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Anti-immigrant plan threatens health care in Massachusetts

Protesters outside the Federal Building in New York during an immigrant’s check-in meeting with ICE.JUSTIN LANE/EPA

How much more callous can President Trump’s immigration policies get?

The latest outrage is that immigrants — including legal immigrants — across Massachusetts are dropping their health coverage, believing that new Trump policies require them to choose between affordable health care or a green card.

One real life example: María José and her husband are immigrants from Mexico living in Stoneham. They moved to Massachusetts 12 years ago and now work independently as professional house cleaners. Last month, they dropped out of MassHealth, the state’s Medicaid program, a decision that left them with no insurance coverage.

Why cancel a health care benefit they’re entitled to? Because María José — who did not want to use her real name for fear that it would hurt her status — heard on Univision that Trump was contemplating a plan to penalize some immigrants if they were receiving government subsidies through programs such as Medicaid.

The couple has a pending green card application; they’ve been playing by the rules. Even though nothing has formally been implemented, the mere leak of draft proposals reported in the media has scared people like María José away from using benefits to which they’re entitled. It’s not just health coverage: Roughly 18 states reported seeing enrollment drops of up to 20 percent in the WIC federal nutrition program for pregnant women and children.


What’s especially devious about the administration’s tactics is that it’s using fear alone to accomplish its goals. The Trump proposal was only released Saturday, but it was preceded by months of leaks that successfully sowed confusion and fear.

As it turns out, the proposed rule is actually less expansive than feared. In bureaucratic terms, it would alter the “public charge” test, which is designed to identify people who may rely on the government as their main source of financial support. Currently, the test is very narrow; it only considers cash-based benefits. WIC is not included in the draft, for instance, but food stamps and Section 8 housing assistance are. As it is now, it would apply to foreign-born individuals seeking a green card through a family petition or employment-based visa, and to some abroad requesting non-immigrant visas.


While it’s hard to know how to fight against unofficial policies, the state has an obligation to protect the foreign-born population — in part by helping to get accurate information, including the fact the plan is only a draft at this point, out to immigrant communities. One in six state residents, and one in five workers, is an immigrant.

The good news is that state officials are ready to oppose the new public charge proposal, which still must go through a federal review process. Charlie Baker was the first governor in the country to publicly oppose the plan, according to advocates. “We’re going to do everything possible to make sure the voice of our state is heard on how negative and detrimental this proposed rule would be on Massachusetts residents and our state economy,” Secretary of Health and Human Services Marylou Sudders said in an interview. “I think of public benefits as a step up for immigrants who are on their path to economic security.”

There are currently more than 50,000 non-US citizens enrolled in SNAP in Massachusetts, and more than 260,000 in MassHealth, per state figures. The risk to health benefits is especially troubling, and threatens the state’s progress in ensuring health care access for all. But the state’s individual mandate raises the possibility that some foreign-born residents with subsidized insurance through the Health Connector would have to pay a fee if they drop insurance coverage to avoid threats to their green card.


For María José, the choice was clear. “I didn’t think of my health or my husband’s for a second,” she said in Spanish. “Even if [the proposal] is only a rumor. . . if it’s out, that means it will happen — especially with Trump as president.”