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Act now: the proposed public charge rule

The Universal Declaration of Human Rights begins from the premise that “recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice, and peace in the world.” In the years since the Declaration was adopted, philosophers, politicians, and citizens alike have debated the terms of human rights: what should be included within our frameworks of human rights? What should be considered a violation? Most notably, human rights frameworks have been critiqued for paying an inadequate attention to the economic, social, and cultural rights that make it possible not just to survive, but to thrive. Beyond such rights as those bodily autonomy, free speech, and political freedoms, we may also consider the alleviation of poverty a significant pillar in the fight for a more just world. Current shifts in immigration policy represent an insidious threat to the fight for economic justice and migrant rights alike, discouraging immigrants from accessing vital services that help life more livable for fear that they may be disqualified from staying in the United States.

In October, the Department of Homeland Security released a proposed change to the public charge rule with the goal of ensuring “that aliens subject to the public charge inadmissibility ground are self-sufficient, i.e., do not depend on public resources to meet their needs, but rather rely on their own capabilities, as well as the resources of family members, sponsors, and private organizations.” While it has historically been the case that migrants could be denied admission to the United States if it was possible that they would receive more than 50% of their income from public benefits, this proposed change to legislation would expand this “public charge” grounds for inadmissibility considerably. It would expand significantly the definition of a public charge, which derives from 19th century immigration law, to include anyone who uses or receives one or more public benefits. This broad definition may affect a large population, including recipients of public cash assistance or welfare programs such as Temporary Assistace for Needy Families, Supplemental Security Income, Medicaid, and the Children’s Health Insurance Program. Under the draft proposed policy, an estimated 47% of noncitizens in the United States could be considered public charges, up from 3% under the current regulations. In comparison, 32% of U.S.-born citizens would qualify under the new rule, and an estimated 36% percent of naturalized citizens. The assessment of the use of public benefits would also be retrospective, considering the last 36 months of benefit use along with other factors in considering inadmissibility.

This move, which seems designed to curtail legal immigration to the United States, is one that should concern us all as future healthcare providers and members of the American community. In the context of the United States, where many full-time jobs do not provide adequate wages to survive, health insurance costs are steep, and the cost of living is rising in many of the cities where people must live in order to find employment, penalizing immigrants for using state services is misguided. It also has the potential for significant public health consequences. As Dr. Krista M. Perreira and her colleagues argue in the New England Journal of Medicine, this legislation could pose significant health risks for immigrant communities, particularly to their access to public programs and health care services. Research on the effects of healthcare legislation on immigrant health outcomes suggests that rates of healthcare utilization will go down, and that clinics may see a greater number of uninsured immigrants who are concerned that their utilization of health insurance benefits may count against them.

“Everyone,” the Declaration of Human Rights continues, “has the right to social security and is entitled to realization… of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.” The proposed public charge rule poses a significant threat to these rights, and it is important that those of us who have the right to speak up against this shift do so.

The public comment period for the public charge rule is open until December 1st, 2018. Until then, the federal government will be considering comments from the American public. The text of the document is available here. You can submit your comments here or by mail until the open comment period ends on December 10, 2018.

You can also mail your submissions to Samantha Deshommes, Chief, Regulatory Coordination Division, Office of Policy and Strategy, U.S. Citizenship and Immigration Services, Department of Homeland Security, 20 Massachusetts Avenue NW, Washington, DC 20529-2140. To ensure proper handling, please reference DHS Docket No. USCIS-2010-0012 in your correspondence. Mail must be postmarked by the comment submission deadline.

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