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Critics Of Trump's Public Charge Rule Say It Will Cost Americans More In The Long Run


A new Trump administration rule that makes it harder for immigrants using public assistance to get legal residency is drawing opposition. The administration says it's trying to save money by ensuring immigrants are self-sufficient. Critics say this new public charge rule will end up costing more in the long run. NPR's Pam Fessler reports.


NOAMI: Georgetown Home Care, Noami (ph) speaking. How can I help you?

PAM FESSLER, BYLINE: Georgetown Home Care in Washington, D.C., is one of thousands of agencies that provide in-home care for seniors, often so they can avoid moving to more expensive long-term facilities.

NOAMI: No, ma'am, they're not skilled. We're a non-skilled agency.

FESSLER: Like other such agencies, this one relies on immigrant workers to meet a growing demand. CEO John Bradshaw says he hires a dozen new workers a week and estimates that about three-quarters of his 400 employees are foreign-born.

JOHN BRADSHAW: It's hard to find Americans who are looking for work right now, so you're going to have to draw on a bigger pool. An awful lot of the people that come to the United States to work here are not necessarily of means.

FESSLER: So he says many of his workers, at least initially, use programs like food stamps and Medicaid until they can get on their own two feet; just the kind of immigrants targeted by the administration's new rule set to go into effect October 15. Bradshaw says if he has trouble finding new workers, it will mean higher fees for his clients or more of them needing institutional care.

BRADSHAW: Ultimately, that's going to drive up the cost of care for the seniors looking for help from us.

FESSLER: Still, President Trump told reporters yesterday that he doesn't think it's fair for American taxpayers to have to pay for people coming into the country. Ken Cuccinelli, acting head of U.S. Citizenship and Immigration Services, said the new rule will save money by restricting green cards to those who don't need public aid.


KEN CUCCINELLI: Who will not be reliant on the welfare system, especially in the age of the modern welfare state, which is so expansive and expensive, frankly.

DENNIS HERRERA: I think that is a red herring that is meant merely to sort of gin up the base.

FESSLER: Dennis Herrera is city attorney for San Francisco, which, along with Santa Clara County, filed a lawsuit yesterday challenging the new rule. Herrera says if immigrants are dropped from safety net programs, it will endanger public health and leave others to pick up the pieces.

HERRERA: What it's going to do is shift the burden to local and state governments. It's not going to save anybody any money whatsoever.

FESSLER: National medical groups issued a similar warning yesterday, saying the rule will significantly drive up health care costs. Julie Linton is with the American Academy of Pediatrics.

JULIE LINTON: I think it's incredibly misguided to presume that any policy that limits health care to children and families would ever be a cost-saving measure.

FESSLER: Linton, who has a practice in South Carolina, says immigrant families are frightened and confused. She's already seen some pull out of programs, even those not covered by the new rule, because they don't want to jeopardize their status.

LINTON: It's much more expensive to care for a child with asthma who's hospitalized because they weren't able to take their preventive medicine because of lack of access to primary care because they don't have Medicaid.

FESSLER: It's a debate that will likely play out in the coming months in what's expected to be a wave of legal challenges to the new rule.

Pam Fessler, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Pam Fessler is a correspondent on NPR's National Desk, where she covers poverty, philanthropy, and voting issues.