Public Charge Aff and Neg - Michigan7 2018 CPWW

AFF – Public Charge – Compiled 7/22
Adv – Status Quo
Public charge inadmissibility and deportability expanding now
NILC 18 (National Immigration Law Center issue brief, 3/22/18, updated 4/2/18, “Access to
Health Care, Food, and Other Public Programs for Immigrant Families under the Trump
Administration”,, p.1-3)/CWB
Since President Trump’s inauguration in January 2017, his administration’s actions with respect
to immigration have caused tremendous fear in immigrant communities, undermining trust in
government programs and chilling access to health care, food, and other critical benefits and
services. Trump’s reign of terror on immigrants and their families already has caused lasting
damage to our country. Immigration-related executive orders (including a draft order on
immigrants’ access to public benefits that was leaked to the media in January 2017 but that
hasn’t actually been issued), aggressive immigration enforcement actions, harmful and derogatory statements about
immigrants and refugees, and proposals to restrict family-based immigration have terrified communities across the
United States. We have heard numerous reports of immigrant families being afraid to seek
services that they or their U.S. citizen children need, disenrolling from critical programs, and
being reluctant to continue treatment for serious illnesses. NILC is vigilantly monitoring the Trump
administration’s changes to existing policy. In early January 2018, the U.S. State Department revised its
Foreign Affairs Manual (FAM, or “State Department instructions”) on “public charge.” These
revised State Department instructions underscore the administration’s interest in restricting
family immigration and deterring families from securing critical services. We also learned that
U.S. Citizenship and Immigration Services (USCIS) is drafting a Notice of Proposed Rulemaking
(NPRM), proposing changes to the federal government’s longstanding public charge policy.[1] The
proposed rule has not yet been published and may not be implemented until it becomes final, which will take additional time. This
issue brief is intended to clarify what has and has not changed with respect to the policies affecting immigrants’ access to health
care, nutrition, and other critical programs. We invite you to use it as a resource when you speak with immigrants and immigrant
families. It is important to monitor how changes to public charge policy (or rumors about such changes) are affecting individuals,
families, communities, and community-based organizations. Please share with us what you are hearing, via email at
[email protected] What is public charge? Public charge is a ground of inadmissibility (to the U.S.) that has existed for more than
100 years. Under current policy, certain non–U.S. citizens who are seeking to enter the U.S. or to obtain lawful permanent resident
(LPR) status must show that, based on all their circumstances, they are not likely in the future to rely on the government for
subsistence. Overall circumstances considered. The public charge statute — which cannot be changed by an executive order or the
issuing of regulations — requires immigration officials to look at all factors that relate to noncitizens’ ability to support themselves,
including their age, health, income, assets, resources, education/skills, family to support, and family who will support them. They
may also consider whether a sponsor has signed an affidavit of support (or contract) promising to support the noncitizen. Since the
test looks at the person’s overall circumstances, no one factor is definitive. Any negative factor, such as not having a job, can be
overcome by positive factors, such as having completed training for a new profession. FAM
now allows consideration of
noncash benefits. Almost 20 years ago, the government clarified that only monthly cash assistance for income support or
institutionalization at government expense (e.g., long-term care paid for by Medicaid) are relevant to consider in this test. However,
the revised instructions for State Department officials abroad now indicate that noncash benefits may also be considered as part of
the “totality of the circumstances” test. Under
these instructions, a dependent family member’s or
sponsor’s use of benefits may also be considered. These instructions apply only to individuals
who are seeking to enter the U.S. from abroad or who must go abroad to process their
application for LPR status (see below for more information). Deportation based on public charge? The grounds for
deporting an immigrant based on public charge are extremely narrow. They apply only to immigrants
who become a public charge during their first five years after admission to the U.S., for reasons that
existed beforehand.[2] Under current policy, all three of the following conditions must also be met: (1) the use of cash assistance or
long-term care needs to have created a legal debt; (2) the immigrant or sponsor must have received a notice to repay the debt
within the five-year period; and (3) the immigrant or sponsor needs to have refused to repay the debt after the government took
legal action and won. Even if some of these rules change, LPRs could still show that their need for benefits was based on something
that came up after they were admitted — for example, pregnancy, an accident, or a job loss. Key points to keep in mind • Some
immigrants are not subject to the public charge determination. Under federal law, which cannot be changed by issuing a regulation
or administrative guidance, the following categories of noncitizens are not subject to a public charge test: refugees; asylees;
survivors of trafficking, domestic violence, or other serious crimes (T or U visa applicants/holders); VAWA self-petitioners; special
immigrant juveniles; certain people paroled into the U.S.; and several other categories of immigrants.[3] And LPRs are not subject to
a public charge test when they apply for U.S. citizenship. • For people who are subject to public charge, positive factors can be
weighed against negative factors in this future-looking test. Noncitizens
seeking to enter the U.S. or obtain
lawful permanent residence must show that, based on the “totality of the circumstances,” they
are not likely to rely on the government for subsistence in the future. This test considers many factors,
including income, resources, age, family situation, and health. Individuals with health conditions, low incomes, or who are very
young or old, for example, can present other positive factors to demonstrate that they are not likely to rely on the government in
the future. This could include other sources of support, education, skills, a job offer, or family members with a steady income. In
fact, in some cases the receipt of public benefits can help stabilize a family. A parent’s enrollment in Medicaid
while she starts her own business may allow her to maintain her ability to work, which could make her less likely to rely on the
government in the future. Applicants can present evidence of all factors demonstrating that they are not likely to become a public
charge in the future. • People can assess their individual situation in determining whether to enroll in public benefit programs.
People who are concerned about any risks of enrolling in public benefit programs can consider their own situation — including their
immediate needs, whether they or their family members will be subject to the public charge determination, and whether they or a
family member has any pathway to lawful permanent residence in the near or foreseeable future. For those who are not sure about
their prospects for obtaining or adjusting to lawful immigration status in the future, it is a good idea to have available information
about how to access free or low-cost immigration help, such as the online National Immigration Legal Services Directory, • There may be no advantage to disenrolling from a program at this time.
It is too early to tell how the State Department’s instructions will affect non–U.S. citizens seeking to enter the U.S. The rules
governing public charge determinations in the U.S. have not yet changed. The notice of proposed rulemaking has not been published
in the Federal Register. Once it is published, there will be an opportunity for public comments, which the agency must respond to
before finalizing any new regulations. The application for adjustment to lawful permanent residence in the U.S. already asks about
any public benefits applicants have received. Thus, there may be little or no advantage to disenrolling from program that the person
really needs. The draft proposed rule makes it clear that any changes to the consideration of benefits use will apply only to benefits
received after the rule is final. Even if the rules change, applicants will still be able to show why they are not likely to become a
public charge in the future. • Immigrants should not misrepresent information when completing public benefit applications or
dealing with any government agency. Trump’s executive order on immigration enforcement,[4] which targets virtually all
undocumented immigrants for removal from the U.S., warns that “abuse” related to receipt of public benefits may make a person a
priority for enforcement. The U.S. Department of Homeland Security (DHS) has defined this as “hav[ing] knowingly defrauded the
government or a public benefit system.”[5] We always have advised immigrants to avoid any misrepresentations when applying for
or using public benefit programs, since this causes problems with benefit agencies and Immigration.[6] • Federal and state laws that
protect the privacy of people who apply for or receive health coverage, nutrition, economic support, or other public benefits remain
in place. In general, Medicaid, health insurance obtained under the Affordable Care Act (ACA, or Obamacare), the Supplemental
Nutrition Assistance Program (SNAP, formerly food stamps), and other public programs may collect only the information necessary
to determine eligibility for those programs. Applications for public benefits should not request information about the immigration
status of nonapplicants in the household. And, with limited exceptions, benefit agencies may share information with other
government agencies only for purposes of administering their programs. WHAT DO WE KNOW ABOUT CHANGES TO PUBLIC CHARGE
POLICY SO FAR? Changes to the public charge instructions in the U.S. State Department’s Foreign Affairs Manual (FAM). In early
January 2018, the State Department revised the instructions in the manual that officials in U.S. embassies and consulates use to
decide whether to grant non–U.S. citizens permission to enter the U.S. These changes apply only to individuals who seek to enter
the U.S. as a nonimmigrant or as a lawful permanent resident, or who must go abroad in order to have their application for LPR
status processed. The revised State Department instructions address changes to how the public charge determination is to be made,
including treatment of a sponsor’s affidavit of support. In the past, a valid affidavit of support generally has been sufficient to
overcome any negative factors. Under the new instructions, the affidavit of support is a positive factor — but is not enough on its
own. State Department officials must also weigh the other factors in determining whether a person is likely to rely on the
government in the future for cash assistance or long-term care. The revised instructions allow noncash public benefits to be
considered as one of many factors in the “totality of the circumstances” test. State Department officials may also consider a family
member’s or a sponsor’s use of benefits as part of the public charge determination. It is too early to know how the new rules will be
implemented by each U.S. embassy or consular office abroad. Please contact us at [email protected] if you hear of any changes
in practice. A more detailed summary of the changes to the FAM is available here.* The Trump administration’s plan to file a Notice
of Proposed Rulemaking (NPRM). The December 2017 Unified Agenda indicates that the administration plans to release an NPRM
implementing changes to the public charge guidance. We recently learned that U.S.
Citizenship and Immigration Services is
under pressure from the White House to draft an NPRM by early 2018. The proposed rule is likely to alter
the public charge policy by allowing government officials to consider a much broader array of
critical services and work supports in the public charge determination. This could include health
and nutrition programs such as Medicaid, the Children’s Health Insurance Program, and the
Supplemental Nutrition Assistance Program (SNAP, or food stamps). Reuters reported on a leaked draft of
the proposed rule, and the draft was published by Vox on February 8, 2018. More information about the upcoming proposed rule is
available in this fact sheet. The leaked draft of an unsigned executive order. The leaked draft executive order titled “Executive Order
on Protecting Taxpayer Resources by Ensuring Our Immigration Laws Promote Accountability and Responsibility,” reported by Vox
on January 25, 2017, has not been finalized or signed. Instead, it appears that some of the policies described in the leaked order are
being implemented administratively, in the form of revised instructions or forms, or proposed regulations.
Uncertainty over the future of public charge is causing anxiety and drop out of
necessary health and nutrition programs
Baumgaertner 18 (Emily Baumgaertner, New York Times journalist, citing Lisa David,
president and chief executive of Public Health Solutions, Charles Wheeler, legal expert at the
Catholic Legal Immigration Network, 3/6/18, “Spooked by Trump Proposals, Immigrants
Abandon Public Nutrition Services”,
Immigrants hoping for permanent residence are dropping out of public nutrition programs even
before prominent elements of the Trump administration’s proposed policy changes are enacted,
fearful that participating could threaten their citizenship eligibility or put them at risk for
deportation, according to program administrators. Statistics on participation in state and local
efforts show fewer people are using an array of food programs, including the Supplemental
Nutrition Program for Women, Infants and Children (called WIC) as well as the Supplemental
Nutrition Assistance Program (or SNAP, formerly known as food stamps) and food banks. “The
rumor mill is rampant, and the fear is palpable,” said Lisa David, president and chief executive of Public Health
Solutions, a major WIC and SNAP provider for New York City. “The stakes for what could happen in the future are
incredibly high, and people just aren’t willing to take that risk.” The Department of Homeland Security has
drafted a regulation that would allow officials to factor in the use of benefits — like WIC, SNAP, the Children’s Health Insurance
Program and even housing and transit subsidies — when deciding whether to approve some visa or green card applications. A
leaked draft of the proposal first reported by Reuters and then published by Vox showed that immigrants seeking an adjustment
of status, such as those applying for permanent residency, “must
establish that they are not likely at any
time to become a public charge” or rely heavily on long-term government assistance, lest they
be deemed “inadmissible.” The proposed regulation could be sent to the Office of Management and Budget for processing
this month, according to Charles Wheeler, a legal expert at the Catholic Legal Immigration Network. The Department of Homeland
Security did not respond to inquiries regarding the proposal’s timeline and prospects. A
study conducted by the
National Academies of Sciences showed that 45.3 percent of all immigrant-headed households
with children use a food assistance program. The vast majority of those children are American
citizens. Administration officials say that fiscal responsibility motivated the policy move. “The administration is committed to
enforcing existing immigration law, which is clearly intended to protect the American taxpayer,” said Tyler Q. Houlton, the acting
press secretary for the Department of Homeland Security. “Any potential changes to the rule would be in keeping with the letter and
spirit of the law — as well as the reasonable expectations of the American people for the government to be good stewards of
taxpayer funds.” In an email to local WIC agency directors, the Rev. Douglas Greenaway, the president of the National WIC
Association, assured providers that the proposed rules did not yet have “the weight of law.” But he acknowledged that this caveat
“may not resonate with immigrant families” who are now weighing their need for WIC services against their desire for a permanent
future in the United States. Mr.
