Updated immigration rules discourage exploitation of health programs.

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: