1. Kritz, Fran

Article Content

A rule change proposed in September by the U.S. Department of Homeland Security could make it more difficult for immigrants to get green cards, which allow them to live and work in the United States. The proposed change would expand the list of ways a green card applicant might be labeled a "public charge" or likely to become one, enabling the government to deny them entry into the country or permanent legal residency. Currently, the "public charge" designation is limited to people who receive cash assistance or are institutionalized at government expense. The proposed rule would expand the government assistance list influencing green card eligibility to include food stamps, health care through programs such as Medicaid, and housing subsidies.

Figure. Rosa, an und... - Click to enlarge in new window Rosa, an undocumented immigrant, used to get about $190 per month from the Supplemental Nutrition Assistance Program, or SNAP, but stopped taking benefits fearing deportation. The "public charge" rule counts SNAP's food benefits toward its new cap on financial benefits. Photo (C) AP Photo / Bebeto Matthews.

The National Association of Pediatric Nurse Practitioners opposes the proposed rule, saying in a statement that it would have a "devastating impact" by forcing "many immigrant families to avoid seeking basic health and nutrition services." Naomi Schapiro, a professor of clinical family health care nursing at the University of California, San Francisco, told AJN the rule change would put nurses in a "terrible" bind. "We should be able to advocate for children and families to access and receive health care without having to worry that we are inadvertently making their lives worse."


Nancy Berlinger, PhD, an ethics scholar at the Hastings Center in Garrison, New York, noted that the proposal had implications for public health. "If a patient is saying, 'Don't sign me up for anything,' it becomes hard to reach public health goals," Berlinger told AJN. She urged nurses to learn about the proposed rule and monitor its progress in order to be able to knowledgeably guide patients.


The comment period on the rule ended in December; the final rule is expected to be published in early 2019. Look for updates on the National Immigration Law Center website at Kritz