On October 10, the Trump Administration proposed a rule to expand the Department of Homeland Security (DHS)’s definition of a “public charge.” Public charge is the term DHS uses to refer to people who they consider to be primarily dependent on public assistance. Currently, immigration caseworkers can reject green card applicants from staying or entering the county for receiving cash assistance or for using federally-funded long-term care at the time their application was submitted. However, under the Trump administration’s proposed rule, green card applicants could also be denied adjustment to their immigration status or entry to the country for using the Medicaid program, Supplemental Nutrition Assistance Program (SNAP) assistance, Medicare Part D low-income subsidies and housing assistance, and more. The proposed rule would also empower immigration caseworkers to deny a green card to immigrants living with serious ongoing medical conditions, including HIV/AIDS. This move by the Trump administration would incite a public health crisis and worsen the HIV/AIDS epidemic by undermining the ability of immigrants living with HIV/AIDS meet their health care needs and by encouraging people living with HIV/AIDS to discontinue treatment.
It is against this challenging backdrop that National Latinx AIDS Awareness Day marked its fifteenth year on October 15 with the theme, “Ending HIV is Everyone’s Job.” Latinx people represent 18 percent of the U.S. population but account for nearly 25 percent of new HIV infections. LGBTQ+ immigrants, like LGBTQ+ people overall, are at risk for negative health outcomes such as alcoholism, depression and cancer due to stigma and stress associated with discrimination.
The Trump administration’s proposed rule targeting immigrants and Latinx people would worsen the HIV/AIDS epidemic, which already disproportionately affects LGBTQ+ immigrant communities. The proposed public charge rule would worsen the chilling effect taking place across the country, which is leading immigrants to withdraw from public health services due to fear of deportation. Medicaid is the single largest source of insurance coverage for people with HIV, estimated to cover more than 40 percent of people with HIV in care.
The proposed rule also has implications for immigrants living with HIV/AIDS who benefit from their state’s AIDS Drug Assistance Program (ADAP) to receive life-saving medications to manage their condition, and the federally-run Ryan White HIV/AIDS Program to access treatment and preventive health services. The Ryan White HIV/AIDS Program serves more than half a million people each year, and works with 52 percent of all people diagnosed with HIV in the United States. For example, ADAP and Ryan White provide assistance to low-income immigrants living with HIV/AIDS to suppress and manage the virus and prevent adverse health complications. While the proposed rule doesn’t explicitly list ADAP or the Ryan White Programs for consideration in public charge determination, HIV/AIDS patients are reportedly forgoing access to life-saving medications due to fear that their green card application would be rejected. The Trump administration’s proposed expansion of the ‘public charge’ rule would put HIV-positive individuals in a heartbreaking position of choosing between receiving life-saving treatment or keeping their family together. It would also put immigrants at a greater risk of contracting HIV by not getting tested regularly or accessing to HIV prevention services supported by federal programs.
As LGBTQ+ immigrant communities continue to live in fear amidst the proposed public charge rule and anti-immigrant rhetoric, it will be critically important for health advocates to fight alongside immigrant rights, LGBTQ+ groups and HIV/AIDS patient advocacy organizations against the Trump administration’s anti-immigrant and anti-LGBTQ+ agenda that will worsen health outcomes for all people living with HIV/AIDS.
If you haven’t already, join the Protecting Immigrant Families (PIF) Campaign to access the latest details on the health implications the proposed rule would have for all immigrant communities, guidance for submitting public comments on this cruel proposed public charge rule and opportunities to continue advocating to support the health and well-being of LGBTQ+ Latinx immigrants living with HIV/AIDS.