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Fearing Immigration-Related Consequences, Many Families Forgo Basic Health and Nutrition Services

September 6, 2018 at 10:15 AM

A growing number of low-income families and children are going without nutrition and health services due to immigration-related fears, health providers are warning, with potential immediate and long-term impacts on children’s health.

Agencies overseeing the WIC nutrition program for low-income women, infants, and children in at least 18 states report enrollment declines of up to 20 percent, Politico reports, largely due to immigrants’ fears that under the Trump Administration’s expected change in “public charge” rules, they’ll be unable to become lawful permanent residents if they participate in WIC. Politico interviewed WIC service providers in Kansas, New York, and Washington State, nearly all of whom said they had “seen immigrant mothers and their children drop from WIC, citing public charge concerns.”

Forgoing the vital support that WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children) provides — including nutritious foods, nutrition education, breastfeeding support, and referrals to health care and social services — can put women’s and young children’s health at risk. Research shows that WIC improves children’s diets and that when women participate, their babies are healthier, more likely to survive infancy, and go further in school.

Some families are also backing out of Medicaid, Lanre Falusi, a Washington-area pediatrician with Children’s National Health System, told Bloomberg Law. She cited, for instance, immigrant parents who dropped coverage for their son, who has sickle cell disease.

For more than a century, a person seeking to enter the United States or to become a lawful permanent resident (also known as a green card holder) can be turned down if immigration officials determine that they’d likely become a “public charge,” meaning overly dependent on the government. But the President is reportedly considering radical changes in how public charge is administered that would put people at risk of failing the public charge test if they or their family members participate in any of a wide range of public benefit programs — including WIC. That would depart significantly from the longstanding bipartisan policy under which immigration authorities who make public charge determinations consider the receipt of cash welfare assistance or long-term care benefits under Medicaid (such as nursing home care) but not basic health and nutrition assistance like WIC and regular Medicaid coverage, which often supplements low wages. Moreover, the people affected would be individuals and families who are fully eligible for these benefits under federal law.

After the Administration issues the rule, it won’t take effect until after a public comment period and the government’s review of comments, which will take a number of months. Nevertheless, there are already numerous reports of people dropping out of benefit programs such as WIC, SNAP (formerly known as food stamps), and Medicaid due to fear that receiving such benefits now will cause them to fail a future public charge determination and thereby ruin their families’ chances of staying (or reuniting) in the United States.

The reported public charge policy, along with the Administration’s stepped-up immigration arrests and other Administration actions targeting immigrants, has created an atmosphere of fear among immigrant families, with harmful consequences for their children and communities. “In the long term,” Falusi said, “I think what we’ll see then in the health-care system is kids who are sicker because they didn’t have that access to as many healthy foods if they were no longer on WIC and SNAP; we’ll [also] see kids and families who wait longer to see doctors.”


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