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AAP Opposes Dangerous Public Charge Proposal

9/23/2018 Millions of parents forced to choose between vital services or keeping their families together

Washington, DC—Yesterday, the Department of Homeland Security announced its plan to issue a proposed regulation that could threaten the health and well-being of millions of children and families.

"Public charge" is a test used to decide if someone can obtain a visa or a green card. The proposed regulation expands the test to consider whether a parent and, in some cases, her child has used or is likely to use government programs, including Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and housing assistance. By widening the test in this way, millions of children and families are at risk of being deprived of vital nutrition, health and housing services out of fear that using such programs puts obtaining a visa or green card in jeopardy.

The American Academy of Pediatrics (AAP) urges the Administration to immediately rescind its public charge proposal.

"The public charge proposal presents immigrant families with an impossible choice: keep yourself or your children healthy but risk being separated, or forgo vital services like preventive care and food assistance so your family can remain together in this country," said AAP President Colleen Kraft, MD, MBA, FAAP. "This disruption of family unity comes mere months after the same government agency pursued a policy of forcibly separating immigrant parents and children at the border, many of whom remain separated today."

The impact of this public charge proposal is massive: one in every four children in the United States lives in an immigrant family, meaning that the child or at least one parent is foreign-born.

More than 46 million children in the United States relied on Medicaid and the Children's Health Insurance Program (CHIP) in 2017. Children covered by Medicaid and CHIP miss fewer school days due to illness or injury, perform better in school, are more likely to graduate and attend college, and be healthier adults that earn higher wages and pay more in taxes than their uninsured peers. The fear families face as a result of this proposed regulation will lead to fewer children enrolling in these programs. Research also shows that when parents have health insurance, children are more likely to get the care they need; when parents do not have health care coverage, their child's health can suffer. Taken together, this proposal will not only have a negative impact on the economy, but also children's health and well-being.

"Pediatricians will oppose any proposal that puts children's health at risk, and we will continue to speak out to ensure that all children, no matter where they or their parents were born, can be healthy and safe," said Dr. Kraft.

The AAP will submit public comments opposing the public charge proposal and is urging its 67,000 members to do the same.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds