Statement on Final Changes to Public Charge Rule

Statement of Leslie Graham  

On Announcement of Final Changes to Public Charge Rule 

September 13, 2019

The Primary Care Coalition is deeply concerned about the implications of the final ruling on Inadmissibility on Public Charge Grounds released by DHS earlier this week.

The PCC envisions a strong vibrant community that supports all people in achieving healthy lives. As an advocate for health equity in a community where one-third of the population is foreign born we recognize how decisions related to current and future immigration status are a key consideration for many households. Achieving an immigration status that brings residents closer to legal permanent residence or citizenship is often a critical gateway toward greater self-sufficiency and long-term wellbeing.

Yet, in the name of “promoting self-sufficiency of aliens within the United States” the final rule imposes new standards that force our foreign born neighbors to choose between future permanent residence and eventual citizenship and health care and social support services they may need now, today, to establish themselves in a new community so that they can thrive in the future. For many immigrant families there will be difficult decisions ahead.

Montgomery County leaders consistently reassure immigrant residents that they are welcome and safe. This is an inclusive community that is welcoming of immigrants and values diversity in all its forms. At the local level, we must reassure immigrant community members that our local safety-net programs are here for them.

The new ruling also threatens the resilience of communities by placing pressure on important institutions such as hospitals, housing developers, and grocery stores. Because individuals may choose not to receive public benefits that could jeopardize future immigration proceedings, the number of residents going without health insurance, remaining in unstable housing, and experiencing food insecurity is likely to increase. In the document released yesterday, DHS acknowledges that the rule may raise costs of uncompensated care and use of hospital emergency departments. Physician offices, pharmacies, and medical supply companies that serve Medicaid recipients may be affected by a decrease in Medicaid participation. Grocery stores that accept SNAP and landlords that participate in Section 8 may also experience declining revenues. This cost shifting threatens the stability of institutions that form the core of our community infrastructure for all residents.

We must continue to build trust between our immigrant neighbors and the public and private institutions that serve them. We must partner to educate residents about the implications of this ruling for individuals, households, and the community at large. We must stand together to ensure the resilience of the community overall.

In Montgomery County, our message has been, and continues to be one of welcome! PCC stands committed to continuing this practice.


Nearly a year ago, the Department of Homeland Security (DHS) proposed draft regulations that, if enacted, would significantly alter the ‘public charge test.’ Yesterday, DHS released the final ruling which is scheduled for publication to the federal register this week. The new regulations will expand the definition of ‘public charge’ to encompass a much wider array of federal benefits programs, including Supplemental Nutrition Assistance Program (SNAP), Medicaid, Section 8 Housing Choice Vouchers and Section 8 Project-Based Rental Assistance among others. Under the new rule, people seeking an extension of stay or change of non-immigrant status must demonstrate they are not a public charge defined as someone who has received “one or more public benefits for more than 12 months in the aggregate within any 36-month period (such that, for instance, receipt of two public benefits in one month counts as two months.)” In response, Leslie Graham, President and CEO of the Primary Care Coalition (PCC), released the above statement.