Trump Action Will Reduce Immigrant Medicaid Enrollment
David Catron
by

Many Americans are angry about the large percentage of their tax dollars being doled out to immigrants in the form of public assistance, particularly at a time when federal budget deficits are skyrocketing. This is no racist hobgoblin conjured up by “deplorable” knuckle-draggers, as Hillary Clinton would have it. Medicaid, for example, costs the taxpayers $565 billion annually and, according to a widely cited 2017 report by the National Academies of Sciences, Engineering and Medicine, 46 percent of immigrant households receive Medicaid benefits. The Trump administration is therefore taking action to reduce the number of non-citizens who enroll in Medicaid.

Specifically, the President has instructed the Department of Homeland Security (DHS) to issue new guidelines that would broaden the government’s definition of “public charge” as it pertains to non-citizens residing in the United States or applying for resident status. This definition matters because, if an immigrant has a high probability of becoming a public charge (i.e. dependent on welfare to live), it should be difficult for him to gain approval for remaining in the country. In other words, the primary goal of the Trump administration is to make sure that immigrants are self-sufficient rather than burdens on the taxpayers. DHS puts it as follows in its proposed rule:

DHS seeks to ensure that aliens who are subject to the public charge inadmissibility ground and who are admitted to the United States or who adjust their status to that of a lawful permanent resident are self-sufficient… any alien is inadmissible if at the time of an application for a visa, admission, or adjustment of status, he or she is likely at any time to become a public charge.

Under the old rules, which were put in place by the Clinton administration, the determination that an immigrant would probably become a public charge was based on a very narrow range of criteria. They primarily include whether an immigrant receives “cash assistance,” such as Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), or General Assistance (GA). They do not include much more pervasive and expensive “non-cash” assistance, including health care programs paid for or subsidized by federal or state funds, including Medicaid and even Obamacare. Thus, DHS recommends expanding the list of criteria as follows:

DHS proposes to define subsidized health insurance as any health insurance for which the premiums are partially or fully paid by a government agency, on a non-earned basis, including but not limited to, advanced premium tax credits, or other forms of reimbursement. Subsidized health insurance may include non-emergency benefits under Medicaid, CHIP, and health insurance under the Patient Protection and Affordable Care Act (ACA).

This change would vastly increase the number of immigrants designated as public charges, and thus remove the incentive for aliens with no visible means of support to take up residence in the U.S. It goes without saying, then, that the “news” media has devoted very little coverage to what would unquestionably be a very popular change in the way we manage immigration and public assistance. What little coverage it received was typically dishonest. The Washington Post, for example, depicts the proposed rule as a sinister attack on all immigrants, but inadvertently undermines its editorial line by quoting DHS spokeswoman Katie Waldman, who explains its actual purpose:

The administration is committed to enforcing existing immigration law, which is clearly intended to protect the American taxpayer by ensuring that foreign nationals seeking to enter or remain in the U.S. are self-sufficient.… Any proposed changes would ensure that the government takes the responsibility of being good stewards of taxpayer funds seriously and adjudicates immigration benefit requests in accordance with the law.

This, to the extent that the voters receive accurate information about it, will be good news to conservatives in general and Trump supporters in particular. It does not, however, seem to be going over very well with the denizens of the deep state. The bureaucrats of the U.S. Citizenship and Immigration Services (USCIS), if not actually disgruntled, to paraphrase P.G. Wodehouse, are far from being gruntled. The Post story describes the rebellious reaction to the proposed rule during a staff meeting at which Director L. Francis Cissna was challenged by USCIS apparatchiks who don’t seem to get that they work for the taxpayers rather than immigrants.

And that, of course, is one of the reasons Donald Trump is President. The voters are tired of being ignored by bureaucrats whose bloated salaries, not to mention the government goodies they hand out, are financed by the taxpayer. Trump is doing what they hired him to do. His supporters want immigration reined in and they want out-of-control government health care programs like Medicaid and Obamacare cut back if not repealed outright. The DHS proposed rule will make an important contribution toward the accomplishment of those goals. The deep state drones would be well advised to get the hell out of the way and let Trump do his job.

David Catron
David Catron
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David Catron is a health care consultant and frequent contributor to The American Spectator. You can follow him on Twitter at @Catronicus.
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