As Public Charge Fears Escalate, Immigrants Urged Not to Drop Benefits

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As rumors swirl in Los Angeles communities about proposed changes to federal immigration policy on who is considered a “public charge,” medical and legal aid providers are countering misinformation they say is putting immigrants’ health at risk.

This week, community health provider AltaMed Health Services hosted a public town hall meeting at East Los Angeles College, to separate fact from fiction about the public charge rule and urge families not to drop benefits unnecessarily.

The town hall was part of ongoing efforts to educate immigrants about the public charge proposal and prevent people from taking drastic action based on rumors that can end up hurting their own and their families’ wellbeing, said Lily Choi, an attorney with Neighborhood Legal Services of Los Angeles County (NLSLA).

For the past few months, immigrants have been calling NLSLA offices to ask if they should drop out of health and nutrition programs such as Medi-Cal and CalFresh, said Choi. Food stamp enrollment centers are reporting a dramatic drop in applications, she said.

At community clinics, such as those run by AltaMed, providers are seeing people delay preventative care and forgo health insurance for themselves or their children, even though they have no reason to, said Ilan Shapiro, a pediatrician there. He said these actions are a threat to both individuals and broader public health, because they can result in declining vaccination rates, family instability and increases in costly emergency room visits.

“I’m very worried,” said Shapiro, who is also AltaMed’s managing director for health education and wellness. “A lot of people are not having access to the services they actually need, not because there’s a legal problem with it, but because they’re afraid.”

Public charge determines whether applicants for legal residency in the United States are likely to become a taxpayer burden. The proposed change expands the range of programs that count as public charge liabilities to include Medicaid (known as Medi-Cal in California), food stamps, Section 8 housing vouchers and Medicare Part D subsidies for low-income people.

Federal officials still have to wade through over 200,000 comments on the proposal before deciding whether to approve or change it. Even if the new rule does become law, it only applies to certain types of cases, and cannot be applied retroactively. Yet many immigrants are heeding rumors that they or their family members could be deported or face other immediate legal consequences for enrolling in public benefit programs, Choi said.

“We want to inform the community that the public charge rule has not changed yet. That you should not panic, that you should not just simply quit your benefits, that you should see an immigration attorney first,” she said. “This rule may not apply to you, and even if it does apply to you, it’s a complicated rule and you definitely don’t want to do something hasty when the rule hasn’t changed yet.”

Choi said she’s encountered people who are already legal residents, but are nevertheless dropping benefits out of fear. Shapiro spoke of a grandmother who stopped going to the doctor and taking medication for her diabetes, making it difficult for her to care for her grandchildren. Héctor Plascencia, an immigrant health advocate, said some people are avoiding county health programs and other services that aren’t even included in the public charge proposal.

“We understand the power of word of mouth. It’s so powerful within immigrant communities,” said Plascencia. “We want people to attend the town hall so in turn they can be a resource in their communities and… deescalate a lot of the fear about immigrant health.”

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