Proposed Immigration Rule Changes Would Worsen Health Disparities

Tacoma-Pierce County Health Department promotes good health for all Pierce County residents. Equitable access to healthcare, food, housing and other services are essential for individual and community health.

On Oct. 3, the Tacoma-Pierce County Board of Health passed a resolution in a 5-0 vote to oppose a Department of Homeland Security (DHS) proposed immigration rule changes. The resolution, which came at the request of Board Chair Rick Talbert:

• Urges DHS to rescind the proposal.
• Calls on federal lawmakers to oppose the proposed changes.
• Allows Health Department staff to comment on the proposal during the not-yet-announced public comment period.

“Not only would the rule change make local health disparities worse, it would also further burden local governments with healthcare costs for vulnerable members of our communities,” said Rick Talbert, board of health chair. “This cost shift will affect our ability to address the root causes of health,” he said.

A DHS analysis shows the proposal would result in cost shifts to local governments and healthcare providers. Among the possible outcomes:

• Worse health outcomes, including obesity, malnutrition, and reduced prescription adherence.
• Increased use of emergency rooms and emergent care.
• Increased prevalence of communicable diseases.
• Increased rates of poverty and housing instability.
• Reduced productivity and educational attainment.

“The lack of basic healthcare hurts everyone,” said Catherine Ushka, board of health vice-chair. “When fewer people get things like routine exams or immunizations, we see greater health disparities that could last for generations,” she said.

Under the proposal, DHS would expand the public charge test for immigration. Applicants for visas, visa extensions, or permanent resident status would have to show they would not overly use public resources—such as non-emergency Medicaid, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps), Section 8 housing assistance, and the Medicare Part D Low Income Subsidy for prescription drug costs—to meet basic needs.

Thousands of current Pierce County residents benefit from these services. Based on 2017 U.S. Census data, of the county’s estimated 876,000 residents, about 37,600—or 4.3 percent—are non-citizens who are legally permitted to live in the United States. Of that number, 10,600 use Medicaid and 6,600 use SNAP.

The Health Department’s health equity work shows 55 percent of what makes people healthy comes from social, economic, and environmental factors like income, education, and housing. The DHS proposed changes could create barriers for thousands of residents to achieve their best health outcomes. Learn more about the Department’s health equity initiatives.

About Tacoma-Pierce County Health Department: Tacoma-Pierce County Health Department’s mission is to protect and improve the health of all people and places in Pierce County. As part of our mission, the Health Department tackles known and emerging health risks through policy, programs and treatment to protect public health. We are one of roughly 220 accredited health departments in the country and among six in the state to have met or exceeded the Public Health Accreditation Board’s quality standards. Learn more at www.tpchd.org.