they are legally eligible for them.
A chilling effect is already underway as immigrant families fear retaliation and have chosen to forgo enrolling in health coverage and other public health programs that are intricately connected to positive health outcomes. This puts children at risk of lacking access to nutritious food and critical health care services, including dental care and behavioral health care, as families opt out of Medicaid or SNAP benefits. For Medicaid and the Children’s Health Insurance Program (CHIP), specifically, up to 4.9 million people, including U.S.-born children with immigrant parents, may disenroll from these programs. The proposed policy capitalizes on confusion and fear to deter families from accessing services that include:
- Oral health services: Children who do not have access to adequate oral health services are at an increased risk for early tooth decay, difficulty eating and disrupted school attendance. They are also likely to have less frequent dental visits and greater unmet dental needs. Adults who lose access to dental benefits could experience worsening oral health problems, negatively impacting their ability to work and self-esteem;
- Programs that support adequate nutrition: A recent study found a 10 percent drop in SNAP enrollment among eligible immigrant families during the first half of 2018. Lack of nutritious food is associated with developmental concerns, iron deficiency, diabetes, cardiovascular disease and low birth weight among children;
- Mental health services: Approximately 11 percent of youth have been diagnosed with a mental illness while another two-thirds are not receiving adequate services. On the heels of the Trump administration’s attempt to prolong the amount of time immigrant parents and children are detained after crossing the border, screening, diagnostic and treatment services will be even more important for immigrant children; the psychological impact of being held in subpar facilities, even with family members, can increase children’s risk of anxiety, depression, PTSD and suicide;
- Programs that support individuals living with HIV/AIDS: Medicaid covers more than 40 percent of people receiving care for HIV – it is the largest source of insurance coverage for people with the illness. Changes to the public charge rule would negatively impact health outcomes for people living with HIV/AIDS and worsen this public health crisis, especially because the HIV/AIDS epidemic already disproportionately impacts LGBTQ+ immigrant communities.
The proposed changes to the public charge rule – and other anti-immigrant policies proposed by the current administration – are a direct attack on the health and well-being of marginalized immigrant communities. Children and families have increased stress, anxiety and depression as a result of these policies. Disruption to children’s routines have led to greater withdrawal, isolation and poor school performance as they worry about being separated from their families. No parent should have to choose between providing for their child’s well-being or risking never seeing them again.
As new policies are introduced, it is our responsibility to speak up against injustices that threaten the prosperity and welfare of vulnerable communities. That is why it is so important to submit your comment opposing changes to the public charge rule before the deadline on December 10, 2018. You can use Community Catalyst’s public comment or request access to the Protecting Immigrant Families (PIF) campaign’s template comment for language and information to craft your individual or organizational comment. The PIF website also has additional resources, including a digital toolkit, and Community Catalyst has social media images you can use to spread the word in your networks. Don’t forget to submit your comment by December 10, 2018!
Andrea Chu is an MPH student and Community Catalyst intern working on children’s health.