Children’s HealthWatch is alarmed by the U.S. Department of Homeland Security (DHS) proposal to rescind the 2022 public charge rule and give the agency authority to refuse permanent residency based on any past or future use of safety net programs as well as consider an applicant’s health characteristics. This proposal will foster fear and confusion and encourage arbitrary decision-making, threatening the health and economic stability of millions of immigrant families who live, work, and raise their children here in the United States.
More than one in four U.S. citizen children have at least one immigrant parent. Public charge threats and anti-immigrant rhetoric create concrete harm to immigrant and mixed status families. One major impact is the “chilling effect”—when families eligible for safety net programs do not participate because of fear that safety net program enrollment will have negative consequences for their families’ status in the U.S.
We’ve seen this before. Following the 2016 election and leaked public charge rule under the first Trump administration, child participation in federal nutrition and health care programs dropped significantly, putting families’ access to nutritious food and health care at risk. Our research shows these same events were associated with reductions in preventive health care use among young children of immigrants, including fewer well-child visits. This jeopardizes early childhood health monitoring and vaccination, the building blocks for all future health outcomes.
Our findings also demonstrate that immigrant mothers experience fear, stress, and avoidance of health and social services because of immigration-related threats—undermining family mental health, household budgets, and children’s access to care.
As pediatric providers and child health researchers, we know that this proposal jeopardizes children’s health. Decades of public health investments are undermined when families disenroll from programs for which they are eligible—a policy-induced harm.
We urge DHS to prioritize the health of all children and families living in the United States by revoking this damaging proposal.