Posted on 05/11/2018 4:46:16 PM PDT by spintreebob
The Trump administration is considering a policy change that might discourage immigrants who are seeking permanent residency from using government-supported health care, a scenario that is alarming some doctors, hospitals and patient advocates.
Under the proposed plan, a lawful immigrant holding a visa could be passed over for getting permanent residency — a green card — if they use Medicaid, a subsidized Obamacare plan, food stamps, tax credits or a list of other non-cash government benefits, according to a draft of the plan published by The Washington Post. Even the use of such benefits by a child who is a U.S. citizen could jeopardize a parent’s chances of attaining lawful residency, according to the document.
Health advocates say such a policy could frighten a far broader group of immigrants who will avoid government-supported health coverage, creating public health problems that could prove dire. About 3 million people received green cards from 2014 through 2016, government records show. Immigrants with visas or those who may have no legal status but plan to seek citizenship based on a close family relationship would be affected.
“We are very concerned that this rule, if finalized, would have a significant impact on health in this country,” said Erin O’Malley, senior director of policy for America’s Essential Hospitals, which discussed the plan with Trump administration officials in mid-April.
O’Malley said she fears that some visa holders and their families would steer clear of getting routine treatment and resort to going to emergency rooms for medical care. Such a change would “undermine the stability of our hospitals by creating uncompensated care costs and creating sicker patients,” O’Malley said.
Wendy Parmet (Courtesy of Northeastern University)
The policy change could force a mother to weigh the need for hospital inpatient care for an ailing newborn against losing her legal immigration status, said Wendy Parmet, director of the Center for Health Policy and Law at Northeastern University.
“The administration, in the draft, talks about self-sufficiency,” she said. “But we don’t expect that of [babies]” who are U.S. citizens because they were born in this country. “It’s extremely hardhearted.”
Pushback has begun even though the proposal is in the earliest stages of the rulemaking process.
Washington state Gov. Jay Inslee, a Democrat, is sending staff in mid-May to meet with the White House Office of Management and Budget, which is vetting the proposed rule. Inslee sent a letter on April 24 urging OMB Director Mick Mulvaney to consider the impact on tax-paying, lawful immigrants.
Gov. Jay Inslee (D-Wash.) (Courtesy of the Washington Office of the Governor)
“This will undoubtedly lead to people across the U.S. going hungry, not accessing needed medical care, losing economic self-sufficiency, and even becoming homeless,” Inslee wrote.
The leaked draft said immigration officials would count the use of one or more non-cash benefits by the applicant within three years as a “heavily weighed negative factor” in deciding whether to grant permanent residency.
On March 29, the Department of Homeland Security sent a version of the proposal to OMB, which reviews it for conflicts with existing law. Next, it will be published as a proposed rule that the public can comment on before it’s finalized.
Marilu Cabrera, public affairs officer with the U.S. Citizenship and Immigration Services, declined to comment on whether the draft published by the Post mirrors what the OMB is reviewing.
Dr. Julie Linton (Courtesy of Wake Forest Baptist Medical Center)
Fear in immigrant communities already weighs on physicians. Dr. Julie Linton, a spokeswoman for the American Academy of Pediatrics, treats many Latino immigrant families at an outpatient clinic in Winston-Salem, N.C. She said one woman from Mexico, who had a newborn baby and three other children, told Linton she was afraid to keep her family enrolled in the nutrition program for Women, Infants, and Children (WIC). “Is it safe to use WIC?” the woman asked her.
Linton said questions like that put pediatricians in a tough position. She said evidence shows enrolling in WIC leads to better health outcomes for kids. But what if it also puts the family at risk of being split apart?
“It feels very frightening to have a family in front of me, and have a child with so much potential … and be uncertain how to advise them” on whether to accept public benefits, Linton said.
Maria Gomez, president of Mary’s Center, which runs health clinics in Washington, D.C., and Maryland, said she’s seeing three to four people a week who are not applying for WIC and are canceling their appointments to re-enroll in Medicaid.
Maria Gomez (Courtesy of Mary’s Center)
The leaked draft of the proposal zeroes in on who is considered a “public charge.” The concept emerged in immigration law in 1882, when Congress sought to bar immigrants who were “idiots, lunatics” or those likely to become a burden on the government.
The notion of a “public charge” last surfaced in 1999, when the immigration service clarified the concept. Then and now, an immigrant considered a “public charge” is inadmissible to the U.S. if the person is likely to rely on the government for income, or lives in a government-funded long-term institution.
Yet the guideline published in 1999 clarified that legal residents were free to access non-cash benefits like Medicaid, food stamps and assistance for heating bills. “These benefits are often provided to low-income working families to sustain and improve their ability to remain self-sufficient,” the guideline says.
The proposal, as drafted, would upend that.
Under such a policy, anyone who had recent or ongoing use of a non-cash government benefit in the previous 36 months would likely be deemed a “public charge,” and therefore inadmissible to the U.S. The use of such benefits by a spouse, dependent parent or child would also be taken into account.
Applicants who have “expensive health conditions” such as cancer, heart disease or “mental disorders” and had used a subsidized program would also get a “heavily weighed” negative mark on their application, the draft says. Don't Miss A Story
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Marnobia Juarez, 48, battled cancer successfully and is hoping her husband’s green card application is approved; she also dreams of one day getting her own. She said she never wanted to apply for public benefits until she was diagnosed with breast cancer in 2014. Since then, she has been treated at no cost under a program run by the state of Maryland.
