By Elia Gallardo
In late September 2018, the U.S. Department of Homeland Security released a proposed rule to change the factors affecting a “public charge” determination for immigrants to the U.S. The proposed rule represents a dramatic shift in immigration policy and could prevent many low-income immigrants from reuniting with their families in the U.S.
Under federal law, an individual seeking admission to the U.S., or seeking to become a permanent resident (obtain a green card), is “inadmissible” if the individual at the time of application for admission or adjustment of status, is found to be likely at any time to become a “public charge” which includes, among other factors, whether they are likely to rely on public benefits for subsistence in the U.S.
Under the proposed rule, as outlined in the ITUP fact sheet released with this blog, immigration officials must consider a list of additional public health and social services in the determination of public charge. Importantly, based on a preliminary review, the rule does not include as relevant public benefits the Medi-Cal services undocumented immigrants are currently eligible to receive, including federally supported emergency Medi-Cal and state-funded comprehensive Medi-Cal coverage for undocumented children.
Although undocumented immigrants are not eligible for Medi-Cal, except as described above, and are therefore not likely to be affected by that aspect of the rule, the complexity of the proposal may cause some confusion and fear among immigrant Medi-Cal beneficiaries. Previous leaked draft public charge rules included enrollment in Medicaid as an unfavorable factor in a public charge determination. Based on the leaked documents, anecdotal reports in California communities revealed that some immigrants requested disenrollment for themselves or their children from Medi-Cal, California’s Medicaid program, out of concern about the public charge issue.
Although the proposed rule does not directly affect most immigrant use of Medi-Cal benefits, many provisions are of deep concern. For instance, health conditions will be more closely scrutinized as part of a public charge determination, the lack of health insurance will be weighed against an immigrant applicant, and the regulations add an income test that weighs negatively on families earning under 125 percent of the federal poverty level.
Last year, ITUP traveled the state to discuss the health care needs of immigrants and the impact of then anticipated public charge changes. (See ITUP publication, Notes from the Field.) Throughout the state, workgroup attendees discussed the importance of accurate information from a trusted provider in reassuring concerned community members. Outreach and enrollment staff and others found that additional outreach and education to address community concerns improved the retention of recipients in the Medi-Cal program, including children enrolled in Medi-Cal.
The ITUP fact sheet briefly describes existing federal law on public charge and health care programs, the proposed changes, and the impact on immigrants’ access to health care programs in California.