NPR: "Under A Trump Proposal, Lawful Immigrants Might Shun Medical Care"

by Joseph McKeown

The Trump administration is considering proposing a policy change that could have the result of discouraging immigrants seeking permanent residency (i.e., a Green Card) from using government-supported health care. Under the administration's draft plan, an immigrant in valid legal status could be prevented from obtaining permanent residency if they have used Medicaid, a subsidized Obamacare plan, food stamps, tax credits or other non-cash government benefits, according to a draft of the plan published by The Washington Post. Legal immigrants could even be prevented from obtaining a Green Card if their US-citizen child uses such benefits.

The draft proposal is meant to ensure that applicants who wish to "change their nonimmigrant status are self-sufficient" and that "the availability of public benefits [should] not constitute an incentive for immigration to the United States." Under the leaked proposal, the government would consider the use of one or more non-cash benefits by the applicant within three years as a "heavily weighed negative factor" in the permanent residency application. This would affect documented immigrants in the US as well as those with legal status who plan to seek citizenship based on a close family relationship.

Doctors and health advocates worry this proposed policy could frighten a broad group of immigrants and prevent them from seeking government-supported health coverage, which could potentially create public health problems in the long run as well as overwhelm emergency departments. "We are very concerned that this rule, if finalized, would have a significant impact on health in this country," Erin O'Malley, senior director of policy for America's Essential Hospitals, tells NPR. O'Malley says some visa holders and their families would avoid getting routine treatment and instead go to emergency rooms for care, a scenario that would "undermine the stability of our hospitals by creating uncompensated care costs and creating sicker patients." 

Many have protested the leaked draft proposal, and it is in the earliest stages of the rulemaking process. "We're talking about middle-class and working families," Madison Hardee, a senior policy analyst and attorney with the Center for Law and Social Policy, tells NPR. "This could really put parents in an impossible situation — between seeking health assistance for their children and obtaining a permanent legal status in the U.S."