Experts are warning that the Trump administration’s “public charge” rule linking immigrants’ legal status to their use of public benefits will have far reaching impacts on health care coverage as well as the country's safety net.
The final rule, which was announced earlier this month and is set to take effect Oct. 15, targets immigrants trying to enter the United States or those already living here who are trying to obtain a green card.
Under the rule, any immigrant who receives at least one designated public benefit for more than 12 months within any 36-month period will be considered a “public charge” and will be more likely to be denied a green card by immigration officials.
The rule could dramatically limit the number of people using social safety net programs.
Health and immigration experts and activists said the final rule will have a chilling effect even on people who aren’t directly affected and could discourage permanent residents and even U.S. citizens from renewing or applying for benefits they are entitled to.
“The targets of the public charge rule and who it impacts are different,” said Sara McTarnaghan, a researcher at the Urban Institute. "Due to fear, or misinformation about what may be in the final rule, immigrant households may change their decisions about public benefits.”
An Urban Institute study released in May found that 14.7 percent of adults in families where all noncitizen members had green cards reported that they declined to enroll in some sort of public benefit such as Medicaid or food stamps for fear of risking future green card status.
The same study found that 9.3 percent of people in families where all foreign-born members were naturalized citizens also declined to participate in either Medicaid, the Supplemental Nutrition Assistance Program (SNAP) or the Children’s Health Insurance Program (CHIP) — even though the final rule doesn’t apply to CHIP.
The new rule is intended to make it more difficult for immigrants who came to the country legally to stay as permanent residents if they ever have used, or are seen as likely to use, public benefits such as food stamps, Section 8 housing vouchers or Medicaid.
The administration has previously targeted a wide swath of public programs as part of welfare reform.
Critics argue the public charge rule, though, skews the debate over broader public assistance programs to lower support for the otherwise popular programs.
Democrats have slammed the policy as a cruel attack on low-income immigrants.
“The rule will force hundreds of thousands of immigrants to choose between forgoing basic assistance for food, shelter and health care or risk being separated from their families,” House Education and Labor Committee Chairman Bobby ScottRobert (Bobby) Cortez ScottDemocrats hit crunch time for passing Biden agenda Biden celebrates anniversary of Americans with Disabilities Act Now is the time to end the subminimum wage for people with disabilities MORE (D-Va) said in a statement.
Conservatives tout the rule as a way to lower taxpayer spending.
“These programs are a major source of our trillion-dollar budget deficits and the increase in our public debt. Why would we want to bring in immigrants who will only add to that deficit and that debt?” Heritage Foundation analysts Hans von Spakovsky and David Inserra wrote in a blog post.
And during a news conference to announce the rule, acting Director of U.S. Citizenship and Immigration Services Ken Cuccinelli described the rule as a means to ensure immigrants are self-sufficient.
“Self-sufficiency has been a central part of the American value set for so long. ... That’s part of the motivation for a rule like this,” Cucinelli said.
Cucinelli said information about who is impacted by the rule is clear and easy to find.
“Anyone who has any question about whether the receipt of a particular benefit would be considered ... will be able to easily find that from our website,” Cucinelli said during the White House briefing.
The rule explicitly does not apply to U.S. citizens, even if the citizen is related to an immigrant who would be subjected to the requirements. It also explicitly exempts immigrants who have been granted asylum, lawful permanent residents and refugees.
But experts said that even though only a small number of immigrants use public benefits, the true impact of the rule will be much broader.
Most legal immigrants are ineligible for SNAP and Medicaid until after they get a green card. Even then, they must complete a five-year waiting period.
“The implication of the [administration’s] rhetoric is there are huge groups of people taking advantage of the system, and that’s just not true,” said Elaine Waxman, a senior fellow at the Urban Institute.
“We do see already that application rates are failing and for programs like CHIP, where we know kids aren’t affected, but we can appreciate how an immigrant family would err on the side of being very, very conservative,” Waxman said.
Jerry Vitti, founder and CEO of Healthcare Financial, Inc., which connects vulnerable populations with public benefit programs, said misinformation can play a major role in people declining to renew their Medicaid or SNAP enrollment.
People in immigrant communities “don’t know that [attorney generals] are filing suit [to challenge the rule]. They don’t know there’s a bill in Congress to [strip] resources to implement the policy,” said Vitti.
"They know what they hear on the street, and … they don’t get right info, and they default to the most fearful information," he added.