Wheeler of the Catholic Legal Immigration Network said lawyers began
seeing the anxiety over a year ago, when a leaked draft of an unsigned executive order aimed to
promote “immigrant self-sufficiency.” Then, in January, the State Department revised the Foreign Affairs Manual, used
to determine whether to grant noncitizens entrance to the United States. Officials must now carefully consider the
likelihood that the candidate for entry will become a burden to taxpayers, and can factor a
family member’s or sponsor’s use of public benefits into their decision. Immigrants’ reaction is a pattern
providers have seen before. In WIC, unlike SNAP, most agencies do not solicit citizenship information. But in 2014, the State of
Indiana — under Mike Pence, then governor and now vice president — began requiring applicants to affirm their citizenship or
“qualified alien” status on WIC intake forms. Women
immediately began refusing to enroll, said Colleen Batt, an
Indiana WIC agency director at the time. Throughout the first year of the Trump presidency, agencies in
regions with high immigrant populations have reported canceled appointments, urgent requests
for disenrollment and even subsequent requests to have any record of families purged from the
database. Immigrants who have withdrawn from these services are reluctant to speak out about
their plight owing to fears that identifying themselves publicly could result in legal
repercussions. In New Jersey, three neighboring counties — Union, Essex and Hudson — have
immigrant populations above 25 percent, according to census data. In those counties,
participation in some elements of the Community FoodBank of New Jersey’s outreach
programming fell by almost half between 2016 and 2017, according to Julienne Cherry, the
bank’s director of agency relations. As of November 2017, the New Jersey SNAP program also reported a decrease of
8.1 percent in statewide participants over a one-year period. Enrollment rates in Essex and Union Counties had dropped by more
than 10 percent. According to preliminary data, Florida saw a 9.6 percent decrease in WIC participation over the one-year period
from November 2016 to 2017. Texas lost 7.4 percent of WIC participants — and some offices in heavily Spanish-speaking
communities there say they are considering laying off employees because of the drastically decreasing caseload. Adele LaTourette,
the director of the New Jersey Anti-Hunger Coalition, said a church food pantry specifically organized as a safe space for immigrants
has seen “unprecedented decline,” as have reduced-cost breakfast and lunch programs in schools. Ms.
LaTourette, who
also convenes the New Jersey SNAP Working Group and serves on the state’s WIC Advisory
Council, said the same concerns have echoed through every round-table discussion she has led for
nutrition services since the start of the administration. National WIC Association members in
California, New York and Colorado have aired similar complaints. Some local agencies have begun planning
training to help their staff navigate what could be ahead: interactions with immigration enforcement agents, increasingly anxious
clients and final regulations. But
they say they know — just as the White House does — that as the fear
factor among immigrants outpaces the administration’s crackdown, the question of whether
new public charge policies ever come to fruition is, in some ways, irrelevant.
Adv – Health
We isolate 3 impacts – First is structural violence:
Expansive public charge rules increase poverty
Laird 4/6 (Jennifer Laird, PhD in sociology from the University of Washington, Postdoctoral
Research Scientist at the Columbia University Center on Poverty & Social Policy, 4/6/18, “This
Immigration Proposal Could Put 670,000 Children At Risk Of Poverty”,
Child poverty in the U.S. has been on the decline. In 2016, the percentage of children living in poverty reached a
record low of 15.2 percent, according to data from the Census Bureau. And since the late 1960s, the child poverty rate has been
reduced by nearly half. The Center on Budget and Policy Priorities largely attributes this progress to the creation and expansion of
programs like the Supplemental Nutrition Assistance Program (SNAP, also commonly known as food stamps). However, as my
colleagues and I at Columbia University documented in a new report, a troubling
development might reverse this
downward trend. A Department of Homeland Security proposal, if implemented, could put at
least 670,000 more children ― 560,000 of whom are U.S. citizens ― at risk of moving into
poverty, by our calculations. Currently, nearly 90 percent of children with immigrant parents are U.S.-born and therefore eligible
for benefits like SNAP. By our estimates, SNAP participation for children of immigrants is comparable to participation for children of
native-born parents; about one in three children receive SNAP benefits at some point within a given year. Not
only would the
DHS proposal increase the number of children living in poverty, but evidence suggests it’s
already scaring away eligible immigrants from utilizing much-needed benefits for their families.
The proposal addresses what is called “public charge.” It’s a term used by U.S. immigration officials for more
than 100 years that refers to a person who relies on, or is likely to rely on, public cash assistance or government support, including
programs such as Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF). Foreign-born
individuals who are deemed by immigration officials to be a “public charge” can be denied entry
into the U.S. Without a course correction, the U.S. will soon see a measurable increase in the
number of children living in poverty. For now, non-cash benefits, including nutrition programs like SNAP, cannot be
used when determining whether someone is a public charge. The existing definition only includes participation in cash assistance
programs. Consider a U.S. household with citizen children, a mother who has legal permanent residence, and a father with a
temporary work visa. Under
current policy, immigration officers cannot use the household’s
participation in non-cash benefit programs (like SNAP) as a reason for denying the father legal
permanent residence. The father would be ineligible for SNAP based on his status; the mother and her children would be
eligible. But the Trump administration wants to change all that; the proposed DHS regulation
would allow officials to consider a household’s participation in both cash and non-cash benefits
when making decisions about public charge status. Receiving non-cash public benefits like food
assistance could become a liability during the vetting process for immigrants working to obtain
legal permanent residence. Bottom of Form Undocumented parents are already increasingly fearful that any interaction
with the government will lead to arrest and deportation. According to Immigration and Customs Enforcement data, immigrant arrest
rates have risen by 41 percent since 2016, with a 171 percent increase in the number of non-criminal arrests. This, coupled with
word of proposed
changes to the public charge rule, is leading immigrant households to abandon
both SNAP and the Special Supplemental Nutrition Program for Women, Infants, and Children
(WIC), a program that provides food and nutrition education for low-income pregnant women
and their children. Social service agencies in communities with large immigrant populations
have reported a spike in appointment cancellations and “urgent requests for dis-enrollment”
from assistance programs. Nationwide, between 2016 and 2017, there was about a 5 percent decline in enrollment for
SNAP and WIC. In counties with large immigrant populations, SNAP and WIC enrollment declines were closer to 10 percent. My
colleagues and I estimate that if all households with one or more non-citizens gave up the SNAP and WIC benefits to which their U.S.
citizen children are entitled, more than
500,000 of the children could fall into poverty, and more than 200,000
number of all
children ― citizens and non-citizens ― living below the poverty line would increase by 8
percent, and the proportion living below the deep poverty line would increase by 16 percent.
of them could fall into deep poverty (below 50 percent of the Supplemental Poverty Measure threshold). The
Approximately 60 percent of the reduction in child poverty since 2015 would be erased. Receiving non-cash public benefits like food
assistance could become a liability during the vetting process for immigrants working to obtain legal permanent residence. It’s been
well-documented that food insecurity in childhood can have long-term consequences. And as Hilary Hoynes and colleagues have
shown, access to food assistance programs like SNAP in early childhood leads to significant reductions in obesity, high blood
pressure, heart disease and diabetes later in life. The DHS proposal will inarguably put the health and well-being of thousands of U.S.
children at risk and will also set them up for health hardships as they age. In addition to SNAP and WIC, the new public charge
definition includes participation in the Children’s Health Insurance Program, transportation and housing voucher programs, and
refundable tax credits such as the Earned Income Tax Credit. However, immigrants may soon also abandon other much-needed noncash assistance programs not included in the proposal ― such as emergency disaster relief and reduced-price school breakfast and
lunch ― for fear that participation in any public assistance program will affect their immigration status. The Trump administration’s
proposal, along with the recent increase in non-criminal immigrant arrests, may already be triggering a mass exodus of immigrant
families from public assistance programs ― and it’s children who will face the consequences. Without
a course
correction, the U.S. will soon see a measurable increase in the number of children living in
poverty. Simply put, the DHS proposal should not become official policy.
Poverty has widespread physical and mental implications—lack of access to
health care disproportionately affect children, causing trauma, disability, and
APA 12 (American Psychological Association, APA is the leading scientific and professional organization representing
psychology in the US, “Effects of Poverty, Hunger and Homelessness on Children and Youth,” Poverty: What are the
effects of child poverty? 2012,
What are the effects of child poverty? Psychological research has demonstrated that living in poverty
has a wide range of negative
effects on the physical and mental health and well-being of our nation’s children. Poverty impacts
children within their various contexts at home, in school, and in their neighborhoods and communities. Poverty is linked with negative
conditions such as substandard housing, homelessness, inadequate nutrition and food insecurity, inadequate child care, lack of access to
health care, unsafe neighborhoods, and underresourced schools which adversely impact our nation’s children.
Poorer children and teens are also at greater risk for several negative outcomes such as poor academic achievement,
school dropout, abuse and neglect, behavioral and socioemotional problems, physical health
problems, and developmental delays. These effects are compounded by the barriers children
and their families encounter when trying to access physical and mental health care. Economists
estimate that child poverty costs an estimated $500 billion a year to the U.S. economy; reduces
productivity and economic output by 1.3 percent of GDP; raises crime and increases health
expenditure (Holzer et al., 2008). Poverty and academic achievement Poverty has a particularly adverse effect on the academic outcomes of
children, especially during early childhood. Chronic stress associated with living in poverty has been shown to adversely affect children’s concentration
and memory which may impact their ability to learn. The National Center for Education Statistics reports that in 2008, the
dropout rate of
students living in low-income families was about four and one-half times greater than the rate
of children from higher-income families (8.7 percent versus 2.0 percent). The academic achievement gap for poorer youth is
particularly pronounced for low-income African American and Hispanic children compared with their more affluent White peers. Underresourced
schools in poorer communities struggle to meet the learning needs of their students and aid them in fulfilling their potential. Inadequate
education contributes to the cycle of poverty by making it more difficult for low-income children
to lift themselves and future generations out of poverty. Poverty and psychosocial outcomes Children living in
poverty are at greater risk of behavioral and emotional problems. Some behavioral problems may include
impulsiveness, difficulty getting along with peers, aggression, attention-deficit/hyperactivity disorder (ADHD) and conduct disorder. Some emotional
problems may include feelings of anxiety, depression and low self-esteem. Poverty
and economic hardship is particularly
difficult for parents who may experience chronic stress, depression, marital distress and exhibit
harsher parenting behaviors. These are all linked to poor social and emotional outcomes for children. Unsafe neighborhoods may
expose low-income children to violence which can cause a number of psychosocial difficulties. Violence exposure can also predict future violent
behavior in youth which places them at greater risk of injury and mortality and entry into the juvenile justice system. Poverty and physical health
Children and teens living in poorer communities are at increased risk for a wide range of physical
health problems: Low birth weight Poor nutrition which is manifested in the following ways: Inadequate food which can lead to food
insecurity/hunger Lack of access to healthy foods and areas for play or sports which can lead to childhood overweight or obesity Chronic conditions
such as asthma, anemia and pneumonia Risky behaviors such as smoking or engaging in early sexual activity Exposure to environmental contaminants,
e.g., lead paint and toxic waste dumps Exposure to violence in their communities which
can lead to trauma, injury, disability
and mortality.
Second is disease:
Trump’s public charge expansion is coming- even if it isn’t the fear and current
exclusion is enough to increase poverty, health care and the economy
Abramsky 7/12 (Sasha Abramsky, graduate degree in journalism for Columbia University,
fellow at Demos, writer for UC Davis, 7/12/18, “Will ‘Public Charge’ Block Citizenship for
Immigrants?”, EQUAL VOICE NEWS,
Now, however, plans
being floated by the Trump administration, using the argument that too many
immigrants are a drain on the public purse, suggest they are seeking a catch-all expansion of the
definition of “public charge.” If these plans come to fruition, would-be immigrants whose
children are deemed likely to need free school lunches, for example, could be denied entry into
the U.S. And the use of those services, even by U.S.-citizen children, who are legally entitled to
them, would be used as grounds to deny their immigrant parents permanent residency or
citizenship. Masked as a “reform” of the welfare system, it is, in fact, as public interest attorneys and community leaders fear, an
extraordinarily brazen way to limit the immigration of poor people into the U.S., or their
continued stay in the country, if they are already here. It would be, in practice, a massive tightening of
the immigration system, and one the Trump administration hopes to implement on the down-low, as a regulatory reform,
without any Congressional oversight, grassroots observers say. Getting some of your needs met is huge. Having that assistance in
the beginning was a huge game-changer....Years later, I’m still giving back to communities that need me. Mychi Nguyen, a refugee
from Vietnam and now a doctor at a federally qualified health clinic The devil is, of course, in the details: Technically,
government wouldn’t be denying immigrants and their U.S.-citizen children access to health
care, food stamps, school lunches and other programs they now can access; such a move
wouldn’t stand up to legal challenge. What they are doing, however, is saying something like,
“Sure, you can use these services, but we reserve the right to hold that against you down the
road.” “They wouldn’t be denying them access,” Broder says. “But they would be penalizing the
parents, terrorizing families, chilling access to services or reducing family immigration in a way
that Congress hasn’t authorized. The potential scope of the rule is so sweeping it would affect a
large swath of the U.S. population. It’s an abrupt departure from 100 years of law and practice.” While the exact
contours of these regulatory rule changes haven’t yet been published, a number of draft versions of the proposals have leaked over
the past several months. “We’ve been tracking it for some time now,” says Carolina Gamero, of the California Immigrant Policy
Center. “What’s
happening at an administrative level does strike real fear in communities.” The
leaked versions, which suggest an eagerness to penalize immigrants for using not only federal
mean-tested programs but also state ones, have deeply worried immigrant rights and antipoverty advocates, and also have forced them to think far outside the box about how to
respond. It is, says Jessica Bartholow, policy advocate with the Western Center on Law and Poverty, a “potential game
changer,” since accessing universal benefits would not be penalized, whereas accessing means-tested ones would be. It might,
she says in a more hopeful moment, force states such as California to consider implementing universal health care, or universal child
benefits or even the universal basic income, as a way around the Trump administration’s potential changes that would affect
immigrant populations. But, in the meantime, she fears
a vast, and negative, impact on immigrant
communities: “It’s really cruel to allow people in your country to experience that kind of
deprivation.” Already, she says, simply based on rumors circulating in immigrant communities, her
organization has watched in shock as more and more immigrants have stopped applying for vital nutritional
and health benefits. At some point over the summer, the draft regulations will likely be released after review by the Office of
Management and Budget—advocates have, since May, believed the publication was imminent—followed by a
public comment period of up to three months. Given the hardline, anti-immigrant policies favored by some lawmakers, as a central
plank for their midterm strategy, it is likely this comment period will fill the months leading up to the November elections. If so, that
would push a debate on immigrants’ access to public benefits center stage. The Trump administration could seek to make the image
of migrants using benefits serve as the same political lightning rod as did the “welfare queen” in the 1980s. Former President Ronald
Reagan used that term, to powerful effect, a generation ago. Hoping to reshape the narrative, immigrant rights organizations are
gearing up for an enormous fight during this public comment period. But by the end of 2018, there is concern that some version of
these new regulations will likely be on the books. Organizers with the National Domestic Workers Alliance, which works with lowincome workers, mainly women, in heavily immigrant communities, agree with Bartholow’s observation. Which is: That even
they are ultimately not adopted, simply sending out a drip of rumors about such rule changes
will serve the purpose of discouraging large numbers of immigrants from accessing everything
from food stamps and school lunches for their children to health care and the Earned Income
Tax Credit. “It really affects a lot of the domestic workers we work with,” says Natalia Jaramillo, of the NDWA’s
immigration campaign. “Many are immigrants on temporary protected status, or they are undocumented, or they are [non-citizen]
residents. They have children born here.” And, since the funding for so many federal programs is based on a formula that takes into
account usage, as the number of immigrants accessing vital programs such as school lunches declines, so the total moneys available
to poor school districts for these services, and for related services based on overall poverty measures in a school district, also falls
off. Hit access to these programs, and states like California and New York, Florida and Texas, with high numbers of immigrants,
likely will see declining services to, and opportunities for, poor people across the board. The
result likely will be a further shredding of the safety net, and more low-income immigrants, and
others, falling deeper into poverty. Already, as federal policies and bureaucracies “get-tough,”
so immigrants are facing huge hurdles accessing benefits. Take, for example, the story of Lemka, a 46-year-old
undocumented immigrant living in a small town in the western part of Virginia. Shortly after Trump was elected president, she had
to renew Medicaid for her U.S.-citizen daughter. When she went in to the office to fill in the paperwork, the official there
interrogated Lemka about her immigration status, which was not relevant to the visit, and told her that if she didn’t provide all the
information they requested she would refer her to federal immigration authorities. Lemka was only applying for benefits for her
U.S.-citizen child. In a panic, Lemka left the office, and even though her daughter, who also qualifies for food stamps and school
lunches, is legally eligible for Medicaid, she is no longer covered. Lemka’s case speaks to a broader issue. Despite the view by some
so many are either already excluded from or
scared away from the social safety net that they contribute far more in taxes than they will ever
receive in benefits. In 2017, says Robert Pollin, co-director of the Political Economy Research Institute at the University of
Massachusetts at Amherst, “Undocumented immigrants contributed $13 billion to the Social Security
Trust Fund and received only $1 billion in benefits – i.e. they were donating $12 billion to
support everyone else’s Social Security.” In the current anti-immigrant political climate, however, such inconvenient
facts mean little to an administration intent on finding evermore creative ways to limit the ability of
foreigners to migrate into, and remain within, the United States. “It’s all part of a huge plan to
make our country as uncomfortable to immigrants as possible,” argues Amanda Baran, a consultant on
in the U.S. that immigrants, legal and otherwise, are “takers,”
immigration issues to the National Domestic Workers Alliance. As a result, some grassroots advocates fear, kids in immigrant
families may well soon be excluded from even the most basic of health protections. “It’s good health policy to make sure children
are protected and healthy, not just for themselves but for the community at large,” Lemka says, speaking through an interpreter
provided by the NDWA. “We’re talking about the safety and health of U.S.-citizen children. U.S.-citizen children that have rights. As a
mom, I’m concerned about my kid. It’s hard to keep kids safe and healthy.” Back in Oakland, California, Nguyen, the doctor, has seen
firsthand what happens when her patients are scared off of using medical services. “They’re
afraid, very, very scared
about using services they need,” she says. “Food stamps, WIC [Women, Infants and Children
program]. You’re providing food for babies, education. You’re preventing hunger, malnutrition,
costs on society in the long term. I’ve had patients I’ve known for years. I tell them I’m worried
they have cancer, and I’d like to do a workup. They’re afraid if they use a specialist or get a CAT
scan, that’ll be seen as a public charge and hurt them. They’re risking their life. I had a patient,
an old gentleman, he was having a stroke right in front of me. I told him he could die or be
paralyzed if he doesn’t go to the ER right now. He told me he couldn’t take that risk. Now he’s
paralyzed. The right side of his body doesn’t work.” Nguyen worries constantly that, if the proposed
“public charge” changes come into effect, such stories will become commonplace. “We will see
patients not coming in,” she fears. “They won’t come in for their doctors’ visits. It will create a huge impact on the health care
system. People will delay health care till they’re really in crisis. And then they’ll show up in the ERs very sick. From
a public
health policy standpoint, there’s no rationale to do this, to expand the ‘public charge’ definition.
It’s very shortsighted. Economically, it doesn’t make sense.”
New public charge restrictions decrease participation in programs key to health
and financial stability of immigrants and their 10.4 million children
Garfield et al. 5/18 (Rachel Garfield, PhD in health policy from Harvard, Senior Researcher
for the Kaiser Family Foundation, former Assistant Professor in the Department of Health Policy
and Management at the University of Pittsburgh, Samantha Artiga, Director of the Disparities
Policy Project at the Kaiser Family Foundation, Anthony Damico, masters in Health Policy from
Johns Hopkins, Statistical Analyst at the Henry J. Kaiser Family Foundation, 5/18/18, “Potential
Effects of Public Charge Changes on Health Coverage for Citizen Children”,
The Trump Administration is pursuing changes that, for the first time, would allow the federal
government to take into account use of Medicaid, CHIP, subsidies for Marketplace coverage and
other health, nutrition, and non-cash programs when making public charge determinations.
These changes would likely lead to decreased participation in Medicaid, CHIP, Marketplace
coverage, and other programs among legal immigrants and their citizen children, even though
they would remain eligible. This brief provides an overview of citizen children with a noncitizen parent potentially affected
by the changes and analyzes three Medicaid/CHIP disenrollment scenarios to illustrate how the changes could potentially
affect their health coverage and uninsured rate. In 2016, there were 10.4 million citizen children
with at least one noncitizen parent. Nearly nine in ten of these children live in a family with a
full-time worker, but these workers often are in low-wage jobs, leading to lower family incomes
and more limited access to health coverage. As such, over half (56%), or 5.8 million, citizen
children with a noncitizen parent had Medicaid or CHIP coverage in 2016. (See Appendix tables for state
data.) We illustrate the potential impact of different Medicaid/CHIP disenrollment rates and show that, if the policy leads to
disenrollment rates from 15% to 35%, an estimated 875,000 to 2 million citizen children with a
noncitizen parent could drop Medicaid/CHIP coverage despite remaining eligible. The majority
disenrolling would become uninsured, increasing their uninsured rate from 8% to between 14% and
22% and the uninsured rate for all children from 5% to between 6% and 7%. Although it is difficult to predict the effect of the
policy change, these disenrollment rates illustrate the potential impact and draw on previous
research on the chilling effect welfare reform had on enrollment of immigrant families.
However, unlike the current draft policy, welfare reform did not affect immigration status. Thus,
this illustrative analysis may underestimate the policy’s impact on Medicaid/CHIP participation.
In addition, this analysis does not account for coverage losses that would result from decreased participation in Marketplace
coverage. Coverage
losses would negatively affect the health of children and their families’
financial stability. Coverage losses would reduce access to care, contributing to worse health
outcomes. Moreover, reduced participation in nutrition and other support programs that are
also proposed to be considered as part of public charge determinations would likely compound
these effects. Introduction The Trump Administration is pursuing changes that, for the first time, would allow the federal
government to take into account use of health, nutrition, and other non-cash programs when making public charge determinations.
Under these changes, use of these programs, including Medicaid, CHIP, and subsidies for Marketplace coverage, by an individual or
family member, including a citizen child, could result in the federal government denying an individual a “green card” or adjustment
to lawful permanent status or entry into the U.S. These changes would likely result in reduced participation in Medicaid, CHIP,
Marketplace coverage, and other programs by immigrant families, including citizen children, even though they would remain
eligible. Decreases
in Medicaid and CHIP enrollment would increase the number of uninsured and
reduce access to care, increase financial strains on families, and widen disparities in coverage.
This brief provides an overview of citizen children with a noncitizen parent who could potentially be affected by the proposed
changes and presents three Medicaid/CHIP disenrollment scenarios to illustrate how the changes could potentially affect their
health coverage and uninsured rate. It is based on Kaiser Family Foundation analysis of Current Population Survey Data. (See
Methods for more details.) Appendix Tables 2 and 3 provide state-specific data. In 2016, there were 10.4 million citizen children in
the U.S. with at least one noncitizen parent. What are the potential effects of “public charge” changes on health coverage for this
population? Overview of Citizen Children with a Noncitizen Parent In
2016, nearly 20 million, or one in four,
children had at least one immigrant parent, and nearly nine in ten (88%) of these children were
citizens (Figure 1). Over half, or 10.4 million, of these children lived in mixed status families, where the child is a citizen and at
least one parent is a noncitizen. Citizen children with a noncitizen parent are heavily concentrated in a few states. Over half of
children with a noncitizen parent live in California (25%), Texas (16%), New York (7%), and Florida (6%) (Appendix Table 2). Citizen
children with a noncitizen parent range in age and race/ethnicity, although the majority are between ages 6-18 and Hispanic (Figure
2). About one in three (36%) citizen children with a noncitizen parent are below age six; the remaining 64% are between ages 6-18.
Over two-thirds (69%) of citizen children with a noncitizen parent are Hispanic and 11% are Asian. The remaining 19% includes 11%
who are White non-Hispanic, 6% who are Black non-Hispanic, and 2% who are another or mixed race. Although citizen
with a noncitizen parent are more likely to live in a family with a full-time worker compared to those with U.S. born
parents, they have lower family incomes. Nearly nine in ten (86%) citizen children with a noncitizen parent live in
a family with at least one full-time worker (Figure 3). However, over two-thirds (67%) of citizen children with a
noncitizen parent have family incomes below 250% of the federal poverty level (FPL), compared
to 45% of children with U.S. born parents. This finding reflects that noncitizens are often employed in low-wage jobs
and industries. Reflecting their lower family incomes, Medicaid and CHIP play a key role in covering
citizen children with a noncitizen parent, but they remain more likely than those with U.S. born
parents to be uninsured. Given that over two-thirds of citizen children with a noncitizen parent have family incomes below
250% FPL, many are within the income eligibility limits for Medicaid or CHIP.1 As such, Medicaid and CHIP cover over
half (56%), or 5.8 million, citizen children with a noncitizen parent. This coverage helps to fill
gaps in private coverage since many noncitizen parents work in low-wage jobs that often do not
offer health coverage. However, citizen children with a noncitizen parent remain more likely than children with U.S. born
parents to be uninsured (8% vs. 5%). Moreover, their parents are more than three times as likely to be uninsured themselves
compared to U.S. born parents (24% vs. 7%). Potential Coverage Losses Due to Public Charge Policies Under
changes proposed by the Trump Administration, use of health, nutrition, and other non-cash
programs by an individual or a family member, including a citizen child, could result in the
federal government denying an individual adjustment to lawful permanent resident status (i.e.,
a “green card”) or entry into the United States.2 Under longstanding policy, individuals who are determined to be a
“public charge” can be denied lawful permanent residence or entry into the U.S. Today, individuals may be determined a public
charge if they rely on or are likely to rely on public cash assistance or government funded long-term institutional care. Current policy
does not allow the federal government to consider the use of non-cash benefits, such as health and nutrition programs, in public
charge determinations. Under the draft proposed changes, the federal government could consider previously excluded health,
nutrition, and other non-cash programs in public charge determinations. These programs would include Medicaid, CHIP, and
subsidies for Marketplace coverage. In addition, the changes would newly allow the federal government to take into account use of
programs by citizen children and other family members in making a public charge determination. The
changes in public
charge policy would likely lead to decreased participation in Medicaid, CHIP, Marketplace
coverage, and other programs among legal immigrant families, including their citizen children,
even though they would remain eligible. Fears of negative consequences on immigration status
are a barrier to Medicaid and CHIP enrollment for eligible immigrant families today even though
the federal government cannot consider use of Medicaid and CHIP in public charge
determinations under current policy.3 The proposed changes would amplify these fears because
use of Medicaid, CHIP, as well as subsidies for Marketplace coverage and other programs could
negatively affect immigration status. The preamble to the draft proposed rule notes, “the action provides a strong
disincentive for the receipt or use of public benefits by aliens, as well as their household members, including U.S. children.” It is
expected that the public charge policy change would primarily affect individuals seeking a green card through a family-based
petition. However,
increased fears would likely extend beyond individuals directly affected by the
policy to the broader immigrant community.4 Due to increased fears, it is likely that fewer
eligible individuals would enroll themselves and their children in health coverage and individuals
currently enrolled in programs would disenroll themselves and their children despite remaining
eligible for coverage. To illustrate potential effects of these changes on health coverage of children, we present three
scenarios of disenrollment from Medicaid and CHIP among citizen children with a noncitizen parent. As of 2016, 5.8 million
citizen children with a noncitizen parent were enrolled in Medicaid or CHIP (see Appendix 2 for state
data), and 790,000 or 8% were uninsured. We applied disenrollment rates from Medicaid and CHIP of 15%, 25%, and 35%. Although
it is difficult to predict the effect of the policy change, these disenrollment rates illustrate the potential impact and draw on previous
research on the chilling effect welfare reform had on enrollment of immigrant families.5 However, unlike the current draft policy,
welfare reform did not affect immigration status. Thus, this illustrative analysis may underestimate the impact that the policy may
have on participation in Medicaid/CHIP. We assume that 75%
of children disenrolling from Medicaid and CHIP
would become uninsured based on data showing some access to private coverage among this
population.6 However, some families may not be able to afford private coverage even if it is
available. As such, this analysis may underestimate the share of children disenrolling from
Medicaid/CHIP who would become uninsured. In addition, this analysis does not account for
decreased coverage due to fewer individuals enrolling their eligible children in Medicaid or CHIP
or coverage losses that would result from decreased participation in Marketplace coverage. If
the public charge policy change leads to Medicaid/CHIP disenrollment rates ranging from 15% to
35%, an estimated 875,000 to 2 million citizen children with a noncitizen parent could drop
Medicaid/CHIP coverage despite remaining eligible, and their uninsured rate would rise from 8%
to between 14% and 22%. Specifically, as shown in Figures 5 and 6 and Appendix Table 1: A 15% decline in Medicaid/CHIP
enrollment among citizen children with a noncitizen parent would result in 875,000 children losing Medicaid/CHIP coverage and
657,000 becoming uninsured. These losses would increase the uninsured rate for citizen children with a noncitizen parent from 8%
to 14%, and the uninsured rate for all children would increase from 5% to 6%. A 25% decline in Medicaid/CHIP enrollment among
citizen children with a noncitizen parent would result in 1.5 million children losing Medicaid/CHIP coverage and 1.1 million becoming
uninsured.These losses would increase the uninsured rate for citizen children with a noncitizen parent from 8% to 18%, and the
uninsured rate for all children would increase from 5% to 7%. A 35% decline in Medicaid/CHIP enrollment among citizen children
with a noncitizen parent would result in 2.0 million children losing Medicaid/CHIP coverage and 1.5 million becoming uninsured.
These losses would increase the uninsured rate for citizen children with a noncitizen parent from 8% to 22%, and the uninsured rate
for all children would increase from 5% to 7%. Coverage losses
would negatively affect the health of children
and their families’ financial stability. Coverage losses would reduce access to care, contributing
to worse health outcomes.7 Reduced participation in nutrition and other programs that are also
proposed to be considered in public charge determinations would likely compound these
effects. In particular, the Earned Income Tax Credit, free or reduced price lunch program,
Supplemental Nutrition Assistance Program, and Women Infant and Children’s Program (WIC)
provide important sources of support for these households (Appendix 3). Decreased
participation in these programs would negatively affect the financial stability of families and the
growth and healthy development of their children.8
Public charge expansion removes immigrant and citizen children access to food,
shelter and health care- impacts disease spread and family separation
Hernández-Cancio and Fish-Parcham 4/2 (Sinsi Hernández-Cancio, law degree from
NYU, the Director of Health Equity at Families USA, Hays Civil Rights and Civil Liberties Fellow at
NYU, member of the Addressing Disparities Advisory Panel for the Patient-Centered Outcomes
Research Institute, member of the Robert Wood Johnson Foundation’s State Strategy Advisory
Committee, participant in the Allies Reaching for Community Health Equity effort, Public Voices
Fellow with The OpEd Project, former Georgetown University Law Center’s Women’s Law and
Policy Fellowship, former lawyer at the Women’s Rights Project of Human Rights Watch, former
health advisor to the Governor of Puerto Rico, Cheryl Fish-Parcham, Private Insurance Program
Director at Families USA, former employee for the Health Assistance Partnership, former
advocate at AARP’s Legal Counsel for the Elderly, M.S.W. from Howard University, 4/2/18,
“Trump Administration Threatens Health Care for Immigrant Families, Including US Citizen
Last week, the Washington Post published a leaked draft of a proposed regulation to drastically
change requirements for certain immigrants to enter the United States and/or become
permanent residents. The proposed regulation targets families who have immigrated lawfully,
as well as their U.S. citizen relatives, by undermining their access to basic needs, including
food, shelter, and health care. This would undercut years of hard work to build a better future
for themselves, their communities, and our nation. The proposal has several more steps to go before it is
finalized, but it is important for the public to understand the harm it could cause to families and to the nation’s health care system
now. There is still time for health advocates and the general public to raise their voices against this heartless, un-American proposal.
What the leaked draft proposes Most immigrants
who are either entering this country or applying for
lawful permanent residency must show that they are not likely to become a “public charge” –
that is, they will not be dependent on the U.S. government for their financial support. For many
years, the test for public charge has included a look at two types of benefits: whether applicants ever received cash assistance, such
as Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI), and whether they are likely to need that
cash assistance in the future; and whether applicants are likely to need long-term nursing home care paid for by the government.
Other health care benefits were off limits for this public charge determination. The draft
regulation proposes to change
a public charge determination to include (among
others) whether the applicant or his/her dependents ever purchased health insurance through the marketplace
with federal premium tax credits, or enrolled in Medicaid or the Children’s Health Insurance
Program (CHIP), and their likelihood of receiving these health care benefits in the future. In recent
this rule. It expands the list of benefits that would be considered in
days, another troubling issue has surfaced: Under current policy, public charge determinations generally affect the ability of families
to improve their immigration status, but they generally cannot result in deportation. Proposed
regulations may change this
longstanding rule, increasing the authority of federal immigration agencies to deport immigrants
based on nothing more than their use of health care services or other assistance for which
they fully qualify. How will this proposal harm families’ health? If adopted, this rule will force families to
choose between staying together and getting the health care they need, even for the family
members who are US citizens. It will discourage people from signing up for health insurance
and, as a result, they will lose their access to care. The proposed rule will have a huge impact
on the health and well-being of children in particular. Medicaid and CHIP help millions of
children get the regular care they need to develop into healthy adults. For example, CHIP and
Medicaid cover oral health care so that toothaches won’t distract kids from school lessons,
vision exams and glasses to help kids see the blackboard, vaccines and prompt care for the flu to
keep children and their schoolmates healthy, and treatment for life-threatening conditions such
as asthma. This proposal would force parents to make awful decisions. They could insure their
children, who are legally entitled to health care benefits, but that could prevent the parent
from becoming a lawful permanent resident. Which is better: to jeopardize the child’s health,
or jeopardize the family living together? The health insurance coverage of many working adults will also be in peril.
