ACP calls for immigration policies that don't interfere with the patient-physician relationship in light of proposed changes to the public charge rule and discussion of DACA rescission
Nov. 1, 2019 (ACP) – In light of recent proposed changes to U.S. immigration policies, the American College of Physicians is reemphasizing its opposition to changes to the “public charge” rule and rescission of the Deferred Action for Childhood Arrivals (DACA), or “Dreamers,” program.
“ACP believes that immigration policy should not interfere with the patient-physician relationship,” said Renee Butkus, ACP's director of health policy. “Health policy should not foster discrimination against any patient, regardless of immigration status. We believe it is important to protect the interests of patients, particularly those from vulnerable populations.”
In early October, three federal judges temporarily prevented the White House's new “public charge” policy from taking effect. The policy was initially scheduled to begin on Oct. 15.
As reported on National Public Radio, under the rule, in deciding whether an immigrant should be granted a green card, U.S. immigration officials would weigh whether the applicant will be self-sufficient. Officials would consider whether the applicant is using public benefits such as Medicaid, food stamps, housing subsidies and cash assistance.
ACP has joined with other organizations and advocates to oppose the new policy through statements and friend-of-the-court legal briefs. “ACP has been extremely concerned that the public charge rule will undo decades of established policy and could cause patients who are legal immigrants to opt out of health care services for themselves and their children,” Butkus said. “Patients may forgo necessary care rather than face the threat of deportation or family separation, putting their own health and the health of their communities at risk.”
Indeed, she said, a new study from the Kaiser Family Foundation has revealed that nearly half of community health centers report that immigrant patients declined to enroll themselves in Medicaid in the past year.
ACP earlier voiced concerns in a letter to the Department of Homeland Security. It highlighted its 2011 position paper “National Immigration Policy and Access to Health Care,” which calls for immigration policy that provides access to health care equitably and appropriately and protects the public's health. In December, ACP signed onto a letter with other physician organizations to the Department of Homeland Security to request that the government exclude the Children's Health Insurance Program, Medicaid, Medicare Part D Low Income Subsidy and other noncash benefits from the list of benefits considered in determining whether an applicant is a public charge.
In another powerful advocacy effort, ACP has just signed on to a “friend-of-the-court” legal brief with 32 other organizations urging the U.S. Supreme Court to reject the Trump administration's plans to end the DACA program.
As ACP has noted, the plan threatens to deny the United States of the talents of more than half a million individuals who are making enormous contributions to the country. It will particularly undermine public health and medical education.
“Many students with DACA status are currently enrolled in medical school or work as physicians and nurses who have the experience and background to treat a culturally diverse population,” Butkus said. “Rescission of DACA would have a significant negative impact on the health care workforce, which stands to lose an estimated 27,000 health care professionals whose work authorization depends upon DACA.”
ACP will continue to monitor the situation and issue statements or join friend-of-the-court briefs as needed on both of these issues. “In regard to DACA, we continue to urge Congressional leaders to consider and pass legislation that would remove the risk of deportation for Dreamers, such as H.R. 6, the American Dream and Promise Act of 2019, which was passed by the House of Representatives on June 4,” Butkus said. “This bill would establish a three-step pathway to U.S. citizenship for DACA recipients through college, work or service in the Armed Forces.”
The policy paper “National Immigration Policy and Access to Health Care” is available on the ACP's website.