Discriminatory changes to the Department of Homeland Security’s regulations about the U.S. immigration process went into effect last Monday, sending a surge of fear, and negative health consequences, across communities of color and immigrants living on low income.

The Colorado Health Foundation strongly opposes this new rule, commonly referred to as “public charge,” because it directly contradicts our cornerstones centered on creating health equity. These policy changes roll back progress Colorado has made to bring health in reach for historically marginalized and underserved people.

This Is What Systemic Oppression Looks Like

While the public charge test has been around a long time to estimate an immigrant’s need for public assistance, the federal government’s latest changes significantly broaden the factors officials can use to determine if an immigrant seeking permanent residency or visa admission into the U.S. will be welcomed or turned away.

The rule pushes health further out of reach for people who have historically had less power or privilege by giving preferential treatment to individuals and families who have wealth while creating oppressive barriers for those who don’t. This “wealth test” denies green cards to anyone who needs to access, or may need to access, programs that are critical to health – such as Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and housing vouchers.

Simply put, the rule forces individuals and families to make a decision no one should ever have make: to access services crucial to their ability to thrive and risk deportation or denial of entry into this country, or to prioritize their safety and status in this country over services they need to live healthy lives.

Heightened Fear Jeopardizes Health

The harmful ripple effects of this rule reach beyond individuals seeking legal status. While the rule revisions only directly impact some immigrants to the U.S., its prejudicial practices have caused distress, confusion and fear among the broader immigrant community.

We are concerned with the repercussions the rule is already having on the health of Coloradans. We’ve heard from our partners across Colorado that a “chilling effect” (suppression of exercising of rights due to fear of legal consequences) is already evident. Misinformation has spread like wildfire, fueling fear-based decisions that jeopardize people’s ability to access nutritious food, affordable health care and stable housing.

Medicaid disenrollment figures in our state are three times the national average, and combined enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) declined by nearly four times the national average between March 2017 and March 2019. Federally Qualified Health Centers and other safety net healthcare providers have had a sharp uptick in missed appointments. An analysis by the Colorado Health Institute estimates that 75,000 Coloradans, the majority of whom are citizens, will drop their health insurance coverage to become less visible in a hostile immigration environment, or out of fear for losing it eventually anyway.

The rule also puts families that include both citizens and non-citizens in a precarious situation. U.S. citizen children whose parents don’t have permanent legal status are particularly vulnerable as their parents grapple with the impossible decision, for example, to enroll in food assistance programs, even if this could trigger deportation and separation from their children.

What Can We Do Now? Resources for Service Providers and Advocates

Working in partnership with Grantmakers Concerned with Immigrants and Refugees, The Colorado Trust and others, we’ve used our voice to oppose these rule changes since first proposed several years ago.

Advocates are working tirelessly to equip immigrant families and communities with the facts in an effort to slow the “chilling effect” and keep families enrolled in public assistance programs that support health. Here are a few resources for service providers, assisters and advocates:

• Basic facts about public charge rule and who is not impacted (English/Spanish), Colorado Center on Law & Policy
• Desk guide and other immigration resources for service providers and front-line eligibility staff, State of Colorado 
• “What Advocates Need to Know” factsheet and community-facing “Know Your Rights” materials for individuals and families (English/Spanish), Protecting Immigrant Families Campaign
• Benefits comparison chart detailing what counts and what doesn’t count toward public charge, Wynne Health Group
• Fact sheets (English/Spanish), communications toolkits, webinars, a training request form and more, Coalition for Immigrant Health
• Public Charge Stoplight Summary of food assistance programs serving immigrants of all statuses, and a bilingual Food Resources Hotline, Hunger Free Colorado 

Interested in exploring solutions to bring health in reach for immigrant communities? We invite you to listen and learn alongside us at this year’s Colorado Health Symposium: Bridging Ethnicity, Cultural Identity and Health (July 29-31), where we’ll hear from the experts – individuals who live and work within Colorado’s immigrant, refugee and Native communities – about their lived experience and how policy changes like public charge are impacting their pursuit of health.