Written by: Blanca Gutierrez
A new proposal published by the Department of Homeland Security (DHS) aims to scare immigrants out of participating in benefit programs and the impact of the proposal will transcend immigrants to affect general public health.
On October 10, 2018, the DHS published a proposal to change the public charge rules. When someone applies to enter the U.S. or when an individual who resides in the U.S. applies to become a legal permanent resident (to get their green card), they must undergo a public charge evaluation by United States Citizenship and Immigration Services (USCIS). Public charge is a term used by the USCIS to describe an applicant who is likely to become dependent on the government for subsistence. Any applicant who is deemed a public charge will have their application denied.
The proposed changes would make it more difficult for low income immigrants to obtain their green card or enter the U.S. by including non-cash benefit programs as factors in the public charge determination. Applicants that participate in housing programs, non-emergency Medicaid, and food stamps would have their usage counted against them and would be more likely to be labelled a public charge. The proposed changes also aim to expand who must undergo the evaluation to include those that apply to change the category of their visa and to those who apply to extend their visa. Lastly, the proposal will add heavily weighted negative factors that would count against applicants. Under the proposed changes, not knowing how to speak English fluently may count against the applicant.
Clinics across the nation are receiving calls from their immigrant patients who are desperately holding on to the hope of a green card and requesting to cancel or not renew their membership in benefit programs like Cal-Fresh, Medi-Cal, and WIC out of fear and misconceptions surrounding public charge. Many do not know that WIC, Emergency Medi-Cal and locally funded programs will not be counted negatively for public charge and will disenroll from all benefit programs. Public health experts agree that the chilling effect felt by scared immigrant parents will go on to affect their U.S. born children. Half of U.S. born children are enrolled in the nutrition program, Women Infants and Children (WIC); a program which provides breastfeeding support and baby formula to promote healthy baby weight. Some doctors worry about how they could keep their patients healthy and how they could protect infants, individuals with compromised immune systems, and the elderly, if immigrant patients are too afraid to seek health care and keep up with vaccinations. 
It is important to understand that the proposed changes have not gone into effect yet. Individuals can and should submit a comment opposing changes to public charge at : http://clinicconsortium.org/programs/policy-advocacy/public-charge/ . The DHS must respond to every comment before moving forward with the proposed changes. Those who are concerned about their participation in benefit programs are encouraged to learn more about the changes before deciding to drop benefit programs- remember not all benefit programs will be counted as factors and there may be no benefit in disenrolling from programs before the changes become effective.
Blanca Gutierrez is a Project Coordinator at the Community Clinic Consortium, which is a partner of Solano Coalition for Better Health.