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WCMS Comments on Rule to Define “Public Charge” for Immigration Status

Government Affairs and Advocacy Issues

WCMS sent the following comments after coordination with the Washtenaw County Health Department and approval at the November WCMS Executive Council meeting.

______________________________________________________________

November 2018

 

DHS Docket No. USCIS-2010-0012

Samantha Deshommes, Chief, Regulatory Coordination Division
Office of Policy and Strategy, U.S. Citizenship and Immigration Services
Department of Homeland Security
20 Massachusetts Avenue NW
Washington, DC 20529-2140

Dear Chief Deshommes:

On behalf of the Washtenaw County Medical Society (WCMS), we write to oppose the Department of Homeland Security’s (DHS) proposed rule change to define “public charge” and the types of public benefits that may affect individuals’ ability to enter the U.S. or adjust to legal permanent resident (LPR) status. As physicians and public health leaders, we are aptly aware of how critical public benefits are to resident-seekers and communities in which they reside.

WCMS is the leading physician medical association for legislative action and community outreach in Washtenaw County since 1827. We are comprised of approximately 1,000 physicians of various specialties working at major medical and teaching institutions, including the University of Michigan, Trinity Health, and St. Joseph Mercy Ann Arbor; community health centers; and small or private practices. In Washtenaw County, one in 10 residents is in immigrant.[1] WCMS is keenly attuned to the economic, employment, and higher education benefits that the state gains from immigrants. In 2014, undocumented immigrants in the state paid an estimated $86.7 million in state and local taxes and their contribution would rise to $113.9 million if they could receive legal status. Further, nearly 40% of immigrants held a college degree or higher and in 2015, nearly 8% of Michigan’s labor force was comprised of immigrant workers.[2]

In this pursuit, we stand opposed to these three, arbitrary thresholds:

  • The proposed threshold for those benefits that can be monetized easily (cash benefits, SNAP or food stamps, and Section 8 vouchers and rental assistance) is 15 percent of the Federal Poverty Guidelines (FPG) for a household of one within any period of 12 consecutive months, based on the per-month FPG for the months during which the benefits are received. For 2018, the equivalent 15 percent of the FPG dollar value is $1,821.
  • The proposed threshold for those benefits that cannot be monetized easily (Medicaid, the Medicare Part D Low Income Subsidy, and Public Housing) is receipt of such benefits for more than 12 months in the aggregate within a 36-month period (such that, for instance, receipt of two non-monetizable benefits in one month counts as two months).
  • The proposed rule also contains a third standard, under which a person would be considered likely to become a public charge if he or she is likely to receive a monetizable benefit below the threshold, plus one or more non-monetizable benefits for longer than
    nine months.[3]

The WCMS believes that the policy changes will likely reverse public health strides our community has made to increase vaccinations, control infectious diseases, and develop nutrition programs.[4] Further, we are concerned that these changes may force resident-seekers to make adverse decisions that would compromise themselves, their families, and the overall public.[5] As physicians, we know that family unity is critical, particularly in times of significant change, and are concerned about unintended consequences of financial and health instability during family separation.[6] We question the need for DHS to define “public charge” in statue now, particularly considering the charged political climate in our nation. We believe that making these changes will only marginalize resident-seekers working to achieve the American Dream in the short-term and put all Americans at-risk in the long-term.

Once again, we strongly reject DHS’ proposed change to define “public charge.” We remain committed to serving the public in the best ways that we were medically trained to do. WCMS welcomes the opportunity to work together to develop solutions in pursuit of our mutual goal of optimizing patient care and community safety.

Sincerely,

Joseph Nnodim, MD, PhD                                       Gabrielle Szlenkier
WCMS President                                                       Executive Director

[1] https://www.census.gov/quickfacts/washtenawcountymichigan

[2] https://www.americanimmigrationcouncil.org/research/immigrants-in-michigan

[3] https://www.uscis.gov/legal-resources/proposed-change-public-charge-ground-inadmissibility

[4] https://www.healthaffairs.org/do/10.1377/hblog20180927.100295/full/

[5] https://www.ama-assn.org/ama-statement-linking-safety-net-benefits-immigration-status

[6] https://www.kff.org/disparities-policy/fact-sheet/proposed-changes-to-public-charge-policies-for-immigrants-implications-for-health-coverage/

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