‘Public charge’ rule could hurt health care

Hundreds of people rally for improved health care in front of San Francisco City Hall, 2017. (Photo: Kim Wilson, via Shutterstock)

In the national debate over immigration, one proposal threatens the health and well-being of every person living in this country.

The proposed “public charge” rule would make it more difficult for legal immigrants to become permanent residents and prevent immigrants from using the programs their tax dollars help support, like Medicaid (Medi-Cal in California) or nutrition assistance.

Accessing the programs that support their basic needs would count against them, and ultimately threaten their opportunity for a permanent and secure future in the U.S.

Loss of health care, food assistance, and other services impact everyone, creating a poorer, sicker nation in which our neighbors cannot access the basics they need to take care of their families.

Although still only a proposal, our hospitals, community groups and others are already hearing accounts of the fear and anxiety caused by this destructive plan.

Some are cancelling medical appointments or avoiding care altogether. Others are not even signing up for Medi-Cal coverage, afraid that doing so will impact their immigration status. If this proposal goes into effect, it will exacerbate the rise in the uninsured rate we are already facing.

As leading voices for health providers and patients in California, we are strongly opposed to this proposal, out of concern for both the families who are directly impacted and our entire health system.

Loss of health care, food assistance, and other services impact everyone, creating a poorer, sicker nation in which our neighbors cannot access the basics they need to take care of their families. This proposed rule change violates the promise of fairness and opportunity that America was built on.

Our health system is stronger when everyone can get primary and preventive care, and has the ability to be healthy and thrive. Our economy is stronger when we all have the financial security of coverage. No one should be penalized for accessing health care services when they are sick or injured. And, nothing is more important than ensuring that all kids — including the children of immigrants — have access to routine checkups, immunizations and other care so they can go to school healthy and ready to learn.

If this rule goes through, up to 628,000 children could lose coverage despite remaining eligible, according to a report from The Children’s Partnership. Programs like Medi-Cal help families meet their children’s basic needs and provide a buffer against the negative effects of adversity. Restricting access to these programs would be harmful to children’s development and have implications for their well-being into adulthood.

It is the job of our leaders to help us ensure a healthy society. Yet, the Department of Homeland Security in issuing the rule, acknowledges their proposal may have an adverse effect that widens inequalities, including increased rates of poverty and housing instability for millions of immigrants. Everyone deserves food to eat, a place to sleep, and access to needed health care.

Caring for the sick and healing the injured, without regard to where they were born, is the mission of all hospitals. While we may not see eye-to-eye on every issue, California’s health community — from providers to patients — is united in opposing this proposal.

This rule, if implemented, will create unnecessary and unhealthy barriers to people accessing the health care services they need, when they need them.

During the public comment period which ended Monday, over 200,000 comments were submitted to the Department of Homeland Security on the potential impacts of this change in federal rules. We applaud all who made their voice heard.

While citizen action is vital, we stand together now to urge the Trump Administration in the strongest terms possible to simply withdraw this ill-advised proposed rule. We must advance policies that strengthen – rather than undermine – the ability of our communities to thrive.  The health of every one of us depends on it.

Edit0r’s Note: Carmela Coyle is the president & CEO of the California Hospital Association, which represents more than 400 hospitals and health systems in California. Anthony Wright is the executive director of Health Access California, the statewide health care consumer advocacy coalition.

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