Currently, legally present adults whose employers don’t offer affordable health insurance are able to get covered through the Health
Insurance Marketplace and receive sliding scale financial assistance to help pay for the health plan they choose if they qualify.
With health insurance, adults can keep themselves healthy and able to work and parent, keep
contagious diseases from spreading to their coworkers and communities, and afford to get their
illnesses treated before they worsen. Currently, these health benefits are not included in public charge calculations for
applicants seeking legal entry or lawful permanent residency. The leaked proposed rule would change that. If an immigrant,
or even the immigrant’s citizen child, sought, applied for, or received health coverage through
Medicaid, CHIP, or through the marketplace with premium tax credits, it could be held against
them in public charge determinations. Every form of health insurance involves some form of public
subsidy in addition to whatever amount people pay for care themselves: employers get a tax deduction
for covering their workers; people who buy their own health insurance similarly get tax deductions based on their incomes. There
are subsidies for Medicare as well. It
makes no sense to consider Medicaid, CHIP, and marketplace
coverage in a public charge determination when the cost of health care is always shared broadly.
How will this proposal harm communities’ health? The impact of this proposed rule extends well beyond the
directly targeted individuals and families whose health will be at risk. A community’s overall
health depends on the health of all of its members. The impact of this proposed rule will spill
over to others in many ways. Without insurance, families may delay care or forego it altogether.
This means there will be more children in school, and adults in the workplace, without needed
preventive services and untreated illnesses. More people delaying care until the last possible
moment will strain emergency resources. Hospitals’ and clinics’ uncompensated care burdens
will increase. The proposal will further undermine the individual health insurance market. Health
insurance marketplaces must include enough people to attract insurers; they must include a mix of consumers, including many that
are in good health, in order to offset the cost of care to those who are sicker. By
forcing immigrants and temporary residents
to choose between leaving their families uninsured or risking their residency status, the
proposed rule will shrink marketplace enrollment. Moreover, given that immigrants are, on
average, much healthier than citizens, the pool will be sicker in addition to smaller. This is
another potential blow to the stability of the marketplace. The proposal will also hurt the health
care workforce. About 17 percent of all health care workers and nearly one-fourth of health
care support workers, such as nursing aides and home health aides, are immigrants. All too
frequently, agencies that employ these health care workers do not provide them with insurance,
and so these workers must rely on the marketplace or on Medicaid for their coverage. As baby
boomers age and more and more people need health care services, including home care, discouraging
these immigrants
from coming to help, and making it harder for health care workers to get the coverage they need to stay healthy, are exactly the
wrong things to do. What immigrants would be affected? Most commonly, the immigrant groups who are subject to
public charge determinations are relatives coming to the US to reunite with family members
who live here. This includes spouses, children, and parents of US citizens, and family members of lawful
permanent residents (“green card” holders) who may have stayed behind in another country until one parent established a home
and work in the United States. Sixteen million U.S. children have foreign-born parents. Each year, about 700,000 immigrants seek
permanent residency in the U.S. to be united with family. People coming to the US for temporary work and their family members
will also be affected, both when they initially apply to come to the United States and if they decide to seek permanent residency.
Some groups of immigrants – such as refugees, asylees, people fleeing domestic violence, and some other protected groups – are
not subject to public charge determinations and would not be affected by this proposed rule. What you can do Making
families choose between being together or being healthy is cruel, short-sighted, and bad for
the whole country. It is also an affront to our core values as a nation. But we have a chance to take a
stand. We expect the proposed rule to be posted in the Federal Register for public comment very soon. As a member of
the Protecting Immigrant Families campaign, Families USA has partnered with immigrant advocacy, anti-hunger, and anti-poverty,
and other social justice organizations to present a united opposition to this dangerous proposal.
Leaving immigrants without access to care is the primary cause of emerging
disease spread- migration is inevitable
Barnett 8, (Elizabeth D.Barnett, Role of Immigrants and Migrants in Emerging Infectious
Diseases, 11-1-2008, No Publication,
Migrant populations have had a critical role in the spread of infectious diseases since ancient
times. Examples range from biblical plagues, the importation of smallpox into Mexico, the 1918
influenza pandemic, and the AIDS pandemic, to severe acute respiratory syndrome (SARS),
outbreaks of meningococcal meningitis associated with the Hajj, and diseases spread by
population movement due to political conflict.
Stephen S. Morse3
defined emerging infectious diseases as “infections that have newly appeared in a population or
have existed but are rapidly increasing in incidence or geographic range.” Migrant populations
have played roles in introducing infections into naïve populations (smallpox and measles into
Pacific island nations, the global spread of HIV), in changing the incidence of infections in a
population, and in increasing the potential for local transmission (hepatitis A, tuberculosis [TB]).
increase the geographic range at which these infectious diseases
might be encountered by health professionals unfamiliar with them (leishmaniasis, Chagas
disease, and malaria in North America).
1, 2 In the debut issue of the journal Emerging Infectious Diseases,
Migrants may also carry infections that pose little risk to the local population but
Such infections present diagnostic dilemmas and over time also change the face of chronic disease in a population (seizures and neurocysticercosis, heart
disease and Chagas infection, hepatocellular carcinoma and hepatitis B infection). Finally, population mobility may increase the potential for establishing transmission of new infections in North America (dengue and chikungunya fever in areas where vector
Immigrants have ongoing links with populations in their countries of origin that may
provide a channel through which infectious diseases potentially can be introduced to new areas.
This article focuses on the recent demographic changes in North America that have facilitated
the introduction and spread of new microbial threats, the role migrant populations play in
changing the demographics of specific infectious diseases
mosquitoes exist).
, and the potential responses of clinicians and public health officials in addressing the challenges posed by
these infections. The emphasis of the article is on immigrant and migrant populations entering North America; the role of travelers in emerging infectious diseases is addressed in another article in this issue. Migration patterns and emerging infectious diseases
More than 200 million people (roughly 2% of the world's population) currently live outside their
country of birth.4 The largest number, more than 38 million, live in the United States.
Canada is the country with
the sixth largest number of migrants, with just over 6 million.5 The proportion of the United States population who were foreign born was higher in the late nineteenth and early twentieth centuries, when it reached almost 14%, but then it declined to less than 5% in
the 1970s; it has been increasing steadily for the past 3 decades and is now more than 12% and growing. Almost 20% of the pop ulation of Canada is foreign born.6 More than half (54%) of the migrants living in the United States are from the Americas, with an
nternational travel is
also increasing at a record pace. More than 30 million trips outside the United States were made
additional 26% from Asia, 16% from Europe, and 3% from Africa. In contrast, migrants living in Canada are mostly from Europe (41%) and Asia (37%), with 16% from the Americas and 5% from Africa.7 I
in 2006, an increase of more than 10 million in the decade since 1996.
8 Outbound travel from Canada is also increasing rapidly, with an almost
8% increase from 2004 to 2005, and a record number of more than 21 million trips made.9 A larger proportion of trips are made by those, usually immigrants and their famili es, who identify visiting friends and relatives as the primary purpose of their trip.10 The
Population migration has been associated with the spread
of diseases ranging from plague, smallpox, measles, and syphilis to, more recently, HIV and TB.
Travel and trade are also associated with the spread of disease vectors, such as the mosquito
vectors for yellow fever and dengue fever.
2003 Institute of Medicine report identified 13 factors affecting the appearance of new and
emerging infectious diseases, many of which were related to migrating populations.1
profile of travel destinations is linked to the changing demographics of the North American population.
11 The rapidity of air travel has facilitated the spread even of diseases with short incubation periods such as influenza and measles.12, 13
4 Migrant populations can,
however, have other roles in changing the pattern of diseases present in a population. Some chronic conditions are associated with remote acquisition of infections, such as American trypanosomiasis or Chagas disease (heart and esophageal disease), the parasitic
infection cysticercosis (seizure disorders), and hepatitis B and C infection (hepatic cirrhosis). The incidence of some cancers (hepatocellular carcinoma, cervical cancer) in the future may also be affected by the prevalence of infections such as hepatitis B and C and
human papillomavirus (HPV) in mobile populations resettling in areas where these infections are less common. Migrant populations and acute and clinically apparent infectious diseases Immigrants may have a direct role in transmitting acute infectious diseases from
one geographic location to another. This concern is especially great when large groups, such as refugees, are resettled to locations around the world. Since 2004, the resettlement of refugee populations has been disrupted in Kenya, Tanzania, Thailand, Ethiopia, and
Ivory Coast by outbreaks of vaccine-preventable diseases including measles, mumps, rubella, polio, pertussis, hepatitis A, and typhoid fever. The planned movement of 8000 Liberian refugees scheduled to begin in June 2003 and conclude in April 2004 was
interrupted several times by outbreaks of varicella, measles, o'nyong-nyong fever, and rubella.15 During this period, 16 cases of varicella were imported into four states and an infant who had congenital rubella infection was born to a mother who had asymptomatic
infection.16 Experts in refugee resettlement have proposed immunization of large mobile populations before resettlement to reduce the spread of infectious diseases and to realize a cost-savings compared with administering all vaccines in the destination
country.17 The United States and Canada, through successful routine immunization programs, have reduced the rates of vaccine-preventable diseases to extremely low levels in the general population.18 Disease due to Haemophilus influenzae type b has decreased
by more than 99%, and most cases of measles and rubella in the United States are now imported or associated with imported cases.19, 20, 21 Health care professionals have become less familiar with the typical clinical manifestations of some of these infections,
leading to potential delays in diagnosis, as illustrated by several recent outbreaks of measles associated with children adopted internationally.22 Other diseases, including varicella, pneumococcal disease, and pertussis, have been reduced significantly by routine
childhood immunization, although clinicians continue with some regularity to see patients who have these diseases.23, 24, 25 The major role of clinicians when evaluating newly arrived immigrants is to maintain a high index of suspicion for diseases that have
become rare in the United States. Immigrants may not have received in their country of origin vaccines given routinely in North America, or may have had exposures that would be rare in North America. Hepatitis A poses an additional challenge, in that individuals,
usually children, who have anicteric or asymptomatic infection may still shed virus and transmit disease to others. Hepatitis A disease and disease mortality has decreased in the United States since implementation of immunization at age 2 in high-incidence
communities, and is expected to decline further with routine immunization of all children at age 1.26, 27 Cases have been linked, however, to internationally adopted children and to immigrants and their families who live along the United States–Mexico border and
travel back and forth frequently.28, 29, 30, 31 Clinicians must have a high index of suspicion for situations that would plac e individuals at increased risk for hepatitis A, and provide these individuals with hepatitis A vaccine. Children adopted int ernationally are a
special group who deserve additional mention. Because they are not required to receive immunizations before leaving their birth country, they may be susceptible to, or already infected with, vaccine-preventable diseases at the time of arrival in North America.
Transmission of measles, hepatitis A, hepatitis B, TB, and other infectious diseases has been documented from internationally adopted children. Pertussis, rubella, and varicella have been diagnosed in adoptees soon after arrival.32, 33 Children adopted
internationally, because they join families that have not shared similar exposures, may pose a unique potential for transmitting infectious diseases in their adoptive country. Recent reports of measles and hepatitis A outbreaks in association with internationally
adopted children illustrate this phenomenon.22, 28 The potential risk for transmission of diseases from the migrant population of internationally adopted children has led to recommendations for enhanced protection of families traveling to adopt children and of
family members and others who will have close contact with these children on arrival in North America.32, 34, 35, 36 Migrant populations and latent and chronic infectious diseases less familiar to North American health professionals The health characteristics of
migrant populations depend on the conditions to which migrants are exposed in their countries of origin, during migration, an d in their resettlement environment.4 Understanding a person's journey from his/her country of origin to his/her country of current
residence is especially important when assessing risk for diseases of long latency, such as TB, HIV, leprosy, and Chagas disease, and diseases that occur when an individual's immune status changes, such as strongyloides and latent TB. Few of these diseases, with the
In many developed countries, TB occurs disproportionately in the
foreign-born population. In the United States, more than 50% of TB cases have occurred in non–
United States-born individuals since 2002
Multidrug-resistant TB also occurs
more commonly in foreign-born individuals; 84.5% of cases occurred in such individuals in the
United States in 2006.
notable exception of TB, pose significant risk to the local population.
