Ana Martinez, a medical assistant at the Sea Mar Community Health Center, gives a patient a flu shot, Thursday, Jan. 11, 2018 in Seattle.
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Ana Martinez, a medical assistant at the Sea Mar Community Health Center, gives a patient a flu shot, Thursday, Jan. 11, 2018 in Seattle.
Credit: (AP Photo/Ted S. Warren)

3 ways Trump's welfare rule is already terrifying immigrants

If you're an immigrant who benefits from welfare, that could count against you if you apply for a green card or visa.

That's the crux of a federal rule known as the "public charge." It's been hanging over immigrant families for more than a year, and this week it became less theory and more reality.

Aliya Haq, of International Community Health Services, said the mere threat of the rule has had a chilling effect over Seattle.

At a clinic recently, she saw a woman with a child in poor health.

“The provider offered her all the services, told her you qualify for these, why don’t you take these programs," Haq said. Her organization helps immigrant parents sign up for food assistance.

Haq said that the woman replied, "No I’d rather die, because I’m really afraid of the public charge thing."

"She actually said it," Haq said. "‘I’d rather die.’”

Within hours of the rule being published, Washington state and Virginia announced they are leading 13 states in a legal action opposing it.

Washington Attorney General Bob Ferguson said in a statement that the rule forces immigrants to choose between the impossible: the dream of becoming Americans, or letting their families go without.

Service providers in King County and Washington state say they’re already seeing the effects of public charge, even before its October start date.

1. Unvaccinated kids

Bob Marsalli, CEO of the Washington Association for Community Health, said to expect parents skipping doctor visits, and therefore forgoing vaccines.

“It would not be unusual for a parent out of fear and confusion, to not keep that child immunized," he said. "You would see children not allowed in public schools because their immunization record was incomplete."

He said his association expects that up to 30,000 people may remove themselves from Medicaid because of this rule.

And if patients don't show up, then community clinics may end up closing their doors.

2. Hungry families

Aliya Haq, of International Community Health Services, said it's troubling to hear families reject services out of fear.

Haq said often these families are legally entitled to benefits, because their children are U.S. citizens or they’re in a protected immigrant class.

But it’s hard to assuage their fear, especially with what feels like ever shifting policies, she said.

“What can we do?" Haq said. "I’m losing my sleep because every day I ask, what can I tell these families? This doesn’t feel safe to me either.”

The rule redefines restrictions on legal immigrants who use benefits like the Supplemental Nutrition Assistance Program (SNAP), housing vouchers and other public programs. It could ultimately deny them green cards, new visas, and visa renewals.

The Trump administration has said this is simply an enforcement of federal immigration law and that it deservedly tasks immigrants to be self-reliant and not burden U.S. taxpayers with funding those programs.

Research from the Cato Institute, a libertarian think thank, shows that low-income immigrants use programs like SNAP at rates lower than their U.S. citizen counterparts.

3. Sick, less resilient communities

When people forgo preventative services, urgent care centers and emergency rooms can tell.

"We already know that ill individuals that postpone care or don’t receive care end up sicker," said Marsalli, of the Washington Association for Community Health.

In a 2018 letter from the City of Seattle to U.S. Citizenship and Immigration Services, Seattle Mayor Jenny Durkan and the City Council pointed to 85,000 residents they say would have their health care jeopardized in Seattle and King County.

What's more is providers like Marsalli and Haq say the damage is not hypothetical or in the future; it's here in the present.

The confusion, the disinformation, and the fear are enough to leave lasting impacts.