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Marin Voice: Federal Immigration Policy

By December 3, 2018November 24th, 2020No Comments

Federal Immigration Proposal Hurts Everyone –
Time for Action is Now

by Mitesh Popat, MD, MPH and Matt Willis,  MD. MPH

On December 10, the public comment period regarding a proposed federal law will close.  If passed,    this legislation could hurt all of us – people newly seeking safety in the US, current immigrants, health and human service agencies, and our community as a whole (Marin IJ, Nov. 15, “Lawmaker says health clinics hurt by Trump”).

Here’s what the legislation could mean – and how it is already negatively affecting the health of our community.

This Fall, the Trump Administration put forth a proposal that could affect potential and existing immigrants (including those who are lawfully present) if they receive public benefits or are likely to become a “public charge” in the future. This includes those seeking Medicaid, Medicare Part D subsidies, Section 8 housing, and CalFresh (food subsidies). If any of these supportive benefits are indicated on an immigrant’s application for a visa or change in legal status, that application is more likely to be denied.

Impact being felt now

Although the legislation is still just a proposal, we are already feeling the impact in Marin.  Many immigrants who reside in Marin are misinformed about the details and believe that they are at risk of deportation. Reacting out of understandable fear, some are unnecessarily disenrolling from public benefits such as health insurance, declining to register for new ones, or even avoiding getting vital services. In just over 18 months, the number of Marin residents receiving Medi-Cal has dropped by about 1,000 and there has been a 50% drop in applications. Medical appointments are being canceled  or missed, even though the vast majority of patients would not be affected.

The health of Marin’s families is our first concern, but it goes beyond that. The public health of Marin – and our ranking as healthiest county in the state – is threatened when our most vulnerable residents lose access to vital services. The societal benefits of equal access are clear:  outpatient visits/telephone calls to a clinic can prevent costly emergency room or hospital visits and can identify and treat communicable diseases before they spread.

The effect of the proposed legislation is already being seen at social service, housing, and health care agencies that receive federal reimbursement based on amount of services given to those on public assistance.  Marin Community Clinics is just one example;  the majority of patients are on Medi-Cal, so most of its revenues comes from the government.  The Clinics has already seen a marked decrease in Medi-Cal patients since the Trump Administration took office and a resulting $1 million drop in revenue.   Although the Clinics has strategies in place to weather the storm,  this is still a troublesome development for a not-for-profit organization.

Can you imagine what the impact would be if this legislation becomes a reality? As Damon Connolly, the President of the Marin County Board of Supervisors says, “these changes will have a chilling effect.”

Leadership groups throughout Marin –  including the County of Marin, Marin Community Clinics, the Marin County Office of Education, the Marin Community Foundation, First 5 Marin Children and Families Commission, and Canal Alliance  – have mobilized to address this issue and are reaching out to affected members of the public so that they have correct information.

But we need your help.

Make your voice heard: action needed by December 10

If you are concerned about this issue, learn more by visiting  Join us and Senator Mike McGuire; make your voice heard – tell the federal government that this proposal should be rejected.  By December 10, send written comments by mail to Samantha Deshommes, Department of Homeland Security, 20 Massachusetts Ave. NW, Washington D.C. 20529-2140 and make sure you reference “DHS Docket No. USCIS-2010-0012.” Or, submit online comments to


Mitesh Popat, MD, MPH is CEO of Marin Community Clinics; Matt Willis, MD, MPH is Marin County’s Public Health Officer.


Posted in the Marin IJ – Marin Voice on December 2, 2018