, and most of these become apparent within 5 years of entering the United States.37 Although the total number of cases of TB reported in the United
States declined in 2007, 58.5% were in foreign-born individuals, and the TB rates in the foreign-born were 9.7 times higher than in individuals born in the United States.
38 Since the early 1990s, more than half the cases of TB in Canada have been reported in foreign-born individuals.39 Patterns of TB seen in North America today and those predicted for the future are
therefore driven by the trends in immigration now and in the recent past. Currently, more than half of all TB cases in the United States occur in individuals from four countries: Mexico, the Philippines, India, and Vietnam.38 In Canada, most cases are seen in
individuals from the Western Pacific region, although increased numbers of cases from Southeast Asia and Africa are being reported.39 TB control programs must take into account the needs of the foreign-born population and make TB diagnosis and prevention
programs accessible and acceptable to foreign-born populations.40 The global burden of HIV falls disproportionately on individuals from certain parts of the world, especially Africa. In North America, an increasing proportion of individuals living with HIV are foreign
born. In Massachusetts, as of November 2007, 19% of those living with AIDS were foreign born, compared with a foreign-born population of about 12%.41 Less than 1% of Minnesota's population was born in Africa, yet in 2004, 19% of new HIV diagnoses were
among those born in Africa.42 MacPherson and colleagues43 contrast the prevalence of HIV in Canadian immigration applicant children (14/100,000) with the rate of domestically reported pediatric HIV cases (0.02/100,000). They conclude that population migration
and immigration could more than double the number of children who have HIV/AIDS in Canada, requiring a refocusing of efforts to provide culturally and linguistically appropriate programs of HIV care and prevention for immigrant families. Health care professionals
and HIV program directors face significant challenges in accommodating the needs of diverse immigrant populations. Overcoming language and cultural barriers to care, addressing differing beliefs about HIV/AIDS, providing care in the context of competing priorities
such as housing, jobs, and family stress, and addressing the psychiatric needs of immigrants living with HIV are all critical to the success of programs caring for immigrant populations, yet are stretching the resources of these programs in unprecedented ways.44
Immigrants may present with conditions unfamiliar to American-trained health care professionals, resulting in delays in diagnosis. Dermatologic conditions are especially challenging. Chronic conditions such as leprosy, leishmaniasis, and filarial disease can provide
Arriving at the correct
diagnosis often requires detailed information from the patient about migration history, access
to specialized laboratories that can assist in making a diagnosis
long period of treatment required (sometimes
with specialized medications)
diagnostic dilemmas and may not be recognized easily. Keystone45 provides an excellent overview of skin conditions of immigrants, and contrasts these with those likely to be seen in travelers.
, and, for some diseases, access to specialized medications with limited availability. Once a
diagnosis is made, additional challenges include addressing the stigma associated with diseases such as Hansen's disease (leprosy), the
, and, with conditions such as visceral leishmaniasis, addressing the possibility of HIV coinfection.
Access to health care prevents imminent pandemics
Calma, Miley and de Chant 15 (Justine Calma, GroundTruth-Kaiser Family Foundation
global health reporting fellow, Marissa Miley, deputy editor of global health for The
GroundTruth Project, Tim De Chant, editor at NOVA, 10/4/15, “Will changing healthcare access
prevent the outbreak of a global pandemic?”,
For the hard-hit countries in West Africa now rebuilding their communities and lives after the devastating wave of Ebola,
the need for health care that is affordable and accessible is particularly pronounced. “Our recent
experience with the Ebola disease proved to be a real wakeup call because it exposed the weaknesses
of our health system,” said Liberian President Ellen Johnson Sirleaf at the United Nations headquarters last week. “It pointed
out to us that in that call, we need a more vigorous fight against health-related challenges, particularly infectious
diseases such as malaria, cholera, typhoid, all of which are at high levels of incidences in our country.” As heads of state adopted
ambitious goals for the world to achieve in the next 15 years, a corps of health and political leaders, including Sirleaf, are publicly
stressing the importance
of adopting universal health coverage to help stem the next outbreak of
infectious disease. During a week where President Barack Obama has called child death from infectious disease a “moral
outrage” and UN Secretary General Ban Ki-Moon declared that “human security depends on health security,” the
link between health care and human rights is codified in the global agenda more than ever
before. “Universal health coverage with an emphasis on fairness and equity in health, leaving
nobody behind, is exactly what the UN General Assembly has just adopted as one of the
important principles of the SDGs,” said World Health Organization Director General Margaret Chan, at Monday’s panel
discussion, where leaders discussed the path towards universal health coverage. “We need capacities to prevent,
detect and respond to outbreaks and humanitarian crises. And we also need health systems that are
resilient.” While a year ago, Liberia was experiencing hundreds of new cases a week, it is now Ebola-free The virulent disease may
have subsided, but it still lingers as a threat —and it’s not the only one. Public health officials agree that the next
disease outbreak of infectious disease is imminent. The question is, which one? Possibilities
range from the MERS coronavirus in the Middle East and avian influenza in East Asia to mounting drug resistance
that could unleash waves of deadly superbugs around the globe. Then there are the scores of perennial challenges such
as childhood pneumonia and malaria. In 2014, 43 percent of the 5.9 million children who died under the age of 5 fell victim to
infectious disease, according to the UN. For the last several months, The GroundTruth Project has embarked on an in-depth, multipart investigation in collaboration with NOVA Next that explores just
how prepared the world is for a pandemic
of global proportion. In the multimedia series publishing this fall, the “Next Outbreak,” our journalists are reporting on the
ground in Asia, Africa and North America, asking how doctors, epidemiologists and public officials responded to the last pandemic —
and what it will take to be prepared for future outbreaks. They’re looking for places where the response fell short. But they’re
also documenting the bright spots, instances where the ability to prevent, predict and respond to infectious diseases is gaining
momentum. The series features the doctors and scientists who are racing to prepare for the next pandemic, and underscores the
importance of universal health care in all corners of the world. The concept of universal health care — the right to health — was
not explicitly part of the Millennium Development Goals, the first set of global goals, which expire at the end of this year. But health
leaders deemed universal health care so integral to public global health that that it was initially considered as the
overarching health goal for the SDGs, called Goal 3. During negotiations to create this new objective for 2030, however, a broader
goal was selected to “ensure
healthy lives and promote well-being for all at all ages.” Under Goal 3, there is a
specific target to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis,
water-borne diseases and other communicable diseases.” Universal health coverage, Chan said on Monday at the panel event, “is a
very good example to illustrate how Goal 3 can come together.” Infectious
disease control always has been
recognized as an important health priority within development because outbreaks can be a
destabilizing security threat, said Heather Wipfli, associate director of the Institute for Global Health at the University of
Southern California, who has studied the new global goals. "I think the world has recognized how important access to
care is for the most vulnerable populations and how our connectivity has put us all dependent
on each others access to quality healthcare," she said.
Diseases cause extinction- U.S is key- no burnout
Bar-Yam 16 (Yaneer Bar-Yam, Complex systems scientist studying social and economic
systems, president of the New England Complex Systems Institute, "Transition to extinction:
Pandemics in a connected world", 7-3-2016, Medium, but it
turns out that Michael Scott also cut this in internal brain drain
The video (Figure 1) shows a simple model of hosts and pathogens we have used to study evolutionary dynamics. In the animation, the green are hosts
and red are pathogens. As pathogens infect hosts, they spread across the system. If you look closely, you will see that the red changes tint from time to
time — that is the natural mutation of pathogens to become more or less aggressive. Watch as one of the more
aggressive—brighter red —
rapidly expands. After a time it goes extinct leaving a black region. Why does it go extinct? The answer is that it
spreads so rapidly that it kills the hosts around it. Without new hosts to infect it then dies out itself. That the rapidly
spreading pathogens die out has important implications for evolutionary research which we have talked about elsewhere [1–7]. Figure 2: Flight map for
an airline (KLM) some years ago. In the research I want to discuss here, what we were interested in is the effect of adding long range transportation [8].
This includes natural means of dispersal as well as unintentional dispersal by humans, like adding airplane routes, which is being done by real world
airlines (Figure 2). When
we introduce long range transportation into the model, the success of more
aggressive strains changes. They can use the long range transportation to find new hosts and
escape local extinction. Figure 3 shows that the more transportation routes introduced into the
model, the more higher aggressive pathogens are able to survive and spread. Figure 3: As we add more
long range transportation links more aggressive pathogens survive. the types of pathogens change from those that are in the upper red to progressively
the ones in the images toward the lower right. The lowest one on the right is a snapshot just before everything goes extinct. As
we add more
long range transportation, there is a critical point at which pathogens become so aggressive that
the entire host population dies. The pathogens die at the same time, but that is not exactly a consolation to the hosts. We call
this the phase transition to extinction (Figure 4). With increasing levels of global transportation,
human civilization may be approaching such a critical threshold. Figure 4: The probability of survival
makes a sharp transition (red line) from one to zero as we add more long range transportaion
(horizontal axis). The right line (black) holds for different model parameters, so we need to study at what point the transition will take place for our
world. In the paper we wrote in 2006 about the dangers of global transportation for pathogen evolution and pandemics [8], we mentioned the risk
from Ebola. Ebola
is a horrendous disease that was present only in isolated villages in Africa. It was
far away from the rest of the world only because of that isolation. Since Africa was developing, it
was only a matter of time before it reached population centers and airports. While the model is
about evolution, it is really about which pathogens will be found in a system that is highly
connected, and Ebola can spread in a highly connected world. The traditional approach to public health uses
historical evidence analyzed statistically to assess the potential impacts of a disease. As a result, many were surprised by the spread of Ebola through
West Africa in 2014. As the connectivity of the world increases, past experience is not a good guide to future events. A
key point about the
phase transition to extinction is its suddenness. Even a system that seems stable, can be
destabilized by a few more long-range connections, and connectivity is continuing to increase. So
how close are we to the tipping point? We don’t know but it would be good to find out before it happens. While Ebola ravaged three countries in West
Africa, it only resulted in a handful of cases outside that region. One possible reason is that many of the airlines that fly to west Africa stopped or
reduced flights during the epidemic [9]. In the absence of a clear connection, public health authorities who downplayed the dangers of the epidemic
spreading to the West might seem to be vindicated. As with the choice of airlines to stop flying to west Africa, our analysis didn’t take into
consideration how people respond to epidemics. It
does tell us what the outcome will be unless we respond fast
enough and well enough to stop the spread of future diseases, which may not be the same as
the ones we saw in the past. As the world becomes more connected, the dangers increase. Are
people in western countries safe because of higher quality health systems? Countries like the U.S. have highly skewed
networks of social interactions with some very highly connected individuals that can be
“superspreaders.” The chances of such an individual becoming infected may be low but events
like a mass outbreak pose a much greater risk if they do happen. If a sick food service worker in an airport infects
100 passengers, or a contagion event happens in mass transportation, an outbreak could very well prove unstoppable.
