Most of us don’t pay much attention to the details of federal regulations because they don’t seem to affect our daily lives or our community. New regulations issued recently by the Biden administration could help Nevada families who were hit hard by COVID-19 to receive health care, food and other basic necessities. However, this can only come to fruition if local leaders, including doctors, teachers and clergy, act to inform families about these changes.
The Trump administration changed immigration policy in 2019, expanding how officials administered the “public charge” provision of immigration law. The Trump policy put immigration applications at risk if lawfully present immigrants used specific government programs for health care (Medicaid), food (the Supplemental Nutrition Assistance Program) and housing (Section 8). The Trump policy took effect just weeks before COVID-19 hit the United States. Research confirms that the “chilling effect” it created deterred millions of eligible people from immigrant families from getting necessary assistance and care, even as their needs grew due to the pandemic.
As public health experts found, the Trump public charge policy “intensified, rather than mitigated, racial health inequality” during the pandemic.
The Biden administration ended the Trump policy last year, reverting to a policy that had been in place since 1999. However, because that policy had never been formalized, a future presidential administration could change it quickly, putting families at risk again.
Biden’s new, more recent regulation is a major win for local immigrant families. It formalizes the 1999 policy, making it harder for future presidents to target immigrant families. Additionally, it adds critical protections, confirming that eligible people in immigrant families can utilize health care, nutrition and housing programs without public charge concerns.
Much work remains to be done. The new regulation still allows immigration officials to consider “cash assistance” programs like Supplemental Security Income and Temporary Assistance for Needy Families, as well as long-term care like nursing home care, when financed by Medicaid. The regulation is also constrained by the underlying public charge provision of federal immigration law. Enacted alongside the Chinese Exclusion Act in 1882, it legalizes discrimination against low-income immigrants of color, and no regulation can change that.
Nevada can only benefit from the new regulation if local immigrant families know the policy has changed. When the Biden administration reversed the Trump policy a year ago, polling found that less than one-fourth of immigrant families had heard about the policy change. This time, we must all do better.
The Biden administration must continue to lead, leveraging the vast communication resources at the disposal of federal agencies to reach immigrant families. State and local government officials must also commit to the outreach effort. Their leadership is critical, as local and state agencies often have closer and, in many places, more trusting relationships with immigrant families. There is also a role for lawmakers and chief executives in states, cities, counties and towns, who have considerable communication resources of their own, as well as relationships with community organizations, such as the American Academy of Pediatrics, the UNLV Immigration Clinic and NHMA Nevada, that work directly with immigrant families.
Every government agency and official should seek partnerships with such organizations, which are uniquely positioned to effectively close the information gap. What they need — and what government officials and agencies can provide — is funding to do the work.
We must put the mistakes of our past behind us. The Biden administration took an important step in that direction in issuing the new public charge regulation. Local leaders must now ensure immigrant families are informed of the policy change. Moving forward, pediatricians need to speak with their families about this new rule and we must all continue to push our leaders for repeal of the immigration law’s racist public charge provision and the elimination of other barriers to the health and social services safety net.
The new public charge regulation is a crucial win for immigrant families in our broader fight to repeal provisions in immigration law that discriminate against low-income people of color. We can translate this policy victory into healthier and stronger families right here in Nevada, if our leaders act quickly and decisively.
Dr. Randi Lampert is chair of the Immigrant Health Committee at the Nevada chapter of the American Academy of Pediatrics.