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A patient visits a clinic in Solana Beach, Calif., that serves a large immigrant population. Photo: Sandy Huffaker/Corbis via Getty Images

The Trump administration's recently finalized “public charge” rule — which would make use of certain public assistance programs by immigrants grounds for denying lawful permanent residence — extends a series of policy changes that could negatively affect the health of both legal and undocumented immigrants in the U.S.

Why it matters: Health insurance, nutrition benefits and housing assistance are all linked to health outcomes, particularly in children. Although the 46 million immigrants in the U.S. are generally healthier and use fewer health resources than native-born residents, additional barriers to care could increase rates of obesity, malnutrition and transmission of communicable diseases.

What’s happening: The administration's policy shifts would impact a range of programs.

  • Revised White House guidance requires sponsors of legal immigrants to reimburse the government for benefits such as Medicaid and the Children’s Health Insurance Program, likely decreasing participation.
  • The Department of Justice is reportedly considering allowing deportation based on “public charge” status, which also applies to enrollment in the Supplemental Nutrition Assistance Program, known as food stamps.
  • The Department of Housing and Urban Development released a proposed rule that would evict undocumented immigrants and their families from public housing, even if households include a citizen spouse or child. Stable housing contributes to better physical and mental health, and homelessness is associated with lower life expectancy.

Where it stands: Although many of these policies are not yet promulgated, their effects are already being felt.

What to watch: The Homeland Security Department's “public charge” rule is likely to be challenged in court before it goes into effect on October 15.

Dave A. Chokshi is the chief population health officer at New York City Health + Hospitals and a primary care physician at Bellevue Hospital.

Go deeper

Ben Geman, author of Generate
35 mins ago - Energy & Environment

The road to COP26 gets slightly easier

Illustration: Annelise Capossela/Axios

The bad diplomatic vibes heading into the critical United Nations climate summit in Glasgow, Scotland, might be improving slightly.

Catch up fast: Chinese President Xi Jinping yesterday pledged to end overseas finance for building new coal-fired power plants and boost support for clean energy in developing nations.

Narrowing the employee divide

Illustration: Shoshana Gordon/Axios

Companies are narrowing the blue- and white-collar experience as they're forced to adapt to a worker-led market.

Driving the news: Basic office tools and concepts like corporate communications and schedule flexibility are migrating to frontline operations through investments in technology.

2 hours ago - Health

U.S. to buy 500 million more Pfizer doses to share with the world

A nurse fills a syringe with a dose of the Pfizer-BioNTech COVID-19 vaccine. Photo: Ben Hasty/MediaNews Group/Reading Eagle via Getty Images

The Biden administration is planning to purchase 500 million more Pfizer-BioNTech coronavirus vaccine doses to donate to the world, officials said in an op-ed Wednesday.

Why it matters: The move represents a big step toward making the U.S. a major global vaccine supplier just as China has ramped up exports of its Sinopharm, Sinovac and CanSino vaccines, which can be stored at normal refrigerator temperatures.