Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Public Charge Proposed Rule – A Strike on the Health Care and Well-Being of Immigrants and American Families

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The Administration is at it again. Last weekend, the Department of Homeland Security released the text of a proposed rule that would create hardships for certain immigrants seeking permanent residency (green cards) in the U.S. This “public charge” proposed rule would also place additional barriers in the way of immigrants seeking to enter the country. Currently, in keeping with longstanding immigration policy, to be considered a “public charge” one must be likely to become primarily dependent on the government to meet basic needs. As it now stands, receiving government-issued financial assistance benefits such as TANF and SSI, or long-term care benefits through Medicaid, may cause someone to be deemed a public charge and therefore denied a green card or visa.  

This proposed rule – if finalized – will greatly expand the scope of benefits that will be considered in the public charge test. Benefits such as the low-income subsidy (“Extra Help”) for Medicare’s Part D drug benefit, Supplemental Nutrition Assistance (SNAP), non-emergency Medicaid, and Section 8 and other forms of housing assistance would be counted. These are programs that older adults and their families rely on to stay healthy and independent in their communities for as long as possible.

Discouraging use of these critical benefits under the threat of adverse immigration consequences is not only unconscionable, it could impact our nation’s long-term care infrastructure. According to the Paraprofessional Health Care Institute, over 1 million immigrants are in the direct care work force. That is roughly 1 in 4 of our nation’s direct care workers. These are the professionals who provide critical care for the country’s older people or people with disabilities.

The proposed regulation prioritizes wealth over all other factors. It not only puts individuals who rely on these programs at risk, it would also adversely affect families who have been waiting years to be reunited. The Center for Medicare Advocacy is proud to be one of over 1,100 organizations that signed on to a statement in opposition to the proposed public charge rule.

Once the proposed rule is officially published in the federal register, it will be open to public comment for 60 days. We urge others to submit comments to let the Administration know that this change to our immigration policy is unfair, unwarranted and unjust.