Comments on the Public Charge

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Project Title

Comments on the Public Charge

Project Summary

As pediatricians and others who daily provide care to support the health of children and larger communities –both immigrant and non-immigrant– in Baltimore, Maryland, we write to oppose the public charge proposal. We recognize the right and duty of the United States to determine immigration policy consistent with legal, policy, and moral imperatives. It is our strong view that the proposed rule fails these tests.

This proposal (1) is premised on an overly broad definition of “public charge;” (2) errs by including Medicaid, SNAP, and housing as prohibited programs, because their inclusion will substantially damage public health; (3) includes a provision that lacks logical coherence – namely, prohibiting participation in the regular Medicaid program, but allowing receipt of Emergency Medicaid benefits; (4) fails to account for the full scope of the proposed rule’s substantial harms; (5) hurts children in specific and particular ways; and (6) inappropriately interferes with the practice of medicine to the detriment of patients, providers and US communities.

As physicians, we are already witnessing the impact of this proposal on the health of children in Baltimore. Immigrant families, many of whom include U.S. citizens, are refusing to apply for essential health and nutritional benefits for their children. The consequences include increased food insecurity and malnutrition, less success in school, diminished prospects for economic prosperity later in life, and heightened risk of infectious disease. The rule will make matters worse.