The Trump administration is proposing a rule that could force immigrant children to forgo health care and other safety net programs available to children in need.
Longstanding immigration law permits the federal government to prevent individuals from entering or remaining in the country if they are deemed a public charge. People meet that qualification if they depend – or will likely depend – mostly on government support to meet their basic needs, through forms of long-term institutionalized care or public cash assistance. Historically, this definition has been limited to exclude some government aid, such as programs helping with health care and nutrition, because these “work supports” are known to help lower-income people secure work, allowing families to thrive and remain productive.
This new proposal expands the definition of “public charge” and would now put immigrant families that seek those work supports, such as health care, at risk of being denied residency. The breadth of the final rule will not be certain for some time, as the Department of Homeland Security is seeking public comment on the rule until Monday. But, if implemented as written, these proposed changes could result in many children and families going without essential benefits like Medicaid coverage and Supplemental Nutrition Assistance.
Advocates for children separated from their families at the U.S. border were quite effective in spreading awareness of the separation policy as a flawed and harmful one. This public charge policy appears to be just as concerning for children. It’s estimated that up to two million citizen children of noncitizen parents who are now insured publicly could go without health care if their families fear the consequences of seeking affordable coverage. And it is clear that the rule may increase barriers to family reunification and potentially lead to family separation if, for example, an individual is denied a green card due to a public charge determination and that individual loses permission to remain in the United States.
Our pediatricians at Children’s Hospital of Philadelphia have heard stories of lawfully residing immigrant families who are now afraid to bring their children to the hospital because they don’t want to be labeled a “public charge.” This is an alarming trend, as lack of regular access to health care for any child leads to long-term negative consequences for his or her health and well-being. We also must consider the significant mental health toll that all members of a family can experience when uncertainty in the immigration process is coupled with an inability to provide children with nutritious food, quality housing, and preventive care.
Those of us who work with families see firsthand the direct health impact that government has on children. Medicaid and Supplemental Nutrition Assistance, among other programs, represent thoughtful, economically sound policies and funding commitments that ensure all children have a chance at a healthy future. In fact, studies show that these programs make children more likely to graduate from high school and college and less likely to rely on government supports in the future.
This upcoming rule is the antithesis of long-standing programs that help those in need and is deeply concerning. No parents should have to choose between getting health care for their child and protecting their immigration status. Please take a few moments before Monday to submit a comment and encourage the Department to ensure that all children continue to have access to the support they need to thrive.
Madeline Bell is president and CEO of Children’s Hospital of Philadelphia.