“I’m alive thanks to this program,” said Juarez, who is a health volunteer with an immigrant advocacy group. “You don’t play with life, and they are playing with life.”
The draft says immigrants could post a minimum $10,000 bond to help overcome a determination that they are likely to be a “public charge.”
Such changes would affect people sponsored by a U.S. citizen family member, most employment-based immigrants, diversity visa immigrants and “certain non-immigrants,” the draft says. In 2016, 1.2 million people got their lawful permanent residence status, or a green card. Of the total, 566,000 were immediate relatives or spouses of U.S. citizens and 238,000 more were family-sponsored, Department of Homeland Security data show.
Some immigrants, such as refugees and asylees, would not be affected. Nor would the proposed changes apply to undocumented immigrants.
“We’re talking about middle-class and working families,” said Madison Hardee, senior policy attorney with the Center for Law and Social Policy, which has organized a coalition to fight the proposal. “This could really put parents in an impossible situation between seeking health assistance for their children and obtaining a permanent legal status in the U.S.”
The list of benefits includes the Children’s Health Insurance Program, known as CHIP; non-emergency Medicaid; the Supplemental Nutrition Assistance Program, or food stamps; WIC; and short-term institutionalization at government expense and others. The leaked draft notes that foreign-born and native-born Americans use such programs at similar rates.
The draft says the proposal is meant to ensure that people seeking to “change their nonimmigrant status are self-sufficient.” It notes “relevant congressional policy statements,” including one that says “the availability of public benefits [should] not constitute an incentive for immigration to the United States.”
Welfare to immigrants will create another underclass. We should welcome desirable immigrants and reject undesirables.
Immigrants who take welfare are undesirable. if anything, they should pay us for letting them in.
No welfare for immigrants. Doesn't matter if they are legal, illegal, naturalized citizens or refugees.
No welfare for immigrants!
No welfare for ANYONE!!
Native born or not.
Cue Fats Domino: “Ain’t that a shame, my tears fell like rain . . .”
I was REQUIRED to sign away my assets and income to GUARANTEE the Federal Government my wife would not become a Public Charge when she got her green card, the LEGAL WAY!
Gee, why don’t we get us some more?
The mother';s husband should have a job that provides health-care coverage ... so this should not be a problem. They should not come into this country if they cannot support themselves. Enough of this welfare on top of welfare.
I’d be good with it.
Frankly, the world would be a better place if degrees in government were not just worthless but factually useless to getting a job with government because there are so few such jobs outside of the military.
No foreigner should be a burden to the US citizen taxpayers.
How can you be so wrong on borders and so right on immigrant welfare?
They just flat out lie all the time.
Aren’t those who get green cards supposed to be here to do jobs where US workers aren’t available to fill those positions? If the employers are so desperate for foreign labor, shouldn’t they have to pay them a living wage? It makes no sense that we should subsidize employers who have no intention of paying a living wage to employees.
Dems are always so “compassionate” with other people’s money. They can think that they are morally superior to us, but who is going to eventually pay the bills?! The USA is so far in debt that it will probably never repay it. Who is then going to get burned? That debt will eventually lead to stealing from somebody (default on debts or inflating currency). The Dem Leftists never think about the ultimate costs. They only care about feeling and looking good in the short-term.
“the availability of public benefits [should] not constitute an incentive for immigration to the United States.”
Last line.
AMEN!!!!!!!
Exactly. If those employers were forced to offer health care benefits as part of the job, they wouldn’t need so many “workers” then, would they? This is like the HB-1 workers Visa scam-companies don’t want to pay decent wages to Americans, so they import foreigners.
Your response. Aren’t those who get green cards supposed to be here to do jobs where US workers aren’t available to fill those positions? If the employers are so desperate for foreign labor, shouldn’t they have to pay them a living wage? It makes no sense that we should subsidize employers who have no intention of paying a living wage to employees.
grania, that boat left a long long time ago. I moved to Texas 15 years ago and every single construction job and infrastructure job are Hispanics.
In 15 years here in my rural development has gone from 90% white to 4 out 25 houses white and I own 2, so yep 2 other families are left.
I own the property down on the corner and went down to work on it today and noticed about 20 kids get off the school bus and not one white.
Folks we here in Texas very soon will be a minority.
Oh make no mistake these aren’t gang bangers and street rats. These folks are all very law abiding and work and a lot of them.
Most are raising families and working and some have many family members living there either in 1 house or family across the street. That doesn’t bother me though because I grew up in an ethnic NE city where family was always right around the block.
Hey I was a Cruzer and now a Trumper but honestly I can’t see how this problem can be solved.
I’m not sure what any of you or me can say or do that can change anything to be honest.
I will say this, they pop out kids like crazy
Does my personal experience determine my libertarian streak? Or does my libertarian streak guide which experiences I have?
Are you choosing which laws to obey? Breaking the law is breaking the law, personal justification notwithstanding. If I only have to obey the laws I agree with, let me know. That would be good info to have.
Doesn’t matter. It’s not enforced. Neither are sponsorships. I worked for the welfare department 30 years ago and when I asked about it was told....oh we pay no attention to that. I signed them up left and right.
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