As an organization, we will see any patient, regardless of their race, ethnicity, where they are from, or their ability to pay. Unfortunately, the confusion around Public Charge has made some families hesitant to access health services.

AltaMed is committed to empowering the community to advocate for themselves and their loved ones. We want to ease any fears and help educate our members and their families about the proposed Public Charge rule, and how it could impact immigration and citizenship.

1. First off, what does ‘Public Charge’ mean?

Public Charge is a test that the government uses in certain immigration cases to determine who may depend on public benefits as their main source of support. Basically, if someone tries to enter the country with no relatives or skills, and no viable means of supporting themselves; or if they’re very young, very old, or have certain health conditions, the government can say, “This person should not be able to become a permanent residentbecause we believe they will be dependent upon public and taxpayer-funded services and resources to support themselves.”

2. Why are we talking about it now?

On October 10, 2018, the Department of Homeland Security released a proposal to expand the definition of the Public Charge rule. This means even more people could be prohibited from entering the country or getting on a path to permanent residency.

The new proposal expands the definition of public benefits to include certain Federal,non-cash medical, housing, and food benefits such as non-emergency Medicaid (known as Medi-Cal in California), Medicare Part D Low-Income Subsidy, SNAP (CalFresh/food stamps), Section 8 Housing Vouchers, and rental assistance.

3. When does it go into effect?

There is no set date. The next step is for the Department of Homeland Security to complete its review of all public comments – there are more than 260,000– so it could take a very long time. If and when the new guidelines do go into effect, they could be very different from the proposal.

4. Who is affected?

Public charge applies to:
 

• Those applying for permanent resident status or a visa for the first time
• Legal permanent residents who left the U.S. for six months or more
• Individuals applying for a family-based visa petition
• Undocumented children
• Pregnant women
• Anyone applying for a green card for the first time or seeking entry in the U.S.

If you’re not sure of your situation, consult an immigration attorney that is an expert on public charge to determine if you are affected.

The policy does NOT apply to anyone applying for citizenship or renewing a green card. It also does not impact the following groups:
 

• People who are undocumented and not eligible for a green card
• Refugees or asylees
• U Visa or T Visa applicants/holders (survivors of domestic violence, trafficking and crime victims, and witnesses of serious crimes)
• Violence Against Women Act (VAWA) self-petitioners
• Special Immigrant Juveniles
• Temporary Protected Status (TPS) Applicants

5. Can someone be deported for using public benefits?

Yes, but in reality, very few people have been deported based on Public Charge. Under current policy, all three of the following conditions must also be met:

1. Legal obligation to repay the cost of cash assistance or long-term care needs was established.
2. The immigrant or sponsor must have received a notice to repay the debt within the five-year period.
3. The immigrant or sponsor needs to have refused to repay the debt after the government declared legal action and won.

6. Should I continue to take my family to the doctor?

Yes. Once again, these changes have not gone into effect and no one knows if and when they will. We have heard stories that people who are lawful permanent residents, or families of citizens, have been forgoing crucial medical care out of fear that they’ll draw attention to their family that will result in arrests or deportation.

Currently, there is no penalty for using your health care benefits. There is no advantage to canceling, not applying for, or not using the health benefits you and your family are eligible for (except cash benefits and Medi-Cal long term care). If the changes are finalized, the benefits you use now will not be held against you.

Generally, ICE actions such as arrests, interviews, searches, and surveillance will not occur at sensitive locations, which include health care facilities like clinics and health centers.

You and your family’s health is very important to us. We are committed to serving our members with dignity and respect, and we encourage you to seek regular care.

7. Who do I talk to if I have questions?

The following resources may be able to assist you in determining your next steps:

Ready California, dedicated to the advancement of immigrant communities, with legal advice, self-serve educational materials.

Protecting Immigrant Families, a national organization made up of policy experts and advocates.

National Immigrant Law Center, one of the leading U.S. organizations dedicated to defending and advancing the rights of immigrants with low income.

Immigration Law Help, a resource that connects immigrants with local legal assistance.

Legal Aid Foundation of Los Angeles, legal help on a variety of issues including immigration, employment, family law, and more.

Coalition for Humane Immigrant Rights of Los Angeles, offering legal services, community education, fundraising, and more.

Salvadoran American Leadership and Educational Fund, an organization with nearly 25 years of experience in providing citizenship services, advocacy, and community education.