The Biden administration has ended a controversial 2019 change to the “public charge” rule by the Department of Homeland Security (DHS) that the Texas Medical Association and numerous other major medical organizations opposed over concerns it deterred immigrants from obtaining timely medical care.
The public charge rule, which allows the U.S. to deny entry to immigrants who are likely to require public assistance, has been part of immigration law since 1882. But the 837-page revision to the rule in 2019 broadened its parameters to include visa and green card recipients who receive health care, nutrition, and housing services.
TMA and other medical groups opposed the revised rule when DHS first submitted it for public comment in December 2018. Then-TMA President Doug Curran, MD, sent a letter urging U.S. immigration officials to withdraw the proposed rule, pointing out the rule would hurt patient health and undermine physician practices taking care of these patients.
That opposition paid off on July 22, 2021, when the Center for Medicaid & CHIP Services Informational Bulletin informed states the rule had been vacated and is no longer in effect.
Anecdotal evidence from Texas physicians confirmed that due to confusion about and numerous exceptions within the rule change, immigrants had stayed away from health services – a problem for both patients and physicians in a state with the highest rate of uninsured patients in the country.
Though aimed at legal immigrants, some studies showed the changes to the public charge rule also had an impact on undocumented immigrants. An August 2019 survey of undocumented immigrants by the U.S. Immigration Policy Center at the University of California San Diego found that after hearing about the rule change, immigrants were 18.3% less likely to get preventive health care and 8.6% less likely to get care for their noncitizen children. It also found they were 15% less likely to get emergency health care services for themselves and 6.6% less likely to get them for their noncitizen children.
Last Updated On
August 09, 2021
Originally Published On
August 09, 2021