The ATS recently submitted comments to the Department of Homeland Security proposed rule to expand public charge determinations to include consideration of whether green card applicants have utilized Medicaid, housing assistance, Medicare Part-D low income subsidy program and supplemental nutrition assistance. The rule, if finalized, could cause confusion and fear among immigrant individuals and families about whether enrollment and utilization of Medicaid and other programs, to which they are legally entitled, would affect their ability to remain in the U.S. As a result, many would forgo vital health care services, including for serious respiratory conditions such as asthma, and infectious diseases such as flu and tuberculosis.  Concerning TB, the ATS noted, “…The expanded public charge definition will serve to deter legal immigrants who have active or latent TB from seeking care through Medicaid or through state and county public health department TB control programs for this airborne disease, not only jeopardizing their health, but also the health of their families, co-workers and any others they are in close contact with.

In the letter, the ATS expressed particular concern about the potential effects on vulnerable populations, including children. The rule also requested comments on whether utilization of CHIP should be considered in public charge determinations. The letter states, “The ATS urges the Department in the strongest possible terms NOT to include CHIP utilization in public charge determinations in order to protect the health and development of the children of immigrants.”

The Department is due to finalize the public charge determination rule in mid-2019.