On April 22, APA Services submitted comments (PDF, 277KB) in response to the Department of Homeland Security’s (DHS) request for comments on its proposed rule on the Public Charge Ground of Inadmissibility. The comments focused on the effects of the prior, more stringent 2019 public charge rule and the serious concerns it raised about its impact on the physical and mental health of immigrants and other at-risk populations. In the 2019 rule, immigrants participating in an array of public programs were deemed “likely to become a public charge,” and were therefore ineligible to apply for lawful permanent status. By separating the participation in “public benefits” from the determination of an individual becoming a public charge, immigrants are able to participate in public benefit programs such as Medicaid, the Children’s Health Insurance Program, and the Supplemental Nutrition Assistance Program without risking their ability to obtain lawful permanent status in the U.S. The proposed rule would allow immigrants to avoid having to make the impossible choice between staying in the U.S. and receiving essential health benefits.
The comments also explained the psychological impacts of immigration and poverty and demonstrated the long-term mental health impact of poverty on these immigrant communities. The association went on to suggest that access to quality, evidence-based treatment should be a priority for the administration.
Another topic in the comments was highlighting the chilling effect of the 2019 rule. The comments explained that public benefit programs are vitally important to immigrants. Medicaid provides many noncitizen families access to health care, but with the 2019 rule came a decline in participation in Medicaid among these communities, as participation would have negatively affected immigration status. Therefore, the 2019 rule raised serious concerns that if immigrants were hesitant to enroll in vital health programs, their mental health needs were not being met.
The comments also pointed out that if the 2019 rule were continued, it could also lead to family separations if a noncitizen parent used a public benefit program and could be subject to deportation. The comments went on to explain the psychological research showing the negative effects of family separation.
APA Services closed its comments by applauding the efforts of the administration to roll back the 2019 rule by separating the definition of “public benefits” from the definition of “individuals likely to become a public charge,” and by excluding critical public health insurance programs such as Medicaid from the definition of “public benefits.”