The lobby of the Chinatown-International District office of International Community Health Services in Seattle is a welcoming place where kids play with toys while their parents apply for nutrition assistance benefits.
But increasingly, parents come in stressed and troubled. That was the case on a recent morning when a husband and wife originally from China came in with their two toddlers to pick up a food voucher they receive through the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC for short.
Like other immigrants across the country, this couple is worried that if they receive public benefits such as WIC food assistance, it will jeopardize their immigration status. That’s because the federal government plans to broaden the so-called “public charge” rule so that when legal immigrants temporarily get public benefits such as the Supplemental Nutrition Assistance Program, Medicaid or housing vouchers, it will count against them when they apply for permanent residency -- also known as a green card.
“I’m very worried,” said the father, who spoke through a translator and on the condition that his name not be used. “I’m worried, but I have no choice. My kids need nutrition.”
The WIC voucher entitles low-income families to receive nutritious food such as milk, cheese, eggs, fruit and vegetables. WIC isn’t even among the benefits included in the new public charge rule, but Aliya Haq, nutrition services supervisor for ICHS, said clients have been withdrawing because of what she calls the “fear factor.”
The number of WIC clients served by ICHS fell from 1,990 in 2017 to 1,803 in 2018. So far this year, the federally qualified health center has served 1,432 WIC clients. Haq said when clients began withdrawing from the program, she couldn’t understand why and had to press them for an answer.
“At first, they wouldn’t tell you. They’d say, `We like you, we just don’t want to be on that,'” she said. “I said, `I need to know why. What’s the problem?' And they said, `I just don’t want to be deported.’”
For more than a century, the U.S. government used the public charge test to reject immigrants who were very poor and likely to primarily depend on the government for their subsistence. In 1999, the government issued guidance to say that “public charge” applied to someone who depended on public cash assistance or had been institutionalized for long-term care at taxpayer expense.
Now the U.S. Department of Homeland Security has expanded the rule to apply to legal immigrants who receive public benefits such as SNAP, Medicaid or housing assistance for 12 months in a 36-month period.
“Through the public charge rule, President Trump’s administration is reinforcing the ideals of self-sufficiency and personal responsibility, ensuring that immigrants are able to support themselves and become successful here in America,” said Ken Cuccinelli, acting director of U.S. Citizenship and Immigration Services.
Washington is leading a group of 14 states in a lawsuit against the Trump administration over the rule. On Thursday, the Washington attorney general’s office will ask a federal judge in Spokane for a preliminary injunction to block a new rule from going into effect.
The states argue the rule jeopardizes public health because millions of immigrants who are here legally will withdraw from public benefits such as Medicaid because they're afraid of being deported.
“On multiple levels, we think this public charge rule violates federal law, and we anticipate winning like we have in 21 straight cases,” said Washington Attorney General Bob Ferguson.
One way the new rule is unlawful, Ferguson said, is that it conflicts with laws previously passed by Congress. But he said it's part of a larger pattern in how the Trump administration approaches immigration.
“They just seem to have no sympathy for immigrants, who may not look like them or may not have the material possessions that members of this administration have,” Ferguson said.
What's at stake is not just the health of immigrants who decide to drop Medicaid coverage or nutrition assistance out of fear.
Everyone will be at risk for contagious diseases if immigrants forgo important preventive medical care, said Michael Erikson, chief executive of Neighborcare Health, a federally qualified health center in the Seattle area.
“We’re just getting through a measles crisis. Do we want people vaccinated to create public health? Yes, we do,” Erikson said. And yet, immigrants who are fearful of deportation “are likely going to be choosing not to be immunized” because they don’t want to receive any kind of public benefit, including free vaccinations.
At the ICHS office in Seattle, the Chinese immigrant father said he earns an income working in a sushi restaurant, but it’s not enough. His family still depends on the food assistance they get through the WIC program.
The new public charge rule has put many immigrants in the position of having to choose between their family’s health and their ability to stay in this country, said Aliya Haq.
“Instead of raising healthy communities, we’re going to have sick communities that are going to make more communities sick,” she said.
The state of Washington argues in its lawsuit that caring for those sick communities will still wind up costing taxpayers, who will have to cover the cost of emergency room visits when people seek urgent medical care after dropping health coverage because of immigration concerns.