CHICAGO -- Within days of arriving in Chicago from Honduras, the 12-year-old boy sat in Dr. Sue Haverkamp's office, getting a physical.
Haverkamp learned the boy had a history of chest pain and heart palpitations. She told his mother that she'd refer him to a cardiologist once he was on Medicaid.
"She looked at me and said, 'I'm not applying for insurance. I don't want to risk his status,'" recalled Haverkamp, a pediatrician at Erie Helping Hands Health Center in Chicago's Albany Park neighborhood.
Currently, participation in Medicaid doesn't affect a person's ability to get a green card -- but under a new Trump administration proposal, it might. A proposed change to the "public charge" rule would allow immigration officials to consider some immigrants' likelihood of using Medicaid, food stamps and housing programs, among other things, when deciding whether they should be able to become legal permanent residents -- also known as getting a green card. The use of those programs could also weigh against people looking to extend their visas to stay in the U.S. and those seeking to change the types of visas they're using.
The rules now allow immigration officials to consider potential use of cash assistance programs, such as Supplemental Security Income, when deciding whether to allow someone to become a legal permanent resident, but not food stamps, housing assistance or the Medicaid health care program for low-income families and others.
The Trump administration has said the proposal is meant to promote self-sufficiency and save taxpayer money by not allowing immigrants to stay in the U.S. if they're likely to become financial burdens on the country. Comments on the proposal are being accepted through Dec. 10, after which the administration may finalize it.
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But local advocates for immigrants say the proposal goes too far and will result in families, particularly those that include both citizens and noncitizens, skimping on health care and other necessities out of fear that using those public benefits could jeopardize their chances of legally staying in the U.S. That will ultimately cost taxpayers more in the long run, they say.
Many advocates say the proposed change already is having a chilling effect on immigrants, even those who wouldn't be putting themselves or their family members at risk by accepting Medicaid or food stamps.
As many as 1.7 million people in Illinois and 41.1 million people across the country might drop out of public benefit programs or not apply for them because of the proposed rule and fear surrounding it, according to estimates from professional services firm Manatt, Phelps & Phillips.
For example, a child's use of government programs such as Medicaid won't be held against a parent's attempts to get a green card, the proposed rule says. Still, some families are steering clear of Medicaid, food stamps and other programs out of confusion or just to be safe, advocates say.