‘We don’t know what to do.’ Proposed Trump rule strikes new fear in immigrant communities

Oct. 09--A proposed Trump administration rule that would make it more difficult for immigrants to become legal residents if they get government benefits has Fresno County immigrants and advocates concerned, while gaining support from fiscal conservatives who say the U.S. should not have to support individuals coming into the country.

The proposed changes are making legal immigrants reconsider applying for public benefits that they are entitled to, such as Medi-Cal and food stamps. Undocumented immigrants, who are ineligible for most government programs, are afraid that the few services they are able to receive would prevent them from gaining legal residency.

A Fresno mother who takes her special needs son to a health clinic said she fears she's jeopardizing her path to legal residency.

"I don't want the simple act of using Medi-Cal to be an obstacle in me getting papers," she said.

Her son, age 5, has autism. He is eligible for the state-federal health insurance program, but she is an undocumented immigrant and her angst stems from talk in the community that legal permanent residency in the U.S. could be denied to those who had ever used government aid programs.

"Before, I was sure that I was going to keep Medi-Cal because of my son, but now I'm very scared," she said. "We don't know what to do."

Proposed rule up for public comment

The U.S. Department of Homeland Security in late September released a proposed rule that would expand the list of public benefits that would be considered a public charge. The proposal changes the way the department determines who is inadmissible or ineligible to adjust their status in the U.S. because they are likely to become dependent on public assistance.

Under the current policy, the public benefits that are considered a public charge are mainly monetary assistance. They include Temporary Assistance for Needy Families, state and local cash assistance programs and long-term institutionalized care.

The proposed rule would add food stamps, housing vouchers and subsidies, Medicaid (Medi-Cal in California) and prescriptions for the elderly to the list of publicly funded services that would be considered a public charge. The official version of this rule is scheduled to appear in the Federal Register on Wednesday, Oct. 10, and the last day to make public comment will be Dec. 10.

Those who will be scrutinized under the proposed public charge rule would be immigrants trying to come into the U.S. on visas and immigrants already in the country hoping to get a green card, according to Homeland Security. But confusion persists around the issue because most of those adults without a green card wouldn't be eligible to receive most public benefits, such as food stamps, housing vouchers and subsidies, as well as regular Medi-Cal. A green card grants a person legal permanent resident status in the U.S., and gives them full benefits in the country, except the right to vote.

Visas that would be affected under the public charge include temporary business or pleasure visas and some temporary worker visas, for example. The proposed rule would not apply to certain groups, such as refugees and asylum seekers, as well as Afghans and Iraqis with a special immigration visa.

Homeland Security spokeswoman Katie Waldman said the rule has limited exemptions for benefits paid for an emergency condition. But depending on the state, people who have used benefits, such as emergency Medicaid and disaster relief, could be targeted by the new rule.

But since most people who are hoping to come to the U.S. on a visa "are not generally eligible" for public benefits, the proposed policy would heavily focus on how "likely" people are to get public assistance as opposed to whether they have actually received public benefits. "Mostly, this rule is prospective in nature," Waldman said.

Family-based migration under attack?

While it's unclear how many immigrants in the U.S. would be targeted under the proposed rule, something else is clear. President Donald Trump has aggressively pushed to stop family members from sponsoring loved ones to bring them to the U.S. through what is known as family-based migration or chain migration. He has expressed a desire to change to merit-based migration.

During his State of the Union speech in January, Trump called for ending "chain migration." He said, "under the current broken system, a single immigrant can bring virtually unlimited numbers of distant relatives."

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The most common path for people to obtain a green card is through the family-based migration system, representing about 70 percent of the roughly 1 million green cards issued annually, according to the Pew Research Center.

In Fresno County, during the first two quarters of the 2018 federal fiscal year, a total of 1,118 family-based migration petitions were received. Another 1,181 petitions were approved, 87 petitions were denied and 3,909 petitions were pending, according to the U.S. Citizenship and Immigration Services agency.

Mario Gonzalez, who oversees the immigration department at Centro La Familia, said the proposed changes are "trying to attack family-based migration." The Fresno nonprofit organization focuses on providing advocacy services to the immigrant community.

While the public charge has been around for a long time, the way it's being expanded "it's a very cruel way to do it," Gonzalez said. "Any individual or family member who is trying to (become legalized) based on a family petition through their spouse, through their child, and they have received public benefits, then their application is already set up to be denied. It's just creating an additional barrier for them to have to overcome."

Immigrants should be self-sufficient?

The proposed policy changes by the Trump Administration have raised concerns among immigrants and immigrants' rights advocates, but they have also gained the support of others.

Michael Der Manouel Jr., chairman of the conservative Republican Lincoln Club of Fresno County, is backing the proposal.

"A nation in $21 trillion debt and climbing should reconsider giving access to all of our public benefits to people who are not citizens," Der Manouel said. "It doesn't make sense to continue to do that." Immigrants who come to the U.S. should be embraced if they are capable of being self-sufficient, he said. But the U.S. should not allow people to come to access public services at taxpayers' expense.

