When Kam Tam came to the United States at age 16 from China 50 years ago, he spoke little English, had a mouthful of rotten teeth and active tuberculosis, and weighed just 96 pounds. Through perseverance and a little help, he got his health back in order. The providers at his publicly funded community health center in San Francisco pulled four molars and cured his tuberculosis.
It was the character instilled by his parents that got him through college and pharmacy school, Dr. Tam said. Today, he is a successful businessman and pharmacist who has repaid society for the support he and his family received. He continues to generously give back by donating his professional services and financial resources to vulnerable families in Oakland.
Yet under a rule proposed last week by the Department of Homeland Security, legal immigrants could lose their chance to become a success story like Dr. Tam because they used government benefits they were entitled to. The Trump administration wants lawful permanent residence, also known as green-card status, to be denied to greater numbers of legal immigrants for having received public assistance.
A more narrow version of this rule has been in place for years. Currently, immigrants can be refused green cards if they are deemed to rely on government cash assistance for more than half their income. But the Trump administration has proposed expanding the scope of the rule to potentially deny green cards to immigrants who have used any of a much wider range of non-cash public benefits.
The new rule would potentially withhold permanent residency from someone who has used social services like Medicaid; Medicare Part D, which helps the elderly afford prescription medicines; food stamps; and Section 8 housing vouchers.
Even immigrants who received relatively small amounts of assistance for short periods might now be deemed "public charges" and be ineligible for green cards. In the worst case, legal immigrants who have built lives in this country could be denied permanent legal status and be separated from their families. The proposal could become final after a 60-day public review period.
Treating immigrants as public charges is based on the unfair principle that income and wealth determine one's value to society. Immigrants who play by the rules, pay taxes and contribute to their communities could now risk deportation if they did not have enough savings to survive unanticipated emergencies. They could be forced to choose between health care and food for their children and a chance to stay in this country.
A huge number of immigrant families could be affected by this change. An estimated 3.8 million Asian-Americans and Pacific Islanders and 10.3 million Hispanics live in families in which at least one member has used one of these services. And there are 10.5 million children in the United States in families receiving public benefits who have at least one noncitizen parent, according to the Migration Policy Institute. Nine out of 10 of these children are natural-born citizens, and their families could be torn apart if a parent is considered a public charge and no longer able to stay in the country.
Fear of the proposed regulation, which had been rumored for months, may have already dampened the demand for services. Community urgent-care clinics have had patients asking to have their records removed, and some immigrants have refused to sign up for food assistance programs, citing worries about deportation and family separation. Without screenings and access to treatments, they will be vulnerable to asthma, vision problems, high blood pressure, cancer and mental health disorders.
A robust body of research shows that legal immigrants strengthen our society. Immigrants have a higher rate of labor force participation than native-born Americans. Noncitizens use welfare programs at much lower levels than the native-born. Immigrant families tend to use less health services than nonimmigrants, studies show, thus helping keep down health care costs for the wider population.
Despite this evidence, the Trump administration is beholden to an anti-immigrant ideology. This proposed rule is the rankest form of scapegoating, linked to Attorney General Jeff Sessions and his 2015 white paper erroneously blaming legal immigrants for job losses among citizens.
Health care providers and immigrant activists are building coalitions to voice their opposition. But Americans must insist that Congress intervene to block this proposal.
We must defend our identity as one nation that shares a common vision and values, that was built on hard work, strong families, respect and kindness. These values dictate that we care for one another, that we know that we are only as strong as the most vulnerable among us.
"We cannot seek achievement for ourselves and forget about progress and prosperity for our community... Our ambitions must be broad enough to include the aspirations and needs of others, for their sakes and for our own."