Many low-income legal immigrants in the United States may soon have to make a choice: if they want to prolong their stay, they might have to stop using Medicaid, to which they are entitled.

The Trump Administration is expanding the "public charge" rule and is seeking to deny visa extensions or a green card to legal immigrants who use public benefit programs like Medicaid.

"The rule itself is extremely confusing, and I worry greatly that patients will avoid needed medical care for fear that receiving that care would be seen as a 'public charge,'" says Dr. Mitchell Katz, president and CEO of NYC Health + Hospitals.

Only pregnant women and those under 21 are excluded from this new rule. City officials worry it might end up having an impact not only on immigrants, but on all New Yorkers.

"We live in close quarters, where infectious diseases can be easily transmitted," Katz warns.

The administration also worries that Mayor Bill de Blasio's plan to guarantee health care to all New Yorkers, regardless of immigration status, could also be affected.

"It might well be impacted because, again, the perception may be that, 'I'd better not go forward for any services,'" Katz says.

When it comes to food stamps, which are also part of this new "public charge" rule, the city says it has data that shows the impact the debate over the changes has had in the last year.

"We've seen a decrease in enrollment of non-citizen clients receiving SNAP benefits by 8 percent more than citizen clients," said Bitta Mostofi, commissioner for the Mayor's Office of Immigrant Affairs. "That's very dramatic."

Critics of the new "public charge" rule say it goes against the principles on which this country was based, as reflected on Emma Lazarus's poem etched on the Statue of Liberty: "Give me your tired, your poor, your huddled masses yearning to breathe free."

On a National Public Radio (NPR) interview this Tuesday, Ken Cuccinelli, acting director of Citizenship and Immigration Services, had a different take:

"Give me your tired and your poor who can stand on their own two feet and who will not become a 'public charge,'" Cuccinelli said on NPR's Morning Edition.

The new public charge rule will go into effect on October 15 unless it is delayed due to lawsuits like the one New York Attorney General Letitia James plans to file. New York City is expected to join that suit.


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