The Public Charge Rule
On October 15, an update to a federal immigration regulation known as the “public charge rule” is scheduled to take effect. The new rule, which was announced in August, would allow the government to evaluate green card applicants based on their use of public programs like food stamps, housing assistance and Medicaid – potentially denying immigration benefits to those who have used these programs for more than 12 months in aggregate in any 36-month period.
The Immediate and Long Term Impacts on Public Health
Although the rule hasn’t officially taken effect yet, it has already created widespread uncertainty and confusion within immigrant communities. Many immigrants have pre-emptively withdrawn from benefits programs and stopped accessing critical healthcare services for themselves and their families – even though family usage doesn't penalize applicants. In some cases, these families have U.S. citizen children who are entitled to these benefits. Even green card holders and naturalized citizens have stopped accessing services, though they wouldn't be affected by the new rule. Unsure about whether the rule will apply to them, many people are choosing to play it safe.
The potential public health consequences are significant. Children, in particular, stand to be adversely impacted by losing their benefits. Those with chronic health conditions face the most serious risks, but even the loss of routine preventative care can negatively impact school attendance, creating ripple effects throughout the child’s life. Studies have shown that health issues are a leading cause of school absenteeism, and that students who are chronically absent are seven times more likely to drop out. Lack of quality healthcare in a child’s early life can have lifetime effects and negatively impact not just their health, but their education, financial stability and employment.
How Community Organizations Are Responding
Community organizations and more than a dozen states, including California, Oregon and New York, are currently challenging the public charge rule in court. Meanwhile, state and local agencies throughout the country are actively working to educate communities about who is and isn’t impacted by the rule – namely, that the rule does not penalize an applicant for benefits received by a family member, such as a child who is a U.S. citizen, and that Medicaid received by children under age 21 won’t be considered.
While the public charge rule shouldn’t affect the majority of patients at federally qualified health centers (FQHCs), these centers are nevertheless seeing a decline in the number of immigrant families seeking services, many of whom face social determinants of health barriers that place them at additional health risk. To help de-bunk some of the myths around the rule and help patients understand how they might be affected, many centers are beefing up their patient engagement and outreach efforts ahead of the rule taking effect. These centers are not just providing valuable healthcare services; they are also an important source of education about the implications of the rule and a safe place for people to receive the care they need. In many ways, they are a lifeline for the communities that they serve.
Where We Stand
As a non-profit dedicated to improving health outcomes for underserved patients, at CareMessage we believe healthcare is a universal right. We’re committed to supporting FQHCs as they provide critical healthcare services to those who need it most. Our text messaging platform allows health centers to quickly connect with and educate their patient populations at scale and with ease. To learn more about CareMessage’s mission and work empowering community health centers to improve health outcomes, contact us using the form below.
Additionally, FQHCs seeking to stay informed about the latest developments with the rule and how best to educate patients can connect with their local primary care associations (PCAs), like CPCA (California) and CHCNYS (New York), who have resources to share and are there to support.