New federal regulations say that using too many public benefits could keep foreign-born parents from permanent residency and a path to citizenship.

The fear and confusion surrounding this new “public charge” policy may cause immigrant parents to go without health care assistance, like Medicaid coverage, for themselves and their children — even though they qualify because of low household incomes and because they are, in fact, U.S. citizens.

According to the Urban Institute, nearly 90% of children born to immigrant parents are U.S. citizens. More than 60% of children born to immigrant parents have at least one parent who is a citizen.

What’s missing from these statistics are the noncitizens who may be part of these families. Imagine you are a naturalized citizen, living in such a household. You’ve heard that public assistance can affect residency status.

Do enroll your child in Medicaid or CHIP, the Children’s Health Insurance Program, if you fear that doing so could hurt your husband’s green card application? Do you take the chance that your 75-year-old mother may be denied permanent residency because her granddaughter has Medicaid?

Policy and research organizations have considered such scenarios and put numbers to them. Manatt Health estimates that as many as 13.2 million adults and children nationwide may forgo health coverage, and much of their nonemergency health care, because of the new public charge policy. Based on Medicaid and CHIP payment rates, children will account for about 40% of these “lost” health care services.

Going without health coverage and regular doctor’s visits forces immigrant parents to risk their health and that of their children. Troublesome symptoms left unchecked may become crises, and even tragedies. As health goes down, emergency room visits and hospitalizations, and health care expenses, go up. That affects all of us.

Pennsylvania’s health care providers are concerned about the impact of the public charge rule on the health and well-being of our state. A group of 15 organizations representing doctors, community clinics, hospitals, and others sent a letter explaining these concerns when the policy was first proposed.

The courts have blocked the new public charge regulations for the time being, but the legal battle will no doubt continue.

For Pennsylvania’s immigrant families, this will only increase confusion, stoke fear, and undermine health and health care.

Andy Carter is president and CEO of the Hospital and Healthsystem Association of Pennsylvania.