Alarming Federal “Public Charge” Rule Could Threaten More Than 1 Million Texas Kids

/, Immigration, Medicaid & CHIP/Alarming Federal “Public Charge” Rule Could Threaten More Than 1 Million Texas Kids

The new proposed “Public Charge” rule was published on October 10, 2018. Check out the new fact sheet from CPPP for instructions on how to leave a comment.

Texas parents should never have to avoid getting food, housing, or medical care out of fear that accepting that help might derail the parent’s ability to complete the path to legal immigration. But this harsh scenario could become reality because of a federal proposal relating to what’s called “public charge.”

The Trump administration released language this weekend for proposed “public charge” rule changes that would strongly prejudice immigration pathways toward higher-income people, while raising new high barriers for prospective immigrants if they have lower incomes, or have used government benefits like Medicaid, SNAP (food stamps), or housing subsidies. If the government anticipates that an immigrant might need benefits in the future—like Medicare’s sliding-scale “Extra Help” with prescription medication costs for seniors—an immigrant could also be denied a Green Card (legal permanent resident status) for that reason.  The new policy will also create higher barriers for people with a chronic illness or disability to gain a documented immigration status.

Experts are still analyzing exactly how many Texans could be affected by this harsh rule change, but the numbers won’t tell the whole story. Any suggestion that accessing public benefits could jeopardize a person’s chance at immigration adds to the overall climate of fear this Administration has created in the immigrant community. To avoid possibly interfering with a person’s immigration status, it is likely that hundreds of thousands of immigrants and their U.S. citizen family members will simply skip prenatal care, health care, food, and housing assistance.

The most directly affected Texans will be the people applying for an immigration status change—undocumented immigrants are not eligible for most federal benefits—but fear and confusion over the proposed rule would also affect their U.S. citizen family members who are qualified for health care from Medicaid or the Supplemental Nutrition Assistance Program (SNAP, formerly “food stamps”). We do know that there are about 1.8 million Texas children—24 to 26 percent of all Texas kids—who have at least one parent who is not a U.S. citizen. Many of those children – including U.S. citizen children – could lose public health and food assistance for which they lawfully qualify because a parent moving through the immigration system might fear that if their U.S. citizen family members access any federal programs, the parent would be denied immigration. Health centers, food banks, and hospital districts all over Texas have already reported widespread dropping of Medicaid and SNAP in 2018 by U.S. citizens who fear their own use of benefits will jeopardize a loved one’s ability to legally immigrate: a direct result of the Administration’s leaked threats.

Taken together, the effects of this callous rule could drive millions of Texans—including U.S. citizens and current and prospective authorized immigrants—to choose between meeting basic needs like health care, food, and the ability of a family member to legally immigrate.

This harsh regulation would make using health, anti-hunger, or affordable housing programs a disqualifier for immigration, putting hundreds of thousands of families at risk. The result would be a sicker, hungrier, poorer Texas. Entire families suffer when a mother or father can’t complete the immigration process, or can’t get needed health care. And whole families still need to eat even if the family member who has a Green Card has to give up food assistance in order to complete the immigration process.

What specifically do we see in the latest version of this proposed rule?

  • If an immigrant uses Medicaid, a vital health care program that pays for half of all births in the United States and care for 45 percent of Texas children, then he or she could be penalized in the immigration process.
  • A prospective immigrant who is judged “likely” to need ”extra help” subsidies for Medicare’s prescription drug program known as Part D (e.g., a couple earning less than $24,690).
  • If an immigrant uses the Supplemental Nutrition Assistance Program (SNAP, formerly “food stamps”), then the immigrant could be penalized in the immigration process. Families will receive a smaller food budget for only the U.S. citizen members, or may drop the program altogether out of fear.
  • The proposed rule specifically asks for public comments on whether past or future use of the critically important Children’s Health Insurance Program (CHIP) should penalize people in the immigration process. This could affect some children who must apply for Green Cards. This could also affect non-citizen mothers in Texas (both those with authorized immigration status and the undocumented) who get prenatal care from Texas’ CHIP-Perinatal (“CHIP-P”) program. Inclusion of CHIP in the Public Charge rule would push even more women to skip prenatal care, resulting in more high-risk pregnancies and Texas babies born with conditions and special needs that could have been avoided.
  • Several new policies are proposed to favor higher-income immigrants, helping immigrants through the process if their household income is 250 percent of the Federal Poverty Level–nearly $63,000 annually for a family of four.
  • This policy would also make it very difficult for an individual with an income below 125 percent of the poverty income (about $31,000 for a family of four) to get legal immigration status.
  • People applying for a Green Card with lower incomes, a disability, or a health condition may be required to pay a minimum of $10,000 to go through the immigration system and would risk losing this money if they use any public benefits listed in the public charge rule.

CPPP and our partners will continue to study potential impacts to Texas from this proposed rule change, and share resources on the proposed rule. Once the federal government publishes the proposal in the Federal Register, concerned Texans will have 60 days to submit public comments in opposition.  CPPP will provide links to help Texans submit those comment online.

Anne Dunkelberg oversees health care policy for CPPP. She focuses on policy and budget issues related to health care access and immigrants’ access to public benefits. She joined the Center in 1994 from the State Medicaid Director’s Office at the Texas Health and Human Services Commission. Anne is a founding member of the statewide Children’s Health Coverage Coalition (formerly the Texas CHIP Coalition) and the Cover Texas Now Coalition. She has been recognized by Families USA as an outstanding Consumer Health Advocate and by the LBJ School of Public Affairs Alumni Association as a Distinguished Public Servant. She was the primary author of the first edition of Texas Medicaid in Perspective (“the Pink Book”) and serves on the Texas Medicaid Managed Care Statewide advisory committee and the Texas Healthcare Transformation Waiver Executive Waiver Committee. Anne is a native Texan, and received her B.A. from the University of Texas at Austin, and her M.P.A. from the LBJ School of Public Affairs at the University of Texas at Austin.

No comments yet.

Leave a comment

Your email address will not be published.