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Houston Matters

Local Health Provider Speaks Against Rule to Limit Immigration Based on Public Benefits

Legacy Community Health argues the measure proposed by the Trump administration would actually burden taxpayers because more legal immigrants would end up in the ER


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Representatives from Houston-based Legacy Community Health are meeting with lawmakers in Washington to speak against a proposed rule by the Trump administration to limit legal immigration based on the use of public benefits.

Katy Caldwell, CEO of Legacy Community Health, told Houston Matters the rule would put a “financial burden” on the taxpayers of Harris County and Texas. “People will end up in the emergency room because they will forgo their care and will end up in an emergency situation, which will cost all of us more.”

Caldwell described the proposed rule as “bad public policy” and said her organization will its argument against it on the cost of emergency care compared to the cost of preventive care. “Preventive care for people who are already here legally is cheaper than providing emergency care,” said Caldwell, who added that the people the rule would impact “are working” and “are not a burden on society.”

Samantha Artiga, director of the Disparities Policy Project at the Kaiser Family Foundation, said their analysis concludes the rule would have two primary impacts. “It would make it harder for individuals with lower incomes, health conditions, lower education levels or who use or are likely to use certain health nutrition and housing programs, including Medicaid,” Artiga noted, “to get a green card because DHS would consider these to be negative characteristics in public charge determinations under the proposed rule.”

Artiga added “the proposed rule could lead to decreased participation in public programs, broadly among immigrant families, and recent research and previous experience suggest that these dis-enrollment effects could extend broadly across immigrant families and their citizen children beyond those who are directly affected by the rule.”

Artiga explained her organization bases that prognosis on recent research done by interviewing immigrant families, as well as on previous experience regarding eligibility rules in the past.

She detailed that, in the 1990s, welfare reform changed eligibility rules for public programs for some immigrants and research based on that experience showed that “there were broad declines in enrollment in public programs among immigrant families and their children, and that those declines were seen among individuals and children who were not directly affected by those eligibility rules changes” because of “confusion and fear.”

“If immigrant families turn away from public programs and dis-enroll themselves and their children from programs like Medicaid and CHIP because of fear and confusion,” said Artiga, “what we would see would be increases in the number of uninsured.”

The reduced access to care, the expert underlined, contributes to “worse health outcomes” and “people without coverage are at increased risk of delaying and going without needed care, which can contribute to more costly conditions in the long term.”

Artiga also said that losses in coverage would mean lost revenues and increased uncompensated care for providers, particularly safety net providers like community health centers and hospitals.

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