The Trump administration has asked the Supreme Court to allow its controversial rule penalizing legal immigrants for using Medicaid and other public benefits to take effect immediately.
The U.S. Justice Department filed an emergency appeal Monday asking the justices to lift a nationwide temporary injunction on the rule issued by a federal judge in New York in October and upheld by the 2nd U.S. Circuit Court of Appeals last week.
Federal appeals courts in California and Virginia previously lifted temporary injunctions issued by three other federal district judges. A divided 9th Circuit panel ruled last month that the Trump administration was likely to prevail in its arguments that it had authority to issue the rule, which was set to take effect Oct. 15, 2019.
The so-called public charge rule will allow federal immigration officials to consider legal immigrants' use of public health insurance, nutrition, housing and other programs as a strongly negative factor in their applications for permanent legal residency.
Other negative factors under the rule include having a medical condition that will interfere with being able to work or go to school; not having health insurance or being able to afford medical costs; and being younger than 18 or older than 61. The goal of the rule is to prevent people who look they will need public assistance from getting permanent legal status in the U.S.
A number of state governments and organizations that work with immigrants had filed lawsuits around the country to block the rule, which drew more than 260,000 public comments, mostly negative, when it was proposed by the Department of Homeland Security in 2018.
Leaders of many healthcare organizations, including the American Hospital Association, America's Essential Hospitals, the American Academy of Family Physicians and the American Academy of Pediatrics, have warned that the rule will hurt public health efforts and reduce their ability to serve millions of low-income children and families. They point to evidence that fear created by the proposal already has shrunk participation in health programs.
Solicitor General Noel Francisco asked the Supreme Court Monday to lift the injunction and let the rule take effect while the legal challenges play out. The nationwide injunction hurts the Supreme Court's "interest in allowing an issue to percolate in the lower courts," he wrote.
But opponents of the rule say that would cause widespread suffering, including among children who are U.S. citizens living in immigrant families.
"We believe it will result in immediate harm by denying people access to needed health services," said Dr. Georges Benjamin, executive director of the American Public Health Association.
Opponents hope the high court turns away the administration's request.
"The Trump administration is grasping at straws in their desperate attempt to expedite implementation of their racist wealth test for immigrants even before the government's appeals have been heard by the circuit courts," the Legal Aid Society of NYC, one of the litigants, said in a written statement. "We hope that the Supreme Court sees this motion for what it truly is and immediately denies it."
The Department of Homeland Security estimated the regulation will affect about 382,000 people a year. But many experts predicted it will have a far broader impact because families will worry that any member's use of a public benefit programs could jeopardize their legal status.
Healthcare leaders and advocacy groups say the rule already has had a drastic impact on participation in healthcare, nutrition, housing and other public programs before it's even taken effect.
The chilling effect is expected to reduce participation in programs not covered by the rule, such as the Children's Health Insurance Program; the Women, Infants and Children nutrition program; Head Start; and Affordable Care Act premium subsidies, experts said.
Immigration officials currently are only allowed to consider families' use of public cash benefits and Medicaid long-term care benefits in evaluating applications for legal permanent residency and legal entry into the United States.
DHS has said the rule is consistent with long-standing U.S. policy requiring immigrants to show they can support themselves financially.
Healthcare providers claim the rule will drive up uncompensated-care costs, increase use of emergency departments, endanger maternal and infant health and heighten the risk of infectious disease epidemics. It also could shift major costs from the federal government to state and local governments.
A study published last May by the Urban Institute found that 13.7% of adults in immigrant families reported they did not participate in public benefit programs because they feared losing their legal status under the then-proposed rule. The percentage rose to 20.7% among adults in low-income immigrant families.
Of the families that reported not participating in a public benefit program due to concerns about the rule, 14.7% were in families where all the members who weren't citizens already had green cards, and 9.3% were in families where all members were naturalized citizens.
Adults in immigrant families with children were more than twice as likely to report chilling effects as adults in families without children—17.4% versus 8.9%.
SNAP, Medicaid and CHIP were the three most-common programs that immigrants reported dropping out of or not signing up for.
The public charge rule is part of the administration's broader campaign to limit both legal and illegal immigration.
Last year, Ken Cuccinelli, then-acting director of the U.S. Citizenship and Immigration Services, defended the rule by rephrasing the Emma Lazarus poem on the base of the Statue of Liberty as: "Give me your tired and your poor who can stand on their own two feet and who will not become a public charge."
But U.S. District Judge George Daniels, who issued the temporary injunction being challenged by the Trump administration, wrote that the rule "is repugnant to the American Dream of the opportunity for prosperity and success through hard work and upward mobility."
