Another blow to immigrants and their families

The Trump administration’s zero-tolerance policy, which resulted in the tragic separation of children from their parents at the border, has dominated the news cycle these last few weeks.

However, there is another disturbing issue – one that has gotten far less attention and may not be immediately familiar to most – that could be equally devastating for immigrant families across the nation, including those who are here lawfully and their U.S. citizen family members. This issue is the proposed changes to the “public charge” rule.

So, what is the “public charge rule?”

For more than 100 years, immigrants seeking to obtain lawful immigration status in the U.S. had to prove to the government that they are not “public charges” – that is, that they would not be dependent on the government for support.

During the past two decades, the federal government has stated that eligible immigrants could use programs such as Medicaid or SNAP (food stamps) and that any benefits used by immigrants’ U.S. citizen children or family members do not count against the immigrants themselves in seeking citizenship.

The Trump administration’s proposed changes to the existing public charge rule would make it so that if immigrants use these critical programs, the government will now use it against them in determining whether they can obtain lawful immigration status.

Of great concern is that the rule also says any benefits used by an immigrant’s U.S. citizen children or dependents can be used against the immigrant as well.

This rule does not punish those defrauding the system; rather, it punishes those who are lawfully using benefits that Congress has decided they are eligible to obtain.

These “public charge” rule changes represent a hugely concerning issue that could directly affect tens of thousands of North Carolinians, and as doctors, the effects of which we see playing out in front of our very eyes on a daily basis. We are among the majority of North Carolina’s pediatricians, along with teachers and child and immigrant advocates, who are gravely concerned about this issue.

Immigrant families – many who have worked for years in our state and contributed to our economy, and some who are fleeing threatening circumstances in their countries of origin – will have their ability to obtain a lawful immigration status put at risk if they use these programs.

These families are fearful and anxious, and are stepping away from crucial services they need for their daily well-being. For example, many North Carolina immigrant parents are choosing to forgo well-child pediatric visits, which provide preventative health care like vaccines, safety tips and opportunities for parents to ask questions about their child’s development. Others are choosing to not reapply for WIC or SNAP benefits.

As a result, too many immigrant children are not getting the consistent health care they need, are going hungry, or are experiencing toxic stress, all because their parents fear the possibility of deportation. The public charge issue is causing a disruption of the child-parent bond, food insecurity, and the benefits of consistent medical care. It is an active deterrent to the immigrant children who are experiencing fear and anxiety on a daily basis as well as their families who are seeking a better life.

One of us recently treated a young 9-year-old Latina girl. She was so terrified her parents would be deported while she was at school that she was experiencing recurring headaches, stomach pain, anxiety and was missing school due to her fear and these resulting health issues. Her parents are aware she needs medical care but are scared to seek treatment because of the public charge issue.

Pediatricians across the state are reporting multiple incidences of immigrant patients not showing up for their clinic visits. All families deserve the opportunity to thrive across our state and great nation – in school, at their health care clinic, and at their family home and table. From pediatricians like us working in the trenches to teachers who have seen increased absentee rates amongst their immigrant students – we are speaking out against any changes to the public charge rule and standing in support of our immigrant neighbors and their children.

Dr. Kathleen Clarke-Pearson and Dr. Lourdes Pereda are active members in the American Academy of Pediatrics and the NC Pediatric Society