The following is a message from Colleen Kraft, MD, MBA, FAAP
President of the American Academy of Pediatrics.

Throughout the summer, you heard from me several times about the devastating stories of immigrant families being separated at the border, and the critical role of the Academy in giving a voice to the detrimental consequences of family separation and detention to child health.

Today, I’m reaching out with details of a new proposal that threatens to jeopardize the health of millions of children and families. It may not dominate as many headlines, but its impact could be dangerous and wide-reaching.

Yesterday evening, the Department of Homeland Security announced a proposed regulation that could prevent immigrant families from getting the health care and nutrition assistance they rely on and are eligible for. The Academy issued this press release this morning, outlining its strong opposition to the regulation and the damaging impact it could have on child health.

In short, the proposal expands the “public charge” test, which is used to decide if someone can obtain a visa or green card. The proposed regulation expands the test to consider whether a parent and, in some cases, her child has used or is likely to use government programs, including Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and housing assistance. This New York Times article has more information.

The impact could be significant. In our country, one in four children lives in an immigrant family. The new proposal could force families to choose between keeping their families together or accessing vital health and nutrition programs.

This proposal was first leaked in 2017, and since then, the AAP has undertaken a multi-faceted advocacy strategy to oppose the proposal and prepare for its likely publication.

Pediatricians will play a critical role in explaining how this proposal is damaging to children’s health. In fact, many pediatricians across the country have already witnessed the chilling effect of the leaked proposal in their own practices, with families disenrolling from programs or avoiding health services that they are eligible for.

The proposal is just that – a proposal. There will be a 60-day comment period before which the proposal can be finalized. As such, it is not currently in effect and we need to make our voices heard. The Academy will be submitting comments opposing the public charge proposal and empowering its members with information to add their voice to these efforts, including a forthcoming Public Charge Toolkit. In the meantime, I joined a press call this morning to respond to the breaking news.

We will be in touch in the coming days with ways you can speak out and help amplify these messages. As child health experts, we have a unique and important role in illustrating what this proposal means for our patients and children everywhere.

The Academy will continue to stand firmly by its mission to protect, support and promote the health and well-being of all children – no matter where they or their parents were born; that guiding mission could not be more evident in our opposition to this dangerous proposal. All children deserve access to the programs they rely on to grow up healthy and thrive.

Thank you for your tireless advocacy this summer and for your continued commitment to advocating on behalf of immigrant children and families.


Colleen Kraft, MD, MBA, FAAP
President, American Academy of Pediatrics