National Council for Behavioral Health

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Sophia Majlessi
(202) 621-1631

WASHINGTON, D.C. (August 13, 2019) – The National Council for Behavioral Health strongly opposes the Department of Homeland Security’s final rule on the Public Charge Determinations [DHS Docket No. USCIS-2010-0012] policy that would expand the definition of “public charge,” effective October 15, 2019.

When reviewing immigrants’ applications for permanent residency via visas and green cards, the federal government takes into account whether they are likely to become a “public charge” by becoming dependent on the government for financial support.

The administration’s policy change will result in significant harm to the health and welfare of migrant families.

By broadening the criteria for the public charge determinations rule, immigrant families will be forced to choose between receiving public health coverage and food assistance or remaining in the United States. As families that lawfully residing in the U.S. decline to seek health care coverage, the health of millions of adults and children will suffer.

Because immigrant adults and children who enroll in Medicaid and/or public nutrition programs will be penalized, legal immigrants will avoid enrolling in Medicaid or seeking behavioral and physical health services. The impact of this is huge, as one in four children in the U.S. – approximately 20 million – live in an immigrant family.

Implementing this draconian rule change would cause major harm to the children of legal immigrant parents. Although the finalized rule exempts children who are U.S. citizens, the health of legal immigrant parents and their children cannot be separated.

More families will be exposed to toxic stress, which has been shown to negatively impact a person’s long-term physical and mental health, while fewer will have access to treatment. This exposure will be especially hard on children, who are particularly vulnerable.

No family should have to choose between their health or their ability to stay together. The National Council for Behavioral Health opposes restricting people’s access to benefits they’re legally entitled to, and ultimately this rule will dissuade people from seeking care. The National Council for Behavioral Health adamantly urges the Trump administration to withdraw this harmful policy.


The National Council for Behavioral Health is the unifying voice of America’s health care organizations that deliver mental health and addictions treatment and services. Together with our 3,000 member organizations serving over 10 million adults, children and families living with mental illnesses and addictions, the National Council is committed to all Americans having access to comprehensive, high-quality care that affords every opportunity for recovery. The National Council introduced Mental Health First Aid USA and more than 1.7 million Americans have been trained.