Third is economy:
Trump’s public charge changes remove immigrant food security, heath care,
education and financial stability- key to national health and economy
Woomer-Deters 5/24 (Kate Woomer-Deters, law degree from the University of Minnesota,
attorney at the North Carolina Justice Center’s Immigrant and Refugee Rights Project since 2007,
founder of the University of Minnesota Workers' Rights Clinic, 5/24/18, “Latest Trump
immigration ‘public charge’ rule proposal plumbs new depths”,
In the aftermath of the recent successful push to ward off huge cuts to food assistance programs in the federal Farm Bill, advocates
are now organizing to defeat another discriminatory
and destructive attack — this one on supports to
families who are struggling to get by and our immigration system that should allow families to
stay together. The Trump administration is preparing to unveil a new rule severely restricting
access to critical supports to immigrants and their family members, thereby creating new
barriers to economic mobility. What’s more, while the proposed rule is clearly a targeted attack on
immigrants and people of color, it is much more than just an “immigration” matter because it is ultimately about
the health and wellbeing of our entire community, including hundreds of thousands of U.S.
citizen children. If the community raises its voice, however, there may still be a chance to stop it. The proposed rule
revolves around a century-old immigration policy that generally requires immigrants seeking
lawful immigration status to prove that they will not be “a public charge” by becoming
dependent upon the government for support. Despite this general rule, it’s been established
U.S. policy for nearly 20 years that eligible immigrants may make use of life-sustaining health
and nutritional programs that are key to healthy outcomes for children and families – most
notably, Medicaid, Affordable Care Act health coverage, WIC nutrition assistance for babies
and moms and SNAP (Food Stamps). In addition and importantly, current law also makes clear
that any benefits used by the U.S. citizen children or family members of immigrants do not
count against the immigrants themselves. The administration’s new scheme would change all
of this. It states that if immigrants make use of these health and nutrition programs, the
government will use it against them in determining whether they can obtain lawful immigration
status. To make matters even more outrageous, the draft proposal states that even benefits
used by an immigrant’s U.S. citizen children or dependents can be used against her as well.
Needless to say, such a rule could produce devastating humanitarian consequences. Columbia University researchers
estimate the proposed changes could force more than 670,000 children into poverty
nationwide, and about 560,000 of those children would be U.S. citizens. Data also show that 219,000
children in North Carolina who are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) have at least one
immigrant parent. While not all would be affected by this rule, many of them could be. This proposed
rule change could, in
access to health care, sufficient food, and stable housing for thousands of North
Carolina children. The domino effects of such a cut-off in essential services are, sadly, easy to
predict. Study after study has shown the negative effect that food insecurity can have on
children’s academic performance and outcomes, and conversely, the positive effect that
nutrition support programs can have on those same children. Similarly, there is a clear link between
health and academic outcomes. The Earned Income Tax Credit, another program that the new rule may place at
risk for immigrant families and their U.S. citizen children, has also been shown to improve
children’s health and academic outcomes as well as their lifetime earnings. The proposed rule
would force families, including citizen children, to choose between getting the help they need
and reuniting with those they love or even keeping their families together. And, of course, it’s folly
to think that the harm will be confined to the immigrants and their children. Everyone is
affected when their neighbors and classmates are not able to get the healthcare they need to
prevent illness or are not able to eat every day or put a roof over their head. Indeed, public
health generally is put at risk when fewer people have access to care for infectious diseases like
the flu that hit North Carolina so hard this past season. The impossible choice forced on these
other words, jeopardize
families will not only put their physical and emotional wellbeing at risk but will ripple through
the economy. Families unable to make ends meet will turn to private charities for help, and may
be unable to participate in the local economy by purchasing food at the grocery store or paying
their utility bills.
Decreasing immigrant use of public healthcare hurts public health and raises
overall health costs
Okie 18, (Susan Okie, M.D., Immigrants and Health Care — At the Intersection of Two Broken
Systems, 7-5-2018, New England Journal of Medicine,
Whether or not they have health insurance,
immigrants overall have much lower per capita health care
expenditures than native-born Americans,1 and recent analyses indicate that they contribute
more to the economy in taxes than they receive in public benefits. In a study from the RAND Corporation,
researchers estimated that undocumented adult immigrants, who make up about 3.2% of the population, account for only about
1.5% of U.S. medical costs.2 Many immigrants do not seek medical treatment unless they are injured or acutely ill; at our clinic,
patients with type 2 diabetes often have florid symptoms and even incipient renal damage by the time their disease is diagnosed.
One study found that annual per capita expenses for health care were 86% lower for uninsured
immigrant children than for uninsured U.S.-born children — but emergency department
expenditures were more than three times as high.1 Although U.S. hospitals must provide emergency care without
first asking about income, insurance, or citizenship, early diagnosis and treatment in a primary care setting are both medically
preferable and a better use of resources. “If people keep postponing medical care because they're so concerned about being sent
back over the border,” noted Elizabeth Benson Forer, executive director of the Venice Family Clinic, a venerable free clinic in Los
Angeles that serves many immigrants, “then you can end up with some pretty horrendous health situations.” Immigrants live, work,
and attend school in communities throughout the country; laws
and bureaucratic barriers that reduce their use
of key preventive health services, such as immunizations and screenings for infectious disease,
make for bad public health policy, and denying immigrants primary care ultimately increases
health care costs for everyone. For example, labor and delivery costs for undocumented immigrant women are covered
under the federal and state emergency Medicaid program, but most states do not cover prenatal care, and there is no coverage for
family planning. Some of my patients say they would like to use oral contraceptives or an intrauterine device or undergo a tubal
ligation, but they can't afford it. And immigrants, like native-born Americans, are vulnerable to chronic diseases; as my colleague,
nurse practitioner Lois Wessel, notes, “Even the 25-year-old day laborers are eventually going to become 45-year-olds, probably still
undocumented, with hypertension and diabetes. . . . Life in America is going to make them become not so healthy.” Recently,
bipartisan group of U.S. senators, with White House support, introduced an immigration bill that
offered the best chance in years of achieving substantial reform of a dysfunctional system.
However, the bill met with opposition from both conservatives and liberals and was killed in the
Senate this past June, quashing all hope of immigration reform during the current
administration. State legislatures this year are considering a record number of anti-immigrant measures, and the Senate bill's
demise heightens their chances of passage. “You will see the states and cities scrambling to pass their own laws and regulations, and
you're going to get a completely contradictory set of policies,” Senator John McCain (R-AZ) predicted in a Washington Post article on
July 8. In many areas of the country, one consequence is likely to be reduced access to health care for immigrants.
Poor health care decks the economy- absenteeism, presenteeism and
Rasmussen et al. 16 (Bruce Rasmussen, Director of Victoria Institute of Strategic Economic
Studies, researcher for U.S. Chamber of Commerce, WHO, and UNFPA, former Assistant Director
General, Finance in the Department of Management and Budget of the State of Victoria, Master
of Public Administration and Littauer Fellow at Harvard, Kim Sweeny, Peter Sheehan, 2016,
“HEALTH AND THE ECONOMY The Impact of Wellness on Workforce Productivity in Global
Markets”, A Report to the U.S. Chamber of Commerce’s Global Initiative on Health and
This report provides estimates of the economic
cost caused by productivity losses arising from
absenteeism, presenteeism, and early retirement due to ill health around the world, ranging from
highincome countries, such as the United States, to developing countries, such as Kenya. Although the results vary widely,
they indicate (Table ES1) that the cost in lost productivity is high for all countries examined (about 6.5% of GDP
on average), and for almost all countries that cost is projected to increase. The costs in 2015 ranged from 5.4% of GDP in
China to over 8% of GDP in the United States, and are projected to rise by an average of 0.6 percentage
points of GDP by 2030. Countries projected to experience the highest increase in GDP loss
include Poland (8.4%), the United States and Brazil (8.1%), and Turkey and Japan (8%). These estimates are driven by the
intersection of an ageing workforce and the high burden of chronic disease, such as heart and respiratory disease, stroke,
cancer. These diseases were once only a high-income country problem but are now also prevalent in developing countries. The
countries can be usefully clustered into four segments (see Figure ES1): • Countries with already high and rapidly growing GDP costs
(e.g., Poland) • Countries with currently low but rapidly growing GDP costs (e.g., China) • Countries with high but relatively stable
GDP costs (e.g., United States, Australia) • Countries with low and relatively stable GDP costs (e.g., Singapore) In spite of very
different circumstances, most countries face three common challenges: • Their populations are ageing, in different ways and to
different degrees. • A high
prevalence of non-communicable diseases (NCDs) exists, particularly for older age
to rise. Taken
together, these factors already impose heavy costs on businesses, governments, and individuals, and
threaten much greater costs in the future. The economic costs arise largely because people in ill
health aren’t able to work as much as they would like. They may either be sick and absent from
work (absenteeism), present at work but not working at full capacity due to illness
(presenteeism), or retired between ages 50 and 64—due to ill health (early retirement due to ill
health). The economic costs on productivity imposed by each of these groups has been modeled
groups. • Many risk factors for the future incidence of NCDs are high and, in some cases, are continuing
and included in this report. A separate group, which is not explicitly covered in this report, consists of people who may not work at
any time, due to incapacity or a health condition that has been present for most of their lives. Following
an initial report
for the APEC Business Advisory Council (ABAC) and the Life Sciences Innovation Forum (LSIF) in
2014, the Victoria Institute for Strategic Economic Studies (VISES) prepared four reports,
Sheehan et al. (2014), Sweeny et al. (2015), and Rasmussen et al. (2015a, 2015b), that now cover 18
countries on three aspects of these economic costs: The economic and social costs of NCDs The value of a healthy year of
life to an individual or to a community has many dimensions, as do the benefits foregone or the
costs incurred by the loss or impairment of that healthy life year as a result of disease. Some
benefits foregone or costs incurred are economic, even in the narrow sense that they are
included in GDP as currently measured. These include the elements which are the particular focus of this study,
namely reduced ability to work in the paid labor force and reduced productivity while at work. But increased prevalence of NCDs
might impact on GDP in other ways also. For example, the costs of treating and caring for people with NCDs are high and growing
rapidly. It is likely that some significant part of these costs will be met from individual or public savings, hence reducing the ability of
the economy to fund new investment and growth. The table below provides a simple classification of the various
costs of
Nuclear war
Tønnesson 15 - Stein Tønnesson 15, Research Professor, Peace Research Institute Oslo;
Leader of East Asia Peace program, Uppsala University, 2015, “Deterrence, interdependence
and Sino–US peace,” International Area Studies Review, Vol. 18, No. 3, p. 297-311
recent works on China and Sino–US relations have made substantial contributions to the current understanding of
how and under what circumstances a combination of nuclear deterrence and economic interdependence
may reduce the risk of war between major powers. At least four conclusions can be drawn from the review above: first, those who say that
interdependence may both inhibit and drive conflict are right. Interdependence raises the cost of
conflict for all sides but asymmetrical or unbalanced dependencies and negative trade expectations may
generate tensions leading to trade wars among inter-dependent states that in turn increase the risk
of military conflict (Copeland, 2015: 1, 14, 437; Roach, 2014). The risk may increase if one of the interdependent countries is governed by an inward-looking socio-economic coalition
(Solingen, 2015); second, the risk of war between China and the US should not just be analysed bilaterally but include their allies and partners. Third party countries could drag China or the US into confrontation;
third, in this context it is of some comfort that the three main economic powers in Northeast Asia (China, Japan and South Korea) are all deeply integrated economically through production networks within a
decisions for war and peace are taken by very few people,
who act on the basis of their future expectations. International relations theory must be supplemented by foreign policy analysis in order to assess the
value attributed by national decision-makers to economic development and their assessments of risks and opportunities. If leaders on either side of the Atlantic begin to seriously
fear or anticipate their own nation’s decline then they may blame this on external dependence, appeal
to anti-foreign sentiments, contemplate the use of force to gain respect or credibility, adopt
protectionist policies, and ultimately refuse to be deterred by either nuclear arms or prospects of
socioeconomic calamities. Such a dangerous shift could happen abruptly , i.e. under the instigation of actions by a third party
– or against a third party. Yet as long as there is both nuclear deterrence and interdependence, the tensions in East Asia are unlikely to escalate to war. As Chan (2013) says, all states in the region are
aware that they cannot count on support from either China or the US if they make provocative moves. The greatest risk is not that a territorial dispute leads to
war under present circumstances but that changes in the world economy alter those circumstances in ways that
render inter-state peace more precarious. If China and the US fail to rebalance their financial and trading relations (Roach, 2014) then a trade war could result,
interrupting transnational production networks, provoking social distress, and exacerbating nationalist emotions. This could have unforeseen consequences in
the field of security, with nuclear deterrence remaining the only factor to protect the world from
Armageddon , and unreliably so . Deterrence could lose its credibility : one of the two great powers might
gamble that the other yield in a cyber-war or conventional limited war, or third party countries might engage in conflict with each other,
global system of trade and finance (Ravenhill, 2014; Yoshimatsu, 2014: 576); and fourth,
with a view to obliging Washington or Beijing to intervene.
