“How does a bastard, orphan, son of a whore and a Scotsman, dropped in the middle of a forgotten spot in the Caribbean by Providence, impoverished, in squalor grow up to be a hero and a scholar?”
— from the musical “Hamilton”
Lin-Manuel Miranda’s masterpiece recently took over the Music Hall in Kansas City, and if you were lucky enough to grab a ticket, you saw an amazing story of a man who grew up in poverty, came to America at a young age, created opportunity for himself and ended up one of the most influential Founding Fathers of this great country.
That story couldn’t happen today.
The Trump administration’s assault on immigrants has reached a new low. Earlier this week, the White House released an 837-page rule addressing the concept of “public charge” and its impact on legal immigration. To be clear, this isn’t an attempt to address the illegal immigration issues that get so much attention. This rule is a much subtler attempt to end legal immigration by certain types of people.
In essence, immigration officers have been directed to assess whether a person who is currently here legally might rely on government programs for family support in the future. Historically, this rule didn’t pertain to programs such as SNAP benefits (food stamps) or Medicaid health insurance. Monday’s announcement changed all of that.
An example: An immigrant without documentation does not have access to Medicaid. However, that immigrant’s U.S.-born child is eligible for the benefit. Based on the White House’s new rule, immigrants are jeopardizing their future opportunity to receive their green cards if they access Medicaid benefits for their U.S.-born children.
At Vibrant Health, we see families every single day who are making difficult decisions. We know from recent experience that families will choose not to enroll their U.S.-born children in benefit programs they have a legal right to — like Medicaid — because of possible legal consequences. Without this insurance coverage, people will choose not to seek health care for their children when it is needed. That means those children will be less healthy. Their school attendance and grades will suffer, and their families’ overall well-being will be harmed.
In essence, these new rules cut access to services proven to help elevate people out of poverty for the sole reason that they already live in poverty — effectively keeping legal immigrants and their U.S.-born children poor, and contributing to the societal drain of continuous intergenerational poverty.
A recent report from the City University of New York showed multiple ways Medicaid fights poverty. It found:
▪ Medicaid is among the most effective anti-poverty programs, comparable to the combined effect of all social insurance programs, and greater than the effects of refundable tax credits and means-tested non-health benefits.
▪ Medicaid has a larger effect on child poverty than all non-health means-tested benefits combined.
▪ Medicaid is particularly important for people of color, reducing the poverty rates of Hispanics and African Americans significantly.
▪ Health insurance benefits are important to families who receive them. In the study’s simulation, Medicaid lifted people from poverty more effectively than other types of insurance, including employer-sponsored insurance and premium subsidies through the Affordable Care Act.
The disgrace of this new White House rule in our supposed land of opportunity is that legal immigrants’ future is judged entirely on their current circumstances, and they are effectively denied services that would dramatically improve those circumstances.
In 1945, President Harry Truman said in an address to Congress: “The health of American children, like their education, should be recognized as a definite public responsibility.”
Truman was right then, and his words are still right today.
We have to demand better.
Patrick Sallee is CEO of Vibrant Health-Wyandotte Neighborhood Clinics.