By Rupin Thakkar
For The Herald
Because of the immigration policies of the Trump administration, thousands of immigrant children remain separated from their parents or stuck in detention centers.
My pediatric colleagues and I have been seeing parents forgoing health care for their kids out of fear of deportation or family separation. In my own practice, no-show rates and appointment cancellations among immigrant families have noticeably increased. Now the Department of Homeland Security (DHS) is proposing yet another regulation that will lead families to avoid services for which they are eligible and has the potential to plunge millions of children into poverty, hunger and homelessness.
This month the DHS proposed changes to the federal “public charge” policy. The long-standing “public charge” test is designed to identify people who may depend on government as their main source of income by examining whether they receive cash assistance or will need long-term care benefits. If the government determines someone is likely to be a “public charge,” the government can deny admission to the U.S. or refuse an application for lawful permanent residency.
But the unprecedented change proposed by the Trump administration would allow immigration officials to deny green cards and visas to immigrants who use public benefits from an expanded list of programs including Medicaid, the Supplemental Nutrition Assistance Program (also known as food stamps), housing assistance and Medicare Part D. Even people who have not used these programs in the past can be denied a green card or visa if there is a suspected risk they are “likely” to use them in the future. In addition, the DHS proposes a new income threshold. To avoid scrutiny, an immigrant family would have to earn nearly $63,000 annually.
Many taxpaying immigrant parents have children who are U.S. citizens and are eligible for programs like health care and food assistance. Nearly 1 in 4 children in America has at least one immigrant parent, and nearly 90 percent of those children are citizens.
In my own clinic in Edmonds, I see many children of immigrant parents. By making legal use of safety net programs a factor in determining whether an individual qualifies as a public charge, millions of immigrants and their children are likely to forego services vital to their health and wellbeing because of fear of the consequences. With a widespread misunderstanding of which programs are included in the regulations, families are likely to forgo needed services that are not even applicable.
In Washington state, 1 in every 2 children relies on Medicaid for their health care coverage. Children with Medicaid are twice as likely to have routine check-ups and vaccinations than uninsured children. Preventive care and proper treatment for chronic conditions have insured that children are less likely to need expensive hospitalizations.
For example, my patients with asthma review their care with me during their check-ups and see me early during flare-ups. These appointments prevent emergency room visits and Intensive Care Unit admissions and allow kids to participate in school.
Children covered by Medicaid miss fewer school days, perform better in school, are more likely to graduate and attend college, and be healthier adults that earn higher wages and pay more in taxes than their uninsured peers. Research also shows that whether a parent has health insurance is highly predictive of whether their kids are covered. The fear families face as a result of the proposed regulation will lead to fewer children and their parents having health insurance.
The proposal will not only have a negative impact on child health, but also on our economy.
The impact of this rule is enormous and presents immigrant families with an impossible choice: Keep yourself and your children healthy but risk being separated or forgo vital services so your family can remain together. Health care, nutrition and housing keep children learning, parents working, families strong and allow all of us to contribute fully to our communities.
As a first-generation American, a father and a pediatrician I am deeply saddened and angered that our country would consider this proposal.
Our government should ensure that all American children, no matter where they or their parents were born, can be healthy and safe. We must demand that the DHS immediately rescind the new public charge proposal.
Dr. Rupin Thakkar is president of the Washington state chapter of the American Academy of Pediatrics and lead physician at Swedish Pediatrics in Edmonds. He lives in Seattle.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
