September 25, 2018

What is Public Charge?

Karen Siegel, M.P.H.

“Public charge” is a term used by immigration officials to determine that a person seeking to enter the United States, immigrate, or apply to become a Legal Permanent Resident or “green card” holder is or is likely to be dependent on public services.

To date, this determination has included only cash assistance (such as SSI and TANF) and publicly funded long-term institutional care. On Saturday, the Department of Homeland Security issued a press release and text of proposed changes to the “public charge” rule.

 

It is important to note that these changes are not yet in practice. Before changes can be implemented, the administration must give the public 60 days to comment on the proposed rule, consider those comments, and then wait at least 60 days after posting the final rule before implementing changes.

 

What changes have been proposed?

If undertaken, proposed changes would expand the benefits included in a determination of “public charge” to include:

  • Non-emergency Medicaid (with limited exceptions)
  • The Supplemental Nutrition Assistance Program (SNAP)
  • Housing assistance such as Section 8 housing vouchers
  • Low-income subsidy for prescription drug costs under Medicare part D

The draft also asks whether or not the Children’s Health Insurance Program (CHIP) should be included. Additional details about changes to how the rule is applied and to whom are available here.

 

Who would these changes impact?

These changes would affect individuals seeking a change in immigration status, though it does not apply when “green card” holders apply to become citizens.

The public charge statute requires immigration officials to consider overall circumstances, not just the use of services, in making an immigration status decision.  Finally, these changes would not be retroactive; so, they will only apply to enrollment in the specified services after the final rule takes effect.

In Connecticut, many lawfully present “qualified non-citizens” (see definition here) are eligible for enrollment in the state’s Medicaid and SNAP programs.

 

Who is exempt from a public charge determination?

Some groups—such as refugees, asylees, and other protected groups—are not subject to “public charge.”

Further, the determination will consider use of benefits by the individual applicant – not by family members.

Click here for more details about which groups are exempt and a detailed list of relevant programs.

 

Why do the changes to this rule matter?

The primary cause of concern is that fear of a potential rule change and confusion about what has not been changed will lead to lower rates of enrollment in programs that help families meet their basic needs—including SNAP and Medicaid. This “chilling effect” is already taking place according to some reports.

Should the draft rule take effect, lawfully present immigrants who work in low-paying jobs will be forced to choose between obtaining vital services and their immigration status. Many will likely stop using or fail to enroll in health insurance or nutrition programs for themselves or their families for fear that the rules may change again. Such uncertainty adds to the daily stress of living in an immigrant family in today’s political climate.

In Connecticut, 81,000 citizen children who have at least one non-citizen parent are enrolled in Medicaid or CHIP. Children make up 40% of the national Medicaid population and account for just 19% of Medicaid spending. Yet, the services they receive can have lifelong benefits. Further, when parents are uninsured, eligible children are less likely to be insured or see a doctor. Thus, this rule change jeopardizes the health and wellbeing of thousands of Connecticut’s families.

Providing access to health care and nutritional support for non-citizens is an investment in our state’s future and enables families to continue to work and contribute to the economic and social wellbeing of our state.

 

What can you do?

1.    Prepare to comment on the proposed rule change once it is posted—sign up for alerts here.

2.    Help to correct confusion about what the current rule is and who the changes would affect.

3.    Contact Senator Blumenthal, who serves on the Immigration Subcommittee of the Judiciary Committee, to thank him for his defense of our nation’s tradition of welcoming immigrants.

Issue Area:
Health