What is a Public Charge?

Who should be able to live in the United States? For as long as there have been immigration authorities, people have been asking that same question. At Ellis Island, for instance, steerage passengers were asked about their financial status and required to complete a cursory medical exam as a means of limiting the number of immigrants unable to be self-sufficient.

A similar idea is evident in modern-day immigration law, where the “public charge” rule allows immigration authorities to deny entry or a green card to individuals deemed likely to rely primarily on the government for subsistence. Since 1999 the rule has applied to individuals who receive more than 50% of their income from government cash benefits such as TANF or SSI. Earlier this fall, however, the current administration drafted a worrisome revision to the public charge rule. Under the proposed new rule, legal immigrants could be denied permanent resident status based on a much wider range of criteria, including use of Medicaid, nutrition assistance, or housing subsidies.

Why is this a pro-life issue? Because the proposed change would have a disproportionate impact on unborn babies, young children, pregnant women, the poor, and the disabled.

First, the new rule discourages legal immigrants who are eligible for Medicaid from seeking coverage, for fear that it will prevent them from obtaining permanent resident status in the future. For pregnant women who lack private health insurance, access to prenatal care via Medicaid substantially increases the odds that their babies will be born alive and healthy. It also increases the odds that the expectant mothers themselves will avoid potentially life-threatening complications. Access to prenatal care is critical for women who want to choose life for their babies. According to a 2016 report, inability to afford a baby is a key driver of abortion rates among low-income women.

The organization 1,000 Days, which exists to protect children’s well-being in the window from conception to their second birthdays, has urged the administration to withdraw the proposed rule change because of its likely impact on children, the large majority of whom are themselves US citizens. The American Academy of Pediatrics concurs, noting that a quarter of the children in the US live in immigrant families.

It’s also important to note that the proposed rule will limit access to health care and support services for legal immigrants with disabilities, especially those from lower income brackets. Our Lord showed particular compassion for individuals with disabilities, and we are called to follow his example. Extending welcome to individuals with disabilities is a key component of a culture of life. Fear of disability, conversely, is a factor in abortion rates — especially for later abortions.

Disabled immigrants are doubly marginalized. As they seek to acclimate to life in the US, their differences — both in terms of their origins and their abilities — can exact a heavy toll. The Catechism exhorts well-off nations to welcome migrants:

The more prosperous nations are obliged, to the extent they are able, to welcome the foreigner in search of the security and the means of livelihood which he cannot find in his country of origin. Public authorities should see to it that the natural right is respected that places a guest under the protection of those who receive him. (CCC 2214)

Physician Colleen Kraft, president of the American Academy of Pediatrics, described the impact of the proposed rule on immigrant families: “The public charge proposal presents immigrant families with an impossible choice: keep yourself or your children healthy but risk being separated, or forgo vital services like preventive care and food assistance so your family can remain together in this country."

This is not what a preferential option for the poor and vulnerable looks like.

The proposed rule is posted here. The public can comment on the proposed change until December 10.

Image of Ellis Island medical exams from Wikimedia Commons