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Proposed Rule Could Mean Loss of Health, Nutrition Benefits for Millions of Kids

More hard-hearted stuff.

Parents' "fear and confusion" around the specifics could lead to disenrollment of many immigrant children

by Shannon Firth, Washington Correspondent, MedPage Today

July 01, 2019

Millions of children stand to lose health and nutrition benefits if a proposed rule that influences immigrants' legal status in the U.S. is finalized by the Trump administration, according to researchers.

Leah Zallman, MD, MPH, director of research at the Institute for Community Health in Malden, Massachusetts, and colleagues noted that 1.3 million children with at least one potentially life-threatening condition, such as asthma or epilepsy, risk losing benefits if the "Public Charge" rule is enacted in its current form.

In addition, according to the analysis in JAMA Pediatrics .. https://jamanetwork.com/journals/jamapediatrics/article-abstract/2737098 , the proposed rule .. https://www.medpagetoday.com/publichealthpolicy/healthpolicy/75290 .. is "likely to cause parents to disenroll" from 0.8 million to 1.9 million children who have "specific medical needs" -- which includes everything from vaccinations to treatment for asthma, influenza, and epilepsy.

"These losses would likely contribute to child deaths and future disability," the team wrote.

Expanding 'Public Charge' Criteria

When immigrants apply for legal permanent residency (i.e., "green cards"), immigration officials weigh an individual's likelihood of becoming a "public charge" -- someone dependent on public benefits -- and consequently deny entry or re-entry to the U.S. for such individuals, the researchers explained.

Under a long-established policy, those receiving cash assistance or individuals who had been institutionalized in a government-funded facility were labeled public charges.

However, a rule proposed in October would direct immigration officials to expand the range of public benefits used to relegate an individual to "public charge" status, to include (non-emergency) Medicaid, Medicare Part D low income subsidies, and Supplemental Nutrition Assistance Program (SNAP), thus increasing the risk that an immigrant would be denied either entry to the U.S. or a green card, Zallman and co-authors noted.

They said they anticipate these proposed changes will sew "fear and confusion" among immigrant parents, who may disenroll their families from safety-net programs, even in cases where the rule doesn't apply. "Denial of green-card status for parents could lead to family separation or relocation of children (most of whom are U.S. citizens) to their parents' country of origin, where adequate medical care may not be available," the researchers stated.

They also stressed that disenrollment from SNAP or housing benefits would increase a child's risk of food insecurity, malnutrition, poverty, and homelessness.

Study Details

https://www.medpagetoday.com/publichealthpolicy/medicaid/80794