"It's a mistake to allow these type of programs to become a virtual magnet for people to come here," Der Manouel said. "There's nothing unreasonable about asking people to take care of themselves."

Fred Vanderhoof, chairman of the Fresno County Republican Party, said immigrants who need support can find help outside of government programs. "If the government begins to step away from supporting everything and everyone, I think we will see private organizations, faith-based organizations fill in the gap," he said.

Fear, even among green card-holders

The proposed changes are stirring fear, even among those who are already green card-holders.

Margarita Rocha, executive director of Centro La Familia, said before the proposed rule was released, people were already afraid to apply for various services, while some who already had benefits dropped them.

The Trump administration, she said, is making her organization's "work difficult."

Jesus Martinez, executive director at Central Valley Immigrant Integration Collaborative, said the fear among immigrants will have ripple effects. "It will set back efforts such as application process for naturalization and other existing immigration programs and, most likely, application for health and other programs at the federal or state level that people might be eligible for."

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Advocates say this will not affect green card-holders from becoming naturalized U.S. citizens. But concerns may keep some from applying for citizenship.

Linda Du'Chene, deputy director of Fresno County Social Services, has been keeping an eye on disenrollment in CalFresh (food stamps) to see if immigrant families are expressing fears about accessing the public benefit. Only immigrants who are legal permanent residents (green card holders) are eligible for food stamps. There are 9,606 CalFresh cases with at least one legal permanent resident in the household or about 12 percent of the 83,000 households in Fresno County receiving food stamps.

So far, no one has asked to withdraw an application for reasons related to the proposed executive orders, Du'Chene said. "But in working with our community-based organizations, we are hearing from them that the population is sharing they did not want to apply," she said.

A decline in CalFresh enrollment has been seen statewide but Du'Chene is hesitant to pin the trend to fears over public charge. "The economy is improving," she said.

More hungry, more homeless?

Sarah Reyes, former California Assembly member and director of communications for The California Endowment in Fresno, said immigrant families who are eligible for food stamps and housing vouchers are afraid to apply for assistance. "Unfortunately what this can mean is there will be more people going hungry. We're going to see homelessness, and especially here in Fresno, we already have a homeless problem."

Twelve years ago, the Fresno mother, 46, and her now 23-year-old daughter and 13-year-old son departed Michoacan, Mexico, to join her husband in Fresno. She now has a 10-year-old and a 5-year-old born in the U.S.

All four children have full Medi-Cal coverage, including the 13-year-old who is undocumented and the 23-year-old who is eligible under a deferred action that allows young adults who were brought to the U.S. as children to receive benefits.

Homeland Security says if a child is a U.S. citizen or is undocumented and is receiving public benefits it wouldn't be used against a parent trying to get a green card. But if an undocumented child is getting public benefits, and in the future the child wanted to become a legal permanent resident, it would count against the child's petition for adjusted status. In California, undocumented children under the age of 19 are eligible for full Medi-Cal coverage.

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The undocumented Fresno mother and her husband only have the emergency Medi-Cal. They avoid going to the doctor's office. Her husband, 47, has diabetes, and he sought care two years ago when he became seriously ill. That's the last time he has been to a doctor. But the proposed rule scares the couple. "We are afraid that for that simple act of using it, they will single us out," said the mother, who spoke on condition she not be named because she is undocumented.

Health organizations across California and nationwide have expressed concern over the proposed rule that would include Medi-Cal as a public charge.

Since the implementation of the Affordable Care Act, California has expanded its Medi-Cal eligibility, including coverage of undocumented children. The proposed public charge rule could erode the gains made in getting people health coverage, said Gregory Hund, CEO at CalViva Health, the locally governed Medi-Cal managed care plan for Fresno, Kings and Madera counties.

"We fear that people who qualify for Medi-Cal will not take advantage of this highly beneficial and cost-effective health coverage, resulting in people delaying medical treatment until they are very sick," Hund said.

The only resource left for people without coverage would be to get medical treatment at hospital emergency departments, which can cost 500 percent more than going to a doctor's office, he said. "This proposal is counterproductive and will lead to higher health care costs."

The Fresno mother said her biggest concern is her 5-year-old son. She knows each therapy session is costly and the family would not be able to afford them without Medi-Cal. "If they took away Medi-Cal or if I disenrolled him, I know my son would deteriorate."

But she's torn. She wants to get a green card so she can go to Mexico to visit her family and legally return to the U.S., but she worries that her enrollment in Medi-Cal could ruin that possibility.

"Do I keep it? What should I do? This is something that I'm really frustrated about that I can't even sleep because I'm constantly thinking of what to do."

Yesenia Amaro: 559-441-6144, @YeseniaAmaro Barbara Anderson: 559-441-6310, @beehealthwriter

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