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Washington — Michigan immigrant and health advocates say a new Trump administration rule aiming to curb legal immigration could make it more difficult for low-income immigrants and those with health problems to get a green card or come to the United States.

The advocates also worry the rule change published Monday could result in immigrants already in the country — including many not subject to the rule — withdrawing from social services or not seeking help when they need it out of fear of retribution.

"The main goal of the rule appears to be to frighten people out of accessing benefits that they are eligible for," said Susan Reed, managing attorney at the Michigan Immigration Rights Center. 

"We think this rule goes way beyond what the statute authorizes, and we’ll continue to be part of efforts to challenge it legally."

Immigration attorneys stressed that the rule doesn’t apply to many categories of immigrants, including refugees, asylum applicants, victims of human trafficking, pregnant women, certain juvenile immigrants and those who already have green cards.

The rule, which goes into effect in mid-October, places greater emphasis on the current financial situation of legal immigrants, giving immigration officials broad discretion to decide whether an individual is likely to use public benefits such as food stamps or Medicaid in the future and potentially denying their application on that basis. 

"Through the public charge rule, the Trump administration is reinforcing the ideals of self-sufficiency and personal responsibility, ensuring that immigrants are able to support themselves and become successful here in America," Ken Cuccinelli, acting director of Citizenship and Immigration Services, said Monday at the White House. 

"The benefit to taxpayers is a long-term benefit of seeking to ensure that our immigration system is bringing people to join us as American citizens, as legal permanent residents first, who can stand on their own two feet, who will not be reliant on the welfare system, especially in the age of the modern welfare state which is so expansive and expensive."

It was unclear Monday how many immigrants in Michigan the rule could affect. State officials could not immediately provide data on how many non-citizens are enrolled in programs administered by the state such as Medicaid, food stamps or cash assistance.

Only five out of 28,500 households in the state's Housing Choice Voucher program, also known as Section 8, had non-citizens in them, according to the Michigan State Housing Development Authority. 

The federal rule broadens the definition of a "public charge" as someone who receives one or more means-tested public benefits for over 12 months in total within a 36-month period.  

The government currently only considers cash-based assistance and Supplemental Security Income when considering if an immigrant is dependent on public benefits, but will now also count enrollment in the Medicaid health program, food stamps and housing vouchers, among other forms of public aid. 

The rule's potential chilling effect would outweigh any direct effect it has on local immigrant communities, said Erin Quinn, senior staff attorney at the Immigrant Legal Resource Center in San Francisco.

"When you put something out broad-sweeping like this, it’s difficult for folks to decipher whether this applies to them, and we expect many folks to dis-enroll from needed safety-net programs including health and nutrition," Quinn said. 

Lawyers also noted that, while the new rule singles out immigrants as users of the programs, many aren’t eligible for most of the benefits newly mentioned in the rule due to their immigration status. 

"Many immigrant families aren’t eligible for these programs in the first place," Quinn said.  "Those that do have access are likely not subject to this rule, which is why we’re so worried about the fear factor."

The new regulations change the standards for eligibility based on income and assets, and make it harder to overcome a determination that an individual is likely to become a "public charge" by having the backing of a financial sponsor,  Reed said.

"You can imagine that, of course, everyone goes through different stages in their life of ability and disability, of youth and working age to older age, so changing the definition in that way really is a radical restriction on who can immigrate to the country legally," Reed said. 

"It is likely to effectively limit family-based immigration to wealthy people." 

Other factors designated "negative" for immigrants going through the process are having a large family, having a health condition and not having private health insurance, Quinn said. Possessing a higher household income is designated as a "positive" factor. 

"Somebody under this rule will be penalized if they participate in the marketplace for subsidized affordable health insurance," Quinn said. 

When the rule was proposed last year, the Henry Ford Health System in Detroit submitted comments predicting it would discourage legal immigrants from enrolling in Medicaid or the federal Children's Health Insurance Program since use of the programs could be used to deny a green-card application or entry into the United States. 

"If this happens, safety-net hospitals like Henry Ford Hospital (in Detroit) and Henry Ford Allegiance Health (in Jackson) will likely see the number of uninsured people we treat rise, causing a concomitant rise in the amount of charity care we provide in our hospitals," wrote Robert Riney, Henry Ford's president of health care operations and chief operating officer. 

"We are also concerned that if our charity numbers grow, we may be forced to reduce health care services that we provide to the entire community." 

Other health providers echoed these concerns, including the Michigan Primary Care Association, which represents 44 federally funded community health centers around the state. 

"Anecdotally, we’ve heard from health centers about people who are asking questions about whether they shouldn’t be thinking about enrolling in the health insurance program they need and are eligible for based on their legal status, thinking it could affect their chances later on of getting a green card," spokeswoman Jen Anderson said.

Reed said several immigration groups have indicated their intent to sue the administration to try to block the rule from going into effect. 

mburke@detroitnews.com 

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