The Latest Threat to Immigrant Child Health: Public Charge AAP Webinar Tuesday, October 30, 2018
Immigrant Child Health Colleen Kraft, MD, MBA, FAAP President, American Academy of Pediatri cs 2
In several letters to the Department of Homeland Security, the American Academy of Pediatrics has urged an end to parent-child separation, which researchers have said can cause lifelong trauma in children.
AAP I MMIGRATION A DVOCACY • Grounded in our mission and policy • Engaged in advocacy on family separation, family detention, DACA, enforcement at sensitive locations, and more • Public charge is the latest threat
P UBLIC C HARGE A DVOCACY • Preparing for release of the rule since 2017 • Met with White House Office of Management and Budget to push for delay in publication of rule • AAP chapter/member engagement • Health care sector lead of the Protecting Immigrant Families Campaign
The Public Charge Proposed Rule And What it Means for Immigrant Families American Academy of Pediatrics October 30, 2018 Sonya Schwartz Senior Policy Attorney National Immigration Law Center schwartz@nilc.org Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 10
The Protecting Immigrant Families Advancing Our Future Campaign Created in 2017 and Purpose: Unite to protect and defend access to health Co-Chaired by: care, nutrition programs, public services and economic supports for immigrants and their families at the local, state and federal level. ● More than 280 Active Member Organizations ● 5 Working Groups: Communications, Federal Advocacy, Field, Policy & Legal Analysis, Research ● Click here to see PIF Campaign overview Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 11
Questions I will address • What does this policy look like today? • What would change under the draft proposed regulation? • How should we talk about public charge with immigrant families? • How can you weigh in on these changes? Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 12
What does public charge policy look like today? Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 13
When does the public charge test come up? A public charge assessment is Public charge assessment is NOT made when a person: made when a person: • Applies to enter the U.S. • Applies to become a U.S. citizen • Applies to adjust status to • Falls under certain categories of become a Lawful Permanent immigrants, including refugees, Resident (LPR) asylees, people fleeing domestic violence and more. • A green card holder leaves the U.S. for more than 180 consecutive days (6 months) and reenters Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 14
Current public charge test Totality of Pre-NPRM Definition Circumstances Test Benefits Considered ✓ Age “Public Charge” is a Only two types of term used by U.S. benefits considered: ✓ Health immigration officials to ✓ Family status refer to a person who is 1. Cash assistance for ✓ Financial status considered likely to income maintenance become primarily ✓ Education and skills 2. Institutionalization dependent on the ✓ Affidavit of support for long-term care government for at government subsistence. expense Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 15
How would the public charge test change under the proposed regulation? Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 16
Changes in proposed regulation 1 New definition of “public charge” 2 Totality of Circumstances test has new detailed negative factors that make it harder for low and moderate income people to pass 3 Additional public benefits included Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 17
Definition of public charge Currently As Proposed A person “likely to become An immigrant “who receives one primarily dependent on the or more public benefits” government for subsistence Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 18
Totality of Circumstances Test: Heavily Weighed Factors Heavily Weighed Heavily Weighed Positive Factors Negative Factors Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 19
Public benefits included *Cash Support for Income *Long Term Institutional Care at **Non-Emergency Medicaid Maintenance Government Expense Housing Assistance Supplemental Nutrition Medicare Part D Low Income (Public Housing or Section 8 Assistance Program Subsidy Housing Vouchers and Rental (SNAP or Food Stamps) Assistance) * Included under current policy as well ** Exception for certain disability services offered in school. DHS is asking for input on inclusion of CHIP, but the program is not included in the regulatory text Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 20
Public benefits not included Any other benefit not specifically listed in the regulation is not included • Disaster relief • Women Infants and Children (WIC) • Emergency medical assistance • School Breakfast and Lunch • Entirely state local or tribal • Energy Assistance (LIHEAP) programs (other than cash • Transportation vouchers or non assistance) cash transportation services • Benefits received by immigrant’s • Non-cash TANF benefits family members • Federal Earned Income Tax Credit • CHIP* and Child Tax Credit • Student Loans *DHS is asking for input on inclusion of CHIP, but the program is not included in the regulatory text. Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 21
Totality of Circumstances Test: Other Factors Age Health Family Status Income and Financial Status Education and Skills Affidavit of Support Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 22
Totality of Circumstances Test: Family Status ● Receipt of benefits by dependents (including U.S. citizen children) will not directly be a factor in applicant’s public charge test. ● If a child or family member is an immigrant, his/her own use of benefits counts toward his/her own public charge determination. ● Dependents are included in the calculation of household size and may make it harder for immigrants to meet the income test. Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 23
Who would the proposed regulation harm? Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 24
Impact of the proposed regulation As many as 26 million people in families with immigrants might be chilled from participating in programs that make their families healthier and stronger. 1 in 4 children have an immigrant parent Source “Public Charge Proposed Rule: Implications for Non - Citizens and Citizen Family Members Data Dashboard,” Manatt Health, October 2018 Source : Samantha Artiga and Anthony Damico“Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies” Kaiser Family Foundation, 2018 Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 25
Impacts of the proposed regulation Impacts by race and ethnicity • 18.3 million LATINOS • 33.4% of all LATINOS • 3.2 million ASIAN & API • 17.4% of all ASIAN & API • 1.8 million BLACK & AFRICAN • 4% of all BLACK & AFRICAN • 2.5 million WHITES • 1% of all WHITES Source : “Public Charge Proposed Rule: Implications for Non -Citizens and Citizen Family Members Data Dashboard,” Manatt Health, October 2018 Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 26
Summary: Why the proposed policy is a radical change Definition would change from someone who relies on government Definition for main source of support to someone who participates in a Change health, nutrition or housing benefits to support work. Immigrants can fail totality of circumstances test if they are low More Gov income, don’t speak English well, receive an included benefit. Discretion Additional benefits included in the test: non-Emergency Medicaid, Additional Benefits SNAP, Housing, Medicare Part D low-income subsidy Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 27
Keep in Mind • Other than cash or long-term care, benefits used before rule is final and effective will not be considered in the public charge determination. • The existing 1999 public charge guidance is still in place in the U.S. until a new rule is finalized. • The proposed regulation may never be finalized or the finalized regulation could look different from the proposed version. Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 28
How can you talk to immigrant families about this? Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 29
How can you talk to immigrant families about this? 1. The regulation is not final and you can speak out against it 2. The proposed regulation would not consider any newly listed benefits before it is final 3. The regulation does not apply to all immigrants 4. The privacy of your personal information is protected by law 5. You are not alone, and you can fight back! Get help understanding how this would apply to you. For free or low-cost options, visit: www.immigrationadvocates.org/nonprofit/legaldirectory Protectingimmigrantfamilies.org Protectingimmigrantfamilies.org 30
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