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ACP Vows to 'Do What It Takes' to Protect Immigrants' Access to Health Care

Advocate Masthead

New government proposal could penalize legal immigrants for using Medicaid and more

Oct. 19, 2018 (ACP) – The American College of Physicians is fighting back against the Trump administration's attempt to put pressure on legal immigrants by making it harder for them to stay in the U.S. if they utilize government services like Medicaid.

“We're extremely concerned about this proposed policy, which will have a devastating effect on access to health care by vulnerable populations,” said Bob Doherty, ACP's senior vice president for governmental affairs and public policy. “We're looking at all kinds of options to block it.”

ACP has joined with other physician organizations in opposition to the policy, which could be overturned by Congress. ACP is also considering a legal challenge.

“It's vital for us to stand up and protect the interests of patients,” Doherty said.

The proposed policy would drastically change the federal government's approach to the decisions that immigration officials make when people from other countries apply for a green card that would allow them to live and work here permanently.

Currently, “immigration officials consider whether an applicant received federal, state and local welfare assistance,” according to a report in The Washington Post. As of now, an applicant who received welfare could be considered a burden – a “public charge” – and get rejected.

“But under the proposed rule, whether an immigrant enrolled in Medicaid, collected food stamps or participated in public-housing programs would also become factors for the first time and they'd be weighted heavily in the determination of whether to award legal status,” The Post reported. “And that could discourage legal immigrants from availing themselves of government help for which they're eligible, for fear it could jeopardize their prospects of staying in the United States for the long term.”

As Doherty explained, the policy would enable immigration officials to deny immigrants permission to enter the U.S., to deny green cards to those who are already here and to deport someone who's already a permanent legal resident.

“There are many legal residents who are here with green cards and working extremely hard, maybe in low-wage jobs,” he said. “Those without health insurance may avail themselves of Medicaid. Or they may not be on Medicaid themselves but have a family member who is.”

These residents could face the threat of deportation because of the proposed policy, he said.

“If you're worried that Medicaid could lead to you being deported, or a member of your family being deported, a very practical response would be to not take any Medicaid benefits,” Doherty said. “You may choose to go into hiding and not see a doctor or a nurse. They'll fall through the cracks.”

ACP believes that forcing this kind of choice is “morally wrong,” Doherty said, adding that “the majority of people on Medicaid are working people who are contributing to the economy.”

“This is an ill-advised policy in all respects,” he said.

The Trump administration officially unveiled the proposed policy Oct. 10, triggering a 60-day review period in which it must accept comments from the public.

ACP intends to provide comments and has already issued a statement in conjunction with the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Psychiatric Association. Together, the alliance represents more than 500,000 physicians and medical students.

The statement says, in part: “The regulation upends decades of settled policy with regard to public charge and would make it much more likely that lawfully present immigrants could be denied green cards or U.S. visas, or even be deported, merely on the basis of seeking needed health services for them and their family, including those for which they are eligible.”

It adds: “Rather than face that threat, many of the patients served by our members almost certainly will avoid needed care from their trusted providers, jeopardizing their own health and that of their communities. As a result, the proposed regulation not only threatens our patients' health, but as this deferred care leads to more complex medical and public health challenges, will also significantly increase costs to the health care system and U.S. taxpayers.”

ACP hopes comments from critics of the policy will convince the White House to drop the proposed changes. Congress could reverse the policy if it goes forward, offering another route for ACP and its allies to take. Legal action is also possible.

“We're going to examine all options,” Doherty said. “We will do what it takes.”

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Back to the October 19, 2018 issue of ACP Advocate