Trump Takes Aim at Immigrants Who Use Public Benefits

Plus, the 2019 deficit blows past last year's total

Trump Administration Takes Aim at Immigrants Who Use Public Benefits

The Trump administration rolled out new regulations this week that will make it harder for legal immigrants who use public assistance programs such as Medicaid, food stamps and government-subsidized housing to obtain visas, green cards and U.S. citizenship.

Under the new rules, immigrants will be scrutinized more closely for assets, education and earnings potential, and officials will be given considerable leeway to reject applicants who are using public benefits or are judged to be likely to use them in the future. Applicants who are rejected will be deported.

Key details: The tighter regulations target any non-citizen who receives means-tested public benefits for more than 12 months within a 36-month period. Benefits received from more than one program will count double. But even if an immigrant falls below the threshold, any use of some kinds of public assistance can count against an applicant. Participation in school lunch programs, homeless shelters and food pantries will not be held against applicants.

Changing a long-standing rule: Federal immigration rules dating back to at least 1882 state that any immigrant who is likely to become a “public charge,” or dependent on public aid, can be denied residence in the country. On Monday, Acting Director of U.S. Citizenship and Immigration Services Ken Cuccinelli empathized this point, saying, "This is a 140-year-old legal structure. We’re not doing anything new here. We're simply making effective what Congress already put on the books.”

The conservative Cato Institute took a different view, saying that the new public charge rule “redefines the historic meaning of this term, which will result in far more immigrants not receiving status in the United States based on a bureaucrat’s suspicions that they could use welfare.”

How many people could be affected: About 544,000 people apply for green cards every year, the Associated Press said, and the rule change could affect roughly 382,000 of them. More broadly, there are about 26 million immigrants living in the U.S., many of whom may reconsider their participation in public programs in light of the rule change. Currently, non-citizen participation in public benefit programs is relatively modest, though not insignificant. According to Scott Bixby of The Daily Beast, about 6.5% of Medicaid recipients and 4% of food stamp recipients are not citizens.

Targeting poorer immigrants? Asked if the administration’s rule change was aimed at low-income immigrants, Cuccinelli said, “We certainly expect people of any income to be able to stand on their own two feet, so if people are not able to be self-sufficient, than this negative factor is going to bear very heavily against them in a decision about whether they'll be able to become a legal permanent resident.”

Immigrant advocates are worried: They say the rule change is part of the Trump administration’s broader effort to reduce immigration. Marielena Hincapié, executive director of the National Immigration Law Center, told The New York Times that the new regulations “will have a dire humanitarian impact, forcing some families to forgo critical lifesaving health care and nutrition. The damage will be felt for decades to come.” Bob Greenstein, president of the Center on Budget and Policy Priorities, told Bloomberg News that the “rule will sow fear in immigrant communities and lead many immigrants who are here legally — and their families — to forgo needed health coverage, nutrition assistance and housing assistance they are eligible for.”

What’s next: The regulations will take effect 60 days after the 837-page final rule, titled “Inadmissibility on Public Charge Grounds,” is published in the Federal Register, which is expected to occur on Wednesday. Several immigration groups are expected to sue the administration to prevent the rule from taking effect.

Budget Deficit Blows Past Last Year's Total

The U.S. budget deficit rose to $866.8 billion through the first 10 months of the fiscal year, up 27% from the same period in 2018, the Treasury Department said Monday. The deficit for all of 2018 totaled $779 billion — and was the largest since 2012.

From October through July, receipts totaled $2.86 trillion, up 3.4% from the same period last year, while outlays rose 8% to $3.73 trillion.

The Treasury Department projects that the full-year deficit will edge past $1 trillion.

Was the Budget Control Act a ‘Colossal Failure’?

The two-year budget deal passed by Congress and signed into law by President Trump earlier this month lifted spending caps for the next two years imposed under the 2011 Budget Control Act, effectively ended the era of spending restrictions under that law.

The 2011 law called for across-the-board “sequestration” spending cuts as a mechanism to force Congress to pursue other, less indiscriminate deficit reduction measures. Lawmakers failed to agree on a deficit-reduction plan, but nearly all of the sequester cuts were erased in later budget deals.

“The verdict on the law, including from its authors, is stark: it was a colossal failure,” the Associated Press reported last month.

A new analysis, however, a different conclusion — and highlights the hazards inherent in long-term budget projections.

CQ Roll Call Budget Editor Peter Cohn analyzed the impact of the 2011 law and found that discretionary spending did fall “dramatically” — but many of the savings resulted from changes unrelated to the law or actions by Congress, like lower interest rates and troop drawdowns in Iraq and Afghanistan.

In a new CQ Budget podcast, Cohn says that interest payments between fiscal 2012 through fiscal 2021 will wind up being roughly $3 trillion less than the Congressional Budget Office projected before the 2011 law was enacted. “That’s essentially $3 trillion in spending cuts that Congress had absolutely nothing to do with,” Cohn says.

Troop drawdowns in Iraq and Afghanistan saved nearly $1.9 trillion relative to the Congressional Budget Office’s projections before the 2011 law was passed, he adds. And the projected cost of entitlement programs has fallen by some $2 trillion as well, though largely as the result of economic shifts and other changes.

Even without those savings, though, Cohn says the Budget Control Act was “very effective” in cutting spending, at least initially. “There were big cuts to discretionary spending. People forget how much higher the levels were back in 2010,” he says. “With inflation, they’re just back to where they were in 2010 right now, even with all these big spending deals that everybody’s bashing right now.”

Overall, Cohn says, cumulative deficits are down by about $3.5 trillion over a 10-year period compared with 2011 projections — and they’d be significantly lower if not for tax cuts enacted over the past decade. The Budget Control Act was supposed to save $2.1 trillion.

Listen to the CQ Budget podcast here.

Surprise Medical Bills Have Become More Common, and More Costly

Surprise medical bills are becoming more common — and more expensive — according to a study by Stanford University researchers published Monday in JAMA Internal Medicine. From 2010 through 2016, the incidence of out-of-network billing for emergency department visits rose from 32.3% to 42.8%, and average potential patient costs rose from $220 to $628. The frequency of surprise bills for inpatient in-network hospital admissions rose from 26.3% to 42.0%, with the average potential cost to patients jumping from $804 to $2040. (Charts below from Modern Healthcare.)

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