Fears Raised of ‘Chilling Effect’ on Kids If Trump Proposal Is Adopted

Secretary of Homeland Security Kirstjen Nielsen speaks in front of the border wall separating Tijuana, Mexico, and San Diego, Tuesday, Nov. 20, 2018, in San Diego.

Secretary of Homeland Security Kirstjen Nielsen speaks in front of the border wall separating Tijuana, Mexico, and San Diego, Tuesday, Nov. 20, 2018, in San Diego. AP Photo

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Changes to the “public charge” rule could make it harder for immigrants to secure green cards if they seek government services like Medicaid.

Millions of children who are U.S. citizens, but have at least one parent who is not, are vulnerable to losing public health insurance if the Trump administration moves ahead with a new rule that would make it harder for immigrants to get green cards if they use government programs like Medicaid, a new report said.

The Urban Institute evaluation found that in 2016 there were 6.8 million citizen children enrolled in Medicaid or CHIP health insurance programs who had a noncitizen parent. That is one-fifth of the kids enrolled in those programs for low-income families.

This fall, the Trump administration announced its proposal to rework the “public charge” rule, a longtime part of immigration policy aimed at ensuring people who become permanent residents won’t end up needing to be supported by the government. In the recent past, officials have looked at whether applicants received cash assistance when evaluating green card applications, but the Trump proposal would also include whether immigrants used programs like food stamps or Medicaid.

“Under long-standing federal law, those seeking to immigrate to the United States must show they can support themselves financially,” said Homeland Security Secretary Kirstjen Nielsen in a statement at the time. Supporters of reduced immigration celebrated the move, calling the new proposed standard a more accurate reflection of public support.

In the Urban Institute report, authors Genevieve M. Kenney, Jennifer M. Haley and Robin Wang acknowledged that the administration’s rule specifically says that benefits used by immigrants’ children who are citizens won’t count against the parent when they apply for a green card. But they wrote that despite this, “experience suggests such policy changes can have broad ‘chilling effects’ that lead to immigrant families opting out of public benefits and avoiding interactions with government authorities.”

Public comment on the proposal ends on Monday, with more than 180,000 comments on regulations.gov as of the afternoon. One filing by New York Gov. Andrew Cuomo’s office underscored the concerns raised by the Urban report, saying officials feared both a drop in coverage of citizen children and the 700,000 non-citizens enrolled in Medicaid and CHIP in New York.

“These individuals, if uninsured, would seek care at later stages of illness and at much higher costs, creating stress on hospitals and clinics that provide care to the uninsured. These impacts would be costly to New York State and run directly contrary to our constitutional mandate to provide aid, care, and support of the needy,” Cuomo’s office wrote in the comment.

In recent years, states and advocates have sought to boost enrollment among immigrant communities in Medicaid or states’ Children’s Health Insurance Programs, as many families are eligible and lack other health insurance.

Courtesy of the Urban Institute

But recent research by Georgetown University’s Center for Children and Families found that, overall, the number of children covered by health insurance dropped last year for the first time in a decade. In particular, the group found a reduction in the number of children enrolled in Medicaid and CHIP.

The full Urban Institute report can be accessed here.

Laura Maggi is Managing Editor of Route Fifty and based in Washington, D.C.

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