Immigration Policy Affects Kids

The Department of Homeland Security has announced regulation changes to the US Government’s “public charge” policy which could affect the health of 20 million children in the U.S. Almost nine in 10 of these children are U.S. citizens.

The proposed regulation changes would expand the list of benefits that immigration officials may consider in deciding whether an applicant is likely to become a “public charge,” someone who depends on public assistance. Applicants who are ruled likely to become a public charge may be denied green cards.

What is public charge?
The “public charge” test has been part of federal immigration law for decades. It is designed to identify people who may depend on government as their main source of support. If the government determines someone is likely to be a “public charge,” the government can deny admission to the U.S. or refuse an application for lawful permanent residency.

Many taxpaying immigrant parents have U.S. citizen children who are eligible for programs like health care and food assistance. Some are even eligible themselves. The proposal would make them afraid to access programs that support these essential needs.

Under current policy, the only benefits considered in determining who is likely to become a “public charge” are cash assistance such as Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF) and government-funded long-term care.

What is changing?
If the proposed rule is finalized, immigration officials could consider whether individuals have received or sought access to government programs. Benefits that could be considered in a “public charge” determination would be expanded to include programs such as:

  • Non-emergency Medicaid, with some exceptions.
  • Supplemental Nutrition Assistance Program (SNAP).
  • Medicare Part D Low Income Subsidy.
  • Housing assistance such as public housing or Section 8 housing vouchers.

In addition, there is a new income threshold, requiring the immigrant to earn at least 125% of the federal poverty level, and weighting as “heavily positive” those who earn more than 250% of the federal poverty level. To avoid scrutiny, a family would have to earn nearly $63,000 annually. To learn more about the proposed changes, visit

What can we do?
We do not recommend discouraging families from seeking benefits. The rules governing public charge determinations in the U.S. have not yet changed and will be subject to a 60-day public comment period before they can be finalized  Some groups of immigrants—such as refugees and asylees—are not subject to “public charge” determinations and public charge is also not a consideration when lawful permanent residents (green card holders) apply to become U.S. citizens.

**If the families you serve are declining benefits due to fear of Immigration and Customs Enforcement (ICE), we need to know! Please use the following form to report instances of families opting out of benefits: 

WCAAP will keep you informed and we will be calling on you to take action in the coming days and weeks, once the proposed regulations are open for public comment. To be effective, we will need to mount a much larger response than our usual volume. It is imperative that at least one quarter of WCAAP members act in order for us to effectively defeat this change.

Furthermore, the Department of Homeland Security will only review unique comments, so we will call on you to personally describe the impact on the health of children and families you serve.  Thank you in advance for raising your voices for children and sharing this critical information with your colleagues.

Breakfast with Dr. Colleen Kraft

October 26, 2018
Swedish First Hill – Seattle

Join the WCAAP as we welcome American Academy of Pediatrics president Dr. Colleen Kraft to Seattle on October 26th for a breakfast & discussion about immigrant child health.

Dr. Kraft will discuss how U.S. policies regarding undocumented immigration affect the children coming to our southern border and what the AAP is doing to oppose the practices of detention and family separation and protect the health and human rights of immigrant children and families.

Space is limited – please RSVP today!

Caring for Washington’s immigrant families

WCAAP members Elizabeth Dawson Hahn and Vaidehi Pidaparti have just produced WCAAP’s Immigrant Health Toolkit which has resources for you as a clinician to support Washington’s immigrant families, including what benefits immigrant children are eligible to receive. We will be walking through this toolkit with Drs. Dawson-Hahn and Pidaparti on webinars on November 8th and 9th – you can register here: