NAPNAP Opposes Public Charge Proposal, Citing Harm to Children

The National Association of Pediatric Nurse Practitioners, representing more than 9,000 pediatric nurse practitioners (PNPs) and pediatric-focused advanced practice registered nurses (APRNs) committed to providing optimal health care to children, is deeply disappointed that the Department of Homeland Security (DHS) announced Saturday, Sept. 22 its intention to proceed with proposed regulations that could deny permanent resident status (“green cards”) or entry into the United States to immigrants who use a wide range of needed government services, including health insurance, nutrition programs and housing for people struggling to make ends meet. Combined with the recent DHS proposal to extend the detention of immigrant children, a violation of the 1997 Flores Agreement, this policy is an inhumane threat to vulnerable children and families.

The proposed DHS policy would expand the current definition of “public charge” beyond the cash assistance to which it has traditionally applied, to include use of non-cash assistance including health, nutrition and housing programs. If the proposed regulation is implemented, accessing Medicaid, Supplemental Nutrition Assistance Program (SNAP) and many other non-cash programs would be used in deciding if individuals and families can obtain a green card or face possible deportation. The rule could apply to the Children’s Health Insurance Program (CHIP) as well.

If implemented, this callous policy would force many immigrant families to avoid seeking basic health and nutrition services that will have a devastating impact on children, including those born in the U.S. and pregnant women. More than 46 million children are covered by Medicaid and CHIP. This proposal will create fear within many families and will ultimately result in fewer children enrolling in these programs. Since the beginning of 2018, health care providers in at least 18 states have reportedly already seen drops of up to 20 percent in health benefit enrollment.

“An abundance of research demonstrates that healthy, well-fed children miss fewer school days, perform better in schools and will eventually earn more as adults,” said Dawn Garzon Maaks, PhD, CPNP, PNP-BC, PMHS, FAANP, NAPNAP president. “Denying children and families access to basic services—food, health care and education—will only cost the U.S. more in the long run and is intentionally cruel.” 

NAPNAP calls on the Homeland Security Department to withdraw and reconsider this ill-conceived, punitive proposal. NAPNAP will work closely with the nationwide Protecting Immigrant Families coalition effort in opposing this proposed rule and will urge its members to take action against it during the 60-day period to submit comments.

Sept. 24, 2018