By Teresita Batayola
President and CEO, International Community Health Services
On Oct. 11, 2019, three federal courts issued nationwide preliminary injunctions against the U.S. Department of Homeland Security (DHS), stopping it from putting their expanded “public charge” rule into effect. While this is a heartening turn of events, International Community Health Services (ICHS) knows fear and confusion still ripples through immigrant communities here and across the country.
For two years, the federal government has been trying to expand the definition of public charge, seeking to turn the U.S. immigration system into one based on race and wealth. For two years, immigrants and refugees—whether subject to the policy or not—have lived in fear, confusion, and uncertainty. This continues to cause harm today, especially at community health centers like ICHS.
The Urban Institute found in 2018 that about one in seven adults in immigrant families reported that they or a family member did not participate in a non-cash benefit (programs like Medicaid or food stamps) for fear of risking future green card status. New York City reported greater declines in food stamp enrollment among eligible noncitizens than among citizens between January 2018 and January 2019. California’s health insurance exchange reported a greater decrease in new enrollments among non-English speakers than among individuals for whom English was the preferred spoken language. Both governments believed this was due to fears about public charge.
Across the country, declines in public health and nutrition program participation can be traced to public charge, and the fear of its impacts on immigration status.
More alarming is that so many years of misinformation, leaked drafts of the proposed changes, and uncertainty has left people who would not be impacted by the rule, or who use programs not being considered in the new rule, afraid about their future.
ICHS knows this is true. Our patients live in fear every day, whether they use programs included in the final policy or not, or have an immigration status not subject to public charge. A patient enrolled in our sliding-fee scale requested to cancel her mammogram through a state-funded breast cancer program. State health programs and ICHS’s sliding-fee scale would not affect a public charge decision, yet this patient cited fear of impacts to her green card application for cancelling. Another patient, a refugee, cancelled all appointments to see her health providers out of fear of a public charge impact. Refugees are not affected by public charge.
ICHS providers hear the fear and uncertainty from our patients every day. If my child uses this program, can I still get my green card? My U.S. citizen parents sponsor me, but I used Apple Health while pregnant, will I be able to apply for citizenship? I’m a refugee, is it safe for me to see my doctor?
DHS’s public charge rule may have been temporarily stopped by the courts, but people are still afraid. To help push back against the fear and harm, please visit protectingimmigrantfamilies.org and onenationaapi.com.