We at La Clínica del Pueblo strongly denounce the proposed changes to the Public Charge rule, published in the Federal Register by the Department of Homeland Security (DHS.)


These proposed changes directly contradict our mission to build a healthy Latino community, by disrupting and limiting access to basic and necessary health and social services for those most in need. The issue of public charge is open for public comment and we need your voice to help us speak up about these discriminatory exclusions.


This cruel and reckless proposal seeks to expand the current Public Charge criteria for who is considered a Public Charge. Public Charge has been the term used for an individual who is prospectively deemed to primarily rely on government cash assistance or long-term nursing care programs to support their cost of day-to-day living.

The current proposal seeks to block individuals from obtaining legal permanent residency, by allowing more public assistance programs to be considered “public charge.” By expanding the definition of “public charge,” the door is open for the administration to widely discriminate against individuals who are entitled to public services.

The new criteria now proposes to include non-cash, based assistance programs such as

  • Medicaid
  • Supplemental Nutrition Assistance Program (SNAP)
  • Medicare Part D
  • Public Housing enrollment

And characteristics such as

  • Earning a low-income
  • Having a large family
  • Being considered Limited-English Speaking

These proposed changes target lower-income immigrants and will harm the overall stability and health of immigrant households.


These proposed Public Charge changes are already having wide-ranging, negative effects, adding to the ever-increasing fear, stress, and anxiety that immigrant families endure on a daily basis. The proposed changes will have adverse effects on health, not just for the individuals affected, but also for their families and their communities.


The fear of these changes to Public Charge is already having significant detrimental effects on the health of immigrant families. For example, the threat of Public Charge has intimidated immigrant mothers (regardless of their immigration status) from accessing services under the Women, Infants, and Children’s (WIC) program during their pregnancies, for fear that using WIC will deem them a public charge, even if it is for the health of their children.


Beyond what we have already seen, these Public Charges changed will likely continue to harm the health of immigrant families. It could deter patient-provider communication during a critical stage of healthcare, endangering the health of mother and baby. It could prevent this mother from accessing services for mental health if she experiences postpartum depression. The changes to Public Charge could stop her from accessing SNAP to provide enough food for her family, public housing assistance to have an affordable place to raise her family, and/or legal services if she experiences domestic violence or if her work hours are cut due to childcare issues.


Because of her fear of being deemed a Public Charge, her U.S. citizen child could be pulled from the Children’s Health Insurance Program (CHIP), preventing them from receiving their vaccines on time and putting them at severe risk of disease. This mother and her child could forego these crucial services for which they are both eligible, simply out of fear that she could be considered a public charge in the future, not granted permanent residency, and separated from her child. This mother's health, the health of her child, and the community's health are then put at risk if these vital services are foregone. These indirect yet preventable consequences would complicate and compound health and social needs for all of us.


We strongly believe that the DHS Public Charge proposal is misguided, short-sighted, and reckless. It will confuse and create lapses in care for those targeted, and those not targeted, by this proposal at a time when public health in our metro area has experienced significant setbacks, particularly for maternal and child health indicators. Discouraging, restricting access, and walling-off healthcare endangers the health and the health outcomes of everyone in our community. Time and again, we have seen that increasing access to social and public health programs create a win-win dynamic that helps ensure our communities’ health, prosperity, and vibrancy. Recalling this misguided proposal would help ensure that the wellbeing and the interests of our communities are protected by allowing those who may need public services to access them.


We can prevent complex cases like the one described above by taking immediate action today. We emphatically call on the general public and our stakeholders to express their concerns (in English) in the Federal Register [https://www.regulations.gov/document?D=USCIS-2010-0012-0001] before December 10th.


After the comment period has ended, DHS is required to consider the public’s comments and offer a mitigation to the raised concerns before a final proposal is published. Your unique comments are vital now more than ever in standing up for immigrant families. Thank you for speaking up for the health and wellbeing of immigrant families!