‘Safe Benefits’ for Immigrants
U.S. releases guidelines on what is public charge
By Joyce Nishioka

A Vietnamese woman arrives in the United States with a so-called “fiancee visa.” She becomes a mother before her marriage, and because Medi-Cal paid for the delivery, she assumes that there will be no cost to her -- until the INS tells her she must pay back $5,000 in hospital fees within 60 days as proof that she is unlikely to become a burden to the government. Not doing so could mean deportation.

That scenario actually occurred, according to Asian Health Services manager Vanessa Fong Quach, who with the Asian Law Caucus in San Francisco managed to divert the roadblock to the woman’s permanent residency status.

“The problem is social services and the INS give conflicting information,” Quach said. “Social Services said there is no problem with her eligibility as a Medi-Cal recipient, but the INS said she is not supposed to get those benefits with her status.”

Since 1882, the Immigration and Naturalization Service has defined “public charges” as unfit for citizenship, but what exactly would make someone a public charge has remained unclear. Last week, the Clinton administration attempted to clarify its meaning with new guidelines on what the term means and who it does not apply to -- refugees, those granted asylum, and green-card holders. The guidelines also specify that the use of certain benefits -- including Medi-Cal -- will not affect an immigrant’s status.

Karen Narasaki, executive director of the National Asian Pacific American Legal Consortium, said the clarifications “send a message that legal immigrants, who are active contributors to the economy and pay taxes, should be able to access safety net programs and preventive care without fear.”

Defining a public charge or someone likely to become one has never depended only on whether public benefits have been used -- other factors include age, health, income and education. Still, the vague definition led many immigrants to forgo services, especially in the wake of 1996 federal welfare reform and the passage two years earlier of Proposition 187, which sought to deny most benefits to illegal immigrants.

“Even though 187 was never implemented, the idea that the law is out there creates its own confusion in communities, among eligibility workers processing people for benefits and INS officials,” said Sherry Hirota, executive director of Asian Health Services, who spoke at a news conference last week. Among immigrants, she said, “the cumulative effect of the political debate of 187 was a general sense that they were not entitled to the basic safety net of services.”

“We hope this information goes to all INS officers,” said Quach, who added that “it is well known among the community and in clinics” that decisions about immigration status often “depend on which officer you see and the mood they are in that day.”

Beginning in 1994, the Department of Heath Services (DHS) told immigrants returning to the United States that unless they paid back the cost of medical care they had received, they could not re-enter or adjust their status. Said Hirota: “Some people were overzealous in implementing what they believed was the new eligibility and definition of public charge after welfare reform.”

That practice stopped last year after a settlement in a class-action suit required the government to send refunds to those from whom it had demanded repayment. Still, said Hirota, “These practices created legitimate fears that they should not access services.”

As a result, California faces an “uninsurance crisis,” said Martha Jiminez, executive director of the Latino Coalition for a Healthy California. Asian Pacific Islander non-citizen enrollment in Medicaid -- the federal health insurer for low-income people -- plunged 38 percent from 624,116 in 1996 to only 385,528 in 1997. And 7 million people in California alone lack insurance, according to a UCLA and UC Berkeley study.

The Healthy Families program, which since last year has offered health coverage to children in “working-poor” families -- those that make between 100 to 200 percent of the federal poverty level, has also seen under-enrollment, Jiminez said. Only a third of those eligible have enrolled, she said, “due in great part to the fear and confusion of public charge.”

Avoiding medical care, moreover, threatens not only those families but public health. When rubella broke out in New York City two years ago, immigrants were less likely to be screened and to seek treatment because of fears that their status would be jeopardized or that those who sponsored them would be billed. Today, officials continue to worry about above-average rates of tuberculosis among Asian immigrants. They, too, are “afraid to access health care,” said Deeana Jang, a policy analyst with the Asian Pacific Islander Health Forum.

Quach also said many clients she sees are afraid they will have to pay for the costs of any benefits received by relatives they sponsored.

That issue is not so clear. In order to bring a relative to the United States, sponsors must sign an affidavit of support, stating they will be responsible for repayment of cash benefits received by the relative within five years of immigrating.

However, according to Charles Wheeler of Catholic Legal Immigration Network, sponsors are only responsible for repayment of specific federal benefits, for which new immigrants are not eligible in most states. “It’s unusual to access programs that sponsors will have to repay.”

Still, there could be risks. Asian Law Caucus attorney Victor Hwang warns that laws are constantly changing. Thus, getting legal counseling is crucial for making good decisions.

But the chairman of the House subcommittee on immigration, Rep. Lamar Smith, R-Texas, derided the new guidelines, which had been drafted over 18 months. “Americans believe that immigration policy should bring people to our country who will work hard and contribute, but these rules will increase the number of immigrants on welfare who will be able to bring in more immigrants to go on welfare and are an insult to all Americans -- native born and immigrant,” Smith said.

Some have speculated that the clarification -- coming 116 years after the term was first defined -- was motivated by Democrats seeking to snare the “ethnic vote” in 2000. Though API Health Forum’s Jang couldn’t say whether that was the case, she agreed that the “political tide is changing.”

Welfare reform, she said, has hit immigrants especially hard, and now, “immigrants are becoming naturalized and they are going out there and exercising their right to vote and display their displeasure of what policy makers have been doing.”

The Associated Press contributed to this report.