Tell Congress to oppose the public charge rule

The Administration has proposed a dangerous and unnecessary expansion of the definition of “public charge” when determining the eligibility of legal immigrants to apply for lawful permanent residency (LPR). Under the proposed rule, enrollment in the Medicaid program (and potentially the CHIP program) would prevent legal immigrants from attaining LPR, and force many to choose between vital health care coverage and the ability to adjust immigration status.

The current definition of “public charge” has been suitable for decades, and the proposed expansion to include enrollment in health care programs such as Medicaid will have a devastating impact on legal immigrants and their families as well as those providing care to them.

If the proposed broadening of public charge determination goes into effect, millions of immigrants here legally could lose their health coverage or choose not to enroll. The ranks of the uninsured will grow, hospitals will face rising costs for uncompensated care and public health will be adversely affected. The proposed rule’s inclusion of other benefit programs such as housing and nutrition assistance also will harm the health of immigrant families and prioritize citizenship for the wealthy over those with fewer means. Such a system would directly contradict both our nation’s history of offering refuge to the poor and oppressed as well as our Gospel mandate to care for the most vulnerable.

The structure of the rule gives the Department of Homeland Security (DHS) substantial discretion to assess whether someone is likely to become a public charge; that discretion, coupled with the complexity of the rule, is likely to generate confusion about who is impacted and what benefits are included, deterring immigrants from using needed benefits—including benefits that are not implicated by the rule. Family members of immigrants who are citizens may also be deterred from seeking or maintaining benefits.

According to a Manatt Health analysis, nationwide, 22.2 million noncitizens and a total of 41.1 million noncitizens and their family members currently living in the United States (12.7% of the total United States population) could potentially be impacted as a result of the proposed changes in public charge policy. Of citizen family members, more than half (10.7 million) are citizen children living in families with one or more noncitizen family members. While the rule is styled as an immigration regulation, its impact will ripple across the health care industry, states and localities.

We stand with the Catholic Health Association of the United States in strongly opposing this rule and have until December 10 to submit comments. To learn more, including to view extensive data on the effect of the proposed rule on health care programs and the implications for hospitals, Manatt Health prepared a new analysis available here.

Please urge the Department of Homeland Security not to finalize this harmful rule and ask your members of Congress to weigh in as well. A sample letter is available on e-Advocacy.