Patient groups representing millions of Americans with serious health conditions voiced strong concern about a U.S. Department of Homeland Security final rule released on August 12, 2019. The new rule directs DHS to broadly expand the “public charge” evaluation – which aims to determine whether an individual is likely to become dependent on the government for subsistence – to include critical safety net programs including Medicaid. Under the new rule, a legal immigrant’s use of these benefits can be counted as a negative factor when s/he applies for permanent US residency.

The statement from the patient groups expressed concern that this policy will not only penalize immigrants for using public benefits for which they legally qualify, it will also likely have a chilling effect for immigrant communities across all public programs, resulting in fewer people seeking out the support services they and their U.S. citizen family members need and for which they qualify. A recent survey demonstrated that the debate over this issue has already led one in seven adults in immigrant families to forgo public benefits for which they or their children were eligible, including Medicaid and Children’s Health Insurance Program. Penalizing and stigmatizing use of these programs could seriously jeopardize the health and well-being of legal immigrants and their U.S. citizen children, spouses, and relatives.

We are united in our strong opposition to this rule, given the negative impact it is likely to have on the health and wellbeing of the people we represent.

The patient groups that joined in the statement included the American Heart Association, American Lung Association, March of Dimes, and 11 other groups, including HFA and NHF.


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