Protect Children and Families' Health: Public Comment Opportunity

The Department of Homeland Security has published a proposed rule impacting how immigrants who may access certain public benefits, could be restricted from entering the country or obtaining legal permanent residency. Submit your public comment (pre-written by the Protecting Immigrant Families Campaign) HERE or (standard) HERE and feel free to borrow from our language below:

Joining advocates from across the United States, The Praxis Project writes to express our strong opposition to - and concern around - the proposed changes to the public charge determination process to now include factors such as non-cash benefits for food, shelter and healthcare. The proposal is a significant and harmful departure from current policy, creates a wealth test for immigrants, and puts the public’s health at risk.

We see these proposed changes as a grave threat to health equity:

  1. The proposal lowers the threshold for who is considered a public charge and authorizes immigration officials to arbitrate that threshold through considering immigrants’ potential for future use of public benefits. This is a matter of economic justice, a crucial social determinant of health: wealth should not be a prerequisite for opportunities for health.

  2. This will exacerbate the already-occurring chilling effect among, immigrant parents and (especially) mixed-status families that fear accessing health care safety net programs - even programs not included in the proposed policy. This endangers children and families’ equitable access to health care, yet another social determinant of health. Parents are traumatized as they are forced to compromise the health of who they love the most. Children are harmed through their parents’ not accessing preventive care that they as caregivers need to be healthy and well to care for their children.

  3. The chilling effect would further undermine food security and affordable and safe housing, other fundamental social determinants of health.

We expand on the anticipated health impacts below.

First, the proposal creates an arbitrary system that relies on conjecture that immigrants would (legally) access the newly-added government programs in question. The new method of determining public charges  - through assessing the mere likelihood of their accessing services in the future - would preempt immigrants’ ability to develop self-sufficiency through legally accessing government programs created and provided for that specific purpose i.e. SNAP and Medicaid. This is in the context of many low-income immigrants working in low-paying jobs with limited to no benefits. Further, immigration officials typically do not have backgrounds in social services and may not have the appropriate lens to judge the likelihood of a given individual’s propensity for seeking future public assistance. In addition, we are astounded at the blatant preferential treatment - through even-more-heavily weighed positive factors - of immigrants with more financial resources, a disturbing trend described by  the Coalition on Human Needs as yet ‘one more example of...putting money before people and families.’

Citing evidence from the outcomes of comparable policy changes by former Presidents Clinton and George W. Bush, the Center on Budget and Policy Priorities (CBPP) forecasts that this ‘radical’ policy will result in a chilling effect of legal immigrants with lower incomes: to not access needed Medicaid and other health care benefits to which they are entitled by law. Indeed, we have already seen vast reductions to accessing services: prior to any official announcement or implementation of the proposal. Immigrants fear that they will be ‘singled out’ based on the sole act of accessing services that they qualify for. The CBPP also notes that this chilling effect could ‘extend to programs that combat maternal and infant mortality, [that] facilitate children’s ability to learn, and [that] protect broader public health.’ The estimated impact is up to 26 million people (Migration Policy Institute).

What is the price - in terms of basic health and wellness - that the federal government is willing to levy on children and vulnerable adults (their caretakers)? It is unconscionable that this policy could put the public’s health at risk as children and families to go without needed vaccinations, treatment of contagions, emergency care and care for acute and chronic conditions. This can also result in costly public health crises and urgently needed medical care to stave off pandemics.

We know that there is no way to target individual immigrants without hurting children, and that harm ripples from parents to children to families to communities. Further, those who require longer-term treatment of more serious chronic conditions have even more at stake with the heavily weighed negative factor of those types of conditions. Increasing the weight of the abovementioned positive and negative factors clearly makes it more difficult for low-resource immigrants to legally obtain visas and green cards; while shifting this bureaucracy conspicuously to favor those who are most fortunate. Children in the former group would effectively be trapped in the cycle of poverty because of factors outside of their and their parents’ control.

This cycle of poverty would be further cemented by the specific consideration of potential use of food stamps and/or safe housing and homelessness assistance. The chilling effect also extends to these health needs. Instabilities around hunger and housing are proven to be detrimental to health, employment, and self-sufficiency; perpetuating child poverty and negative health and educational outcomes to reinforce intergenerational poverty.

Immigrants, just like everyone, want the best for their families: they desire naturalization, they try to manage their health and wellness and they strive to contribute to their communities. Putting a price on legal immigration does not fix our broken system; nor does it honor the countless legacies of hundreds of millions of immigrants who come to our country with little to nothing and still manage to significantly shape the fabric of our economy, society and culture. Instead, such a policy would make us all less safe, healthy and well: deepening existing health injustice and inequities rather than working to transform them. We urge you to withdraw this proposed regulation.

For more information and access to resources, see:


Protecting Immigrant Families Campaign’s How to Talk About Public Charge with Immigrants and Their Families

Moms Rising's FAQ on Public Charge

Share your story with the PIF campaign