The Public Charge Rule as Public Health Policy

Abstract

This essay identifies concern for public health as a factor in the development of public charge policy and demonstrates how the proposed rule abandons this rationale. Part I describes how public charge policy has remained remarkably consistent over time, even when anti-immigrant sentiment and concerns about the costs of providing public benefits to immigrants brought about restrictions on immigrant access to public benefits. Part II demonstrates how the public health rationale has influenced the development of public charge policy. Part III argues that the changes to public charge policy proposed in October 2018 represent a departure from the longstanding incorporation of public health concerns into public charge policy. I argue that the proposed changes are tied to a broader agenda of more generally restricting access to health-supporting public benefits. Finally, I make a normative case for maintaining the current limitations on public charge policy’s consideration of public benefits use by noncitizens.