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San Francisco Marin Medical Society Blog

Public Charge Threatens Californians’ Health and Well-Being



On August 12, the Department of Homeland Security finalized changes to its “public charge” rule. Along with a variety of new criteria, use of non-emergency Medi-Cal, CalFresh, and certain types of federal housing assistance, among other programs, will now count against immigrants seeking to enter the US or obtain a green card.

In a San Francisco Chronicle op-ed, Sandra R. Hernández, MD, president and CEO of CHCF, wrote, “For a nation of immigrants, this new rule goes against our traditional values of inclusion. It punishes people for accessing services to meet basic human needs such as health care, food, and housing — services for which they are legally eligible." In California, this rule will erode the significant progress that has been made in reducing the uninsured rate and expanding access to health care.

She also stressed, “California’s immigrants should not assume that they or their family members are subject to this new rule. They should get the facts and seek guidance about their situation before making any decisions regarding their participation in Medi-Cal or other public benefits. . . . Anyone with an active role in educating immigrant communities . . . should take care to provide accurate and accessible information about the new rule to families.”

If you are an immigrant or serve immigrant communities, the Protecting Immigrant Families (PIF) Campaign has released a series of updated resources to help you understand the rule. The California Department of Social Services has compiled a list of organizations that provide legal consultation and/or education for families impacted by the public charge rule.

The rule does not go into effect until 60 days after its publication. Several lawsuits have already been filed to block its implementation. For ongoing updates, check the PIF website.

For more in-depth analyses of the new rule, see CHCF’s latest blog post and Insure the Uninsured Project’s public charge resources. This CHCF collection includes a variety of other resources on the rule’s potential impact on access to health care and the state’s economy.

“California’s immigrants are our neighbors, colleagues, friends, and family members,” Hernández reminds us in the conclusion of her op-ed. “Their future is our future. We must stand with and speak up for them. This latest threat must not deter us from working toward the day when all Californians, regardless of immigration status, have the opportunity to thrive.”



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