DHS Docket No. USCIS-2010-0012, RIN 1615-AA22, Comments in Response to Notice of Proposed Rulemaking: Inadmissibility on Public Charge Grounds

DHS Docket No. USCIS-2010-0012, RIN 1615-AA22, Comments in Response to Notice of Proposed Rulemaking: Inadmissibility on Public Charge Grounds

Dear Secretary Nielsen:

The New Jersey Department of Human Services (NJ DHS) is writing in response to the Department of Homeland Security’s Notice of Proposed Rulemaking, Inadmissibility on Public Charge Grounds, published in the Federal Register on October 10, 2018. The NJ DHS has reviewed the proposed rule and strongly urges its withdrawal due to what it believes would be significant harm to immigrant children, families and communities in our State and the negative impact on New Jersey’s health and economic well-being.

Currently, the definition of a “public charge” is a person who has become or is likely to become primarily dependent on the government for subsistence. The benefits that have been considered for the public charge test are Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI) and comparable state or local programs, as well as assistance for long-term institutional care. The proposed rule would expand the public charge test to include use of benefits such as the Supplemental Nutrition Assistance Program (SNAP), Medicaid, Medicare Part D, and various housing and rental assistance programs. It also significantly broadens the range of factors that would be considered in the designation of a “public charge.”  Taken together, we believe these changes create undue burdens and make it unnecessarily difficult for lawfully present low- and moderate-income immigrants and their families to become legal permanent residents and extend or change their temporary status in the United States. In short, the rule would force lawfully present immigrant families to choose between the services they need or may need to support their health and well-being and their ability to become legal permanent residents.

New Jersey is one of the most diverse states in the country with 22 percent of its residents born in a foreign country.[i] The Murphy Administration is committed to building a stronger and fairer New Jersey.   To achieve that goal, our residents who need services to help them get on the best possible financial footing should have access to the supports they need. If the proposed rule were to be implemented as written, too many New Jersey residents  would  fear accessing the health care, nutrition, housing assistance, and other supports that could help their families and our State as a whole be healthier and stronger.  Residents should not need to view the use of services and benefits as a risk that could jeopardize their chances of obtaining legal permanent status. Further, our State would be forced to shoulder the cost of addressing the harms caused by this rule, including the negative economic and public health impacts on our State’s residents.

We strongly urge you to withdraw this unnecessary proposal to avert the negative consequences New Jersey children and families could face. In addition, withdrawing the proposed rule would avoid the needless administrative burdens it would place on our state agencies.

  1. Significant and permanent harm to children, families and communities

 

Nutrition, health care, and other essential supports are investments that keep children healthy, parents working, and families strong. The proposed new definition of a public charge would, however, include individuals who receive even minimal and temporary government assistance, which is often crucial to people’s health and basic needs.  These include Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and Medicare Part D, the prescription drug assistance program for seniors. The proposed rule would significantly deter immigrant families, many of which include U.S. citizen children, from seeking the help they need to lead healthy lives.  Many eligible families would feel pressure to forgo enrolling in vital programs they need.

The proposed expansion of the public charge definition is dangerous for the health of affected individuals and their communities. Individuals without health insurance would be forced to skip routine visits to their doctors, potentially leading to far more serious medical conditions.   New Jersey is especially concerned about the proposed rule’s broadening of the list of public benefits associated with public charge to include Medicaid.  Medicaid is a critical lifeline for families in our State and efforts like the proposed rule will only make it harder to get coverage to individuals who need it.  Uninsured individuals are likely to leave their health conditions untreated until they have to seek emergency care, resulting in poor health outcomes and increased costs to our health care safety net.  Eligible individuals should be covered and not fearful of accessing services.

The Department specifically asked for comment on whether the Children’s Health Insurance Program (CHIP) should be included in its public charge consideration.  New Jersey strongly believes that it should not.  CHIP helps working families with earnings above the Medicaid eligibility threshold who do not qualify for Medicaid get affordable health care for their children.  It also covers certain pregnant women. Immigrant families – particularly pregnant women – could be forced to choose between health care and achieving a more permanent immigration status. CHIP is a crucial program for pregnant women and infants that provides access to health care at a critical time to reduce the risks of developing serious medical conditions or life-threatening harms.

  The proposed rule also would likely increase food insecurity and hunger. An estimated 1 in 10 New Jerseyans are food insecure, which is more than 900,000 residents, including nearly 270,000 children[ii]. The proposed rule would likely increase food insecurity among children and families, as many observers anticipate immigrant families voluntarily withdrawing from SNAP for fear of the public charge implications. Research and studies have confirmed that participation in SNAP and Medicaid significantly improves health outcomes and reduces reliance on cash assistance benefits.

The proposed rule would also make individuals seeking a legal permanent status subject to new burdens as part of the “public charge test.” It would adopt new income thresholds for households, giving negative weight to immigrants earning less than 125 percent of the federal poverty level, or $31,375 for a family of four, and positive weight to those earning more than 250 percent of the federal poverty level, or $62,750 for a family of four. Other criteria that would be weighed negatively include age, family status, financial status, education and language. According to data from Manatt Health, if implemented, this rule could impact as many as 415,000 non-citizen New Jersey residents whose incomes fall under the 125% FPL threshold.

This test would unfairly favor those of means and give unprecedented discretion to officers reviewing immigrants’ applications to deny visas or green cards. Other circumstances that will be heavily weighted include current receipt of one or more public benefit or receipt of one or more benefit in the last three years, having a medical condition that is likely to require extensive medical treatment, and lack of employment. This will make it more difficult for immigrants currently residing in our state who hope to adjust their status in order to get on a better economic footing.  It also will severely impact families with citizen children.  Under this rule, a lawfully-residing single pregnant mother awaiting her green card would feel significant pressure to forgo potentially life-saving health coverage, as well as nutrition assistance for her child, because it would be a heavily weighted negative factor in the public charge test.

 

  1. Chilling effect in immigrant communities

 

Perhaps one of the biggest consequences of the proposal itself is one that has already begun; that is, the widespread “chilling effect” in communities that is impacting immigrants with different statuses, including U.S. citizens in immigrant households. The proposed rule is causing fear among individuals and families who are afraid to use essential programs that their tax dollars support, preventing access to healthy food, health care and secure housing.

Community providers have reported concerns to the NJ DHS’ Division of Family Development of increased confusion among eligible immigrant residents who feel compelled to consider withdraw from the SNAP program or to not apply due to 18 months of rumors and misinformation about this proposed rule. We estimate as many as 50,000 New Jersey residents eligible for and receiving SNAP could be impacted by the chilling effect of the proposed rule.   

New Jersey is especially concerned that this chilling effect will be far-reaching on Medicaid.  We estimate that as many as 20,000 eligible women and children enrolled in Medicaid and CHIP could be impacted by the chilling effect of the proposed rule.

Fear of the new immigration proposal may cause eligible immigrants to drop their benefits or decline to enroll, even if they are exempt from the public charge determination. Therefore the proposed rule would undercut its goals of “acknowledge[ing] the importance of increasing access to health care and helping people to become self-sufficient” if it included Medicaid and SNAP in its public charge determination.

  • Negative impact to State’s economy and administrative burden to agencies that administer public benefit programs

 

The proposal aims to reduce costs of assisting people, but the result would be the opposite and would end up significantly damaging communities. Making people ineligible for or strongly discouraging eligible individuals from applying for key health and nutrition programs would shift the burden onto the State and its residents, harming entire communities as well as the infrastructure that serves them, such as schools, hospitals and clinics.

The policies articulated in the proposal would force families to skip preventive care, chronic disease management and other routine checkups until they are very sick and in dire need of services.  This would shifts costs to the State through increased emergency room visits and hospitalizations.  Delayed health care can lead to far more serious medical conditions and complications that will ultimately require more expensive medical treatment, burdening the health care system and the State. 

Lack of medical care could also lead to a decline in vaccinations and therefore higher incidents of communicable diseases, posing alarming risks to public health at a time when states are struggling with such outbreaks.

A lack of food assistance meanwhile would lead families to look elsewhere, increasing the burden on our already struggling food pantries, shelters and other safety net resources.

We also anticipate significant challenges to state, county and local agencies administering our programs as well as additional costs related to implementation. This includes retraining staff implementing our programs, responding to client inquiries related to the new rule, system updates and modifying existing communications and forms.

 Because the rules for determining whether someone is a public charge are technical and confusing, it will be nearly impossible to train frontline workers to have a good understanding to help potential applicants determine whether they would be determined a public charge under the proposed rule.

 There will be costs associated with any reworking of eligibility and enrollment systems under Medicaid and SNAP to comply with the proposed rule, should it be finalized.  Further, there will be training, outreach and education costs associated with compliance.  We urge the Office of Management and Budget’s Office of Information and Regulatory Affairs to consider the administrative costs to states and localities in evaluating the rule and, again, recommend it not be finalized. 

The New Jersey Department of Human Services strongly urges the Department of Homeland Security to immediately withdraw its current proposal. We call on the Department to instead work together with states to advance the security and well-being of U.S. residents, including immigrants, so that we can ensure our communities thrive and are given the supports they need to remain healthy and productive.

Thank you for your consideration of our views.  We look forward to the Department’s reconsideration and withdraw of this proposal. 

Sincerely,

Carole Johnson

Commissioner

[i] Data from U.S. Census Bureau 2017

[ii] Data from Feeding America’s Map of the Meal Gap 2016