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New “public charge” rule a major setback for public health

August 19, 2019
Area(s) of Interest: Public Health Access to Care 


The Trump Administration last week finalized changes to the “public charge” rule that targets immigrant families, jeopardizes public health and will deter millions of people from receiving critical health care services. The rule will allow federal officials to deny green cards to legal immigrants who use public benefits or who are deemed likely to do so in the future.

In California, these benefits include Medi-Cal, the state’s version of Medicaid, which provides health insurance for low-income residents; housing assistance such as Section 8 vouchers; and CalFresh, commonly known as food stamps.

The California Medical Association (CMA) believes that many immigrants, even those not subject to the rule, will be deterred from accessing these benefits for themselves or their families due to fear and confusion. The new rule will also force noncitizens, especially those with children, to choose between receiving essential medical care or pursuit of their application for admission or adjustment. Families’ fear to participate in Medi-Cal could result in coverage losses throughout California, decreased access to care, and worse health outcomes for the entire family, including U.S. citizen children.

"This new rule hurts our most vulnerable residents and will be a major setback for public health in California and the nation as a whole. This is another effort by the Administration in Washington to target immigrant families – including those who are here legally – for political gain,” said David H. Aizuss, M.D., CMA president. “CMA will aggressively challenge any efforts to take health care away from California residents and will continue to work with state leaders to stand up to misguided public policies that will harm California families."

CMA previously submitted formal comments to the Department of Homeland Security on the proposed rule, raising concerns that the rule could cause confusion and panic among many immigrants, even those not subject to the rule, and lead millions of people to forego essential health care services.

California Attorney General (AG) Xavier Becerra filed a lawsuit in federal court on Friday challenging the rule. The lawsuit, filed in the U.S. District Court for the Northern District of California, claims the rule targets working immigrants and their families by creating unnecessary new barriers to lawful admission to the United States. Joining AG Becerra in filing the lawsuit are the AGs of Maine, Oregon, Pennsylvania and the District of Columbia.

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