Impending “Public Charge” Rule Could Drive Up the Uninsured Rate for Children

From the Pennsylvania Partnerships for Children

The “public charge” test refers to the evaluation by federal immigration officials to determine whether a person applying for a visa or green card is likely to rely on government benefits. The final rule, which was published last week by the Department of Homeland Security, changes the public charge definition by adding more programs into the determination, including Medicaid and the Supplemental Nutrition Assistance Program (SNAP).

It is important to note what is not included in the final rule. Children, pregnant women and new mothers 60-days post-partum on Medicaid, the Children’s Health Insurance Program (CHIP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) are not factored into the public charge determination.

However, confusion and fear among families with mixed immigration status may drive individuals to withdraw their eligible citizen children from essential programs providing health care, food and housing. This is what is known as the “chilling effect,” and according to the American Academy of Pediatrics Council on Immigrant Child and Family Health and many other child health experts and advocates, we are already seeing this occur since the rule was proposed last fall, which underscores the concern of this rule driving up the child uninsured rates across the country.

The final rule is scheduled to go into effect October 15, 2019 unless Congress or the courts act to block implementation of the regulation.

Education about this rule change is key – we must ensure that children continue to enroll and receive the preventive health care and nutritional assistance necessary for their healthy development.

For more information about public charge, please refer to this list of resources.