Adv – Ableism
The current categorization of “public charge” in the U.S. immigration law is
built on a flawed notion of normalcy that perpetuates a politics of eugenic
Fremstad 18 (Shawn - senior fellow at American Progress. He is also a senior research associate at the Center for
Economic and Policy Research 12th February 2018 “Trump Plans New Limits On Family Immigration and Access to
A draft rewrite of long-standing immigration rules being developed by the Trump administration would intentionally skirt the U.S.
Congress to place sharp, new restrictions on working-class immigrants’ ability to reunite with their family members. The draft
radically reinterprets an obscure 1882 provision in federal immigration law—known as the public-charge provision—in a way that
departs from more than a century of precedent established by courts and the executive branch. As a practical matter, the plan
would significantly restrict family-based legal immigration from Mexico and other countries that have been the subject of the
administration’s racist and discriminatory animus. Moreover, the plan would effectively deny the premium tax credit, means-tested
health insurance, Pell Grants, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), other nutrition
assistance, and other public benefits to many immigrants who are lawfully residing in the United States as well as to U.S.-citizen
children living in immigrant families. Immigrants seeking family-based visas would be penalized simply for being eligible for various
programs. To understand what’s at stake, it’s helpful to first know the historical background of the antiquated provision that the
Trump administration is reinterpreting. Under
long-standing law, immigrants seeking a visa to become
lawful permanent residents (LPRs), also known as green card holders, on family-based and certain other grounds can
have their applications denied if they are found “likely to become public charge.” In very rare cases,
green card holders living in the United States may be deported if they become public charges during their first five years in the
United States. The
term public charge is an archaic one. It pre-dates federal immigration law and
was typically used in the 1700s and 1800s to refer to anyone, regardless of immigration or citizenship status,
who was considered unable to work and had become a charge of the state. In short, an adult or child the
government had taken charge of, typically in an almshouse, asylum, state hospital, or other institution. The federal
government’s power to deny entry to immigrants who were deemed likely to become public
charges was first added to federal law in 1882, a few months before the adoption of the notorious Chinese Exclusion Act.
Under the 1882 provision, “any convict, lunatic, idiot, or person unable to take care of himself or
herself without becoming a public charge” was prohibited from entering the United States. Federal immigration law
does not define public charge. However, given the historical roots, federal agencies and courts have a long
history of defining it as someone who is incapable of work, lacks family support, and is likely to
become completely dependent on government or charity for shelter and subsistence. A statement
made during the Great Depression by then-President Herbert Hoover aptly captures this core historical meaning of the term. Hoover
explained that “[i]n normal times an [immigrant applying] for admission, if an able-bodied worker who means to work and has
sufficient funds to support himself until he gets to his destination” would not be excluded on public-charge grounds. Hoover noted:
“It is obvious that relatives of residents in the country are not likely to become public charges.” In
practice, federal officials
have often used the public-charge provision in unconscionable and discriminatory ways,
particularly during nativist periods in the country. As immigration historian Hidetaka Hirota explained, the
origins of the federal public-charge provision were in cultural and class prejudice, particularly
against Irish immigrants. After the establishment of immigration quotas based on national origin
in the 1920s, the provision was used to exclude European Jews seeking to escape Nazi genocide.
For much of its history, the provision has often been used to exclude immigrants viewed as morally
deficient, particularly unmarried mothers. Immigration officials in the first half of the 20th
century viewed LGBT immigrants as “degenerates” and sometimes turned to the public charge
provision to exclude them from the United States. Disabled immigrants have been the group
most consistently targeted for exclusion on public-charge grounds. As Douglas Baynton, a historian at the
University of Iowa, has documented, the public-charge rule “was intended to screen out those considered
‘physically defective.’’’ Often, this judgement was “based solely on impaired appearances, by
officials who thought them therefore unemployable as well as undesirable hereditary
specimens.” Even today, under current policy, immigrants can be excluded on public-charge
grounds if they are found likely to become primarily dependent on Supplemental Security
Income (SSI), or if they are institutionalized for long-term care. In making this determination, immigration
officials must consider age, health, family status, assets, resources, financial status, education, and skills.
The discourse surrounding immigrants labels bodies as desirable/undesirable
that disproportionately affect people with disabilities – they become depicted
as unable to contribute to society and a drain on the state
Wong 12 (Edward Hon-Sing Wong, Department of Social Work at York University, “Not
Welcome: A Critical Analysis of Ableism in Canadian Immigration Policy from 1869 to 2011,”
[CCD Journal], 2012, accessed: 7/11/18,
The label of disability also attaches specific narratives to people carrying the label. A key
narrative, one prominent in the immigration system, is the understanding of people with
disabilities as unproductive and burdensome to society. Pratt’s (2005) argument that immigration
penality serves to define “the desirable/undesirable citizen" is especially relevant to
understanding the border's effect on people with disabilities and other oppressed people (p. 10).
The border serves to mark individuals who pass through it as desirable or undesirable for a
nation. As mentioned, the Canadian immigration policy focuses on the recruitment of ‘productive
workers.’ This, in effect, excludes people with disabilities, who are seen as undesirable, since they
are also often not conceptualized as productive workers within a capitalist system. It is important to
recognize that the argument is not that people with disabilities are inherently unable to productively contribute to society, but
simply that they are understood as unable by the state and by capitalists in a system geared towards able-bodiedness. Through
discourse of dependency and excessive demand, migrants with disabilities have been defined by
the Canadian immigration system as unable to contribute productively to society. Historically, Canadian
immigration policy did not explicitly bar migrants with disabilities; instead, this was done latently through restrictions on individuals
suspected to become dependent on the state or charities. For example, the Immigration Act of 1869 stipulated that if “ . . . such a
person is, in the opinion of the Medical Superintendent, likely to become permanently a public charge,” they are not to be permitted
to enter Canada (Hanes, 2011). Although there were exceptions, such as for people with disabilities who were to be cared for by
family members or who could produce evidence that they had a job or family members already living in Canada (Hanes, 2011), the
demand for evidence reveals the
underlying assumption that people with disabilities are unlikely to
contribute to society. This inability is constructed as inherent to the individual, without
questioning the fact that Canadian society, because of its ableist foundations, creates barriers for
people with disabilities aiming to contribute in ways that are traditionally recognized as
legitimate, such as through paid employment. For example, a disability allowance of $800 “does not give a person
much leeway to pursue her goals in life” (Dossa, 2005, p. 2532). At the same time, the many ways people with disabilities do
contribute to society are often not recognized. Dossa (2005) highlighted the experiences of Mehrun, a racialized social worker with
polio, who spoke of how the agency she worked for saw her more as a client, rather than a peer, and paid her less than other
workers (p. 2534). This
depiction of people with disabilities as unable to contribute to society
occurs concurrently with the depiction of people with disabilities as a drain on state coffers.
This representation can be seen throughout Canadian history, including the case, explored earlier, of the 65 Chinese patients who
were confined in various asylums and deported to China in 1935. Before the deportations, asylum superintendent R. I. Bentley
deplored “that this undesirable class should be such an expense to the country” (Menzies, 2002, p. 201). Bentley’s successor also
commented that “it certainly seems to be a hardship upon the taxpayers of this Province that they should be compelled to maintain
these decrepit and unprofitable Chinese lunatics” (p. 202). Administrators
did not see the ‘Chinese’ as worthy
recipients of public resources, nor was their forced unpaid labour recognized. The deportations
were also framed dichotomously, in that the resources saved were thought to be better spent
providing for ‘other’ patients. As reported by the Victoria Daily Times on February 11th, 1935, “the removal of these
patients will allow more room for other cases” (Menzies, 2002, p. 217). It did not matter that, according to the Chinese consul, there
were no institutions in China to provide care for the patients, as it was clear that the intentions of the Canadian state were never to
provide care. Instead, the intentions were to maintain social control at a reduced cost for the state.
US immigration policy is rooted in ableist discrimination against people of
different identities – public charge as well as barriers in the admission process
disproportionately affect people with disabilities
Sekerci and Altiraifi 18(Kristin Garrity Sekerci & Azza Altiraifi, Sekerci is a researcher on
Islamophobia at Georgetown University while Azza Altiraifi is an award-winning disabled AfroArab organiser based in Washington, DC whose advocacy centers on radical inclusion and
access, racial and disability justice, and collective liberation, “A US immigration history of white
supremacy and ableism," [Aljazeera], 1-31-2018, accessed: 7-11-2018,
From 1882 to 1917, various legislation
codified into law numerous categories of perceived deviancy
and divergence. These ableist classifications, along with bans by nationality and geographic
origin, have shaped the legal basis for US immigration exclusion. For instance: The Immigration Act
of 1882 prohibited entry to any "lunatic, idiot, or any person unable to take care of himself or
herself without becoming a public charge." The Alien Immigration Act (1903) added for
exclusion "insane persons, epileptics, and persons who have been insane within five years
previous; persons who have had two or more attacks of insanity at any time previously," among
other categories. The Immigration Act of 1907 added "imbeciles" and "feeble-minded persons,"
people suffering from tuberculosis, and people "certified" by an immigration official "as being
mentally or physically defective," among other categories. The Immigration Act of 1917 added people who
experienced just one "attack" of insanity (down from two in 1903), and people with "chronic alcoholism" and "constitutional
psychopathic inferiority," such as "moral imbeciles, pathological liars, many of the vagrants and cranks, and persons with abnormal
sex instincts". Also known as the
Asiatic Barred Zone Act or the Literacy Test Act, this legislation barred
immigration from much of the continent of Asia (excluding Japan, eastern China and the Philippines), and
islands off the coasts of the continent. It also implemented a literacy test for the first time. This
long history of excluding immigrants on the basis of perceived or real disabilities set the stage
for another form of immigration exclusion: immigration quotas on the basis of national origin.
Enacted for the first time in the Immigration Act of 1924, these quotas had the effect of severely limiting immigration from southern
and Eastern Europe. Notably, southern and Eastern Europeans did not fit the US racial formation of whiteness at the time.
Moreover, ethnic
groups from the region, such as Italians ("dwarfish"), Jews ("very poor in physique ... the polar
opposite of our pioneer breed"), Portuguese, Greeks and Syrians ("undersized"), and Slavs ("slow-witted"), were barred entry
on the basis of their supposed pathologies and their characterisation as "defective races". The
Immigration and Nationality Act of 1990, which established Temporary Protection Status and
the Diversity Visa programmes, also finally lifted the ban on "sexual deviants", which targeted
LGBTQIA+ people. In 2009, the ban on US immigration for HIV+ individuals was finally lifted, after being in place for 22 years.
This discriminatory law
disproportionately targeted LGBTQIA+ immigrants and stifled research
into HIV and AIDS treatment. Let us here recall President Trump's comments that Haitians "all have AIDS", which,
incidentally, was reported on just a few weeks after the administration's decision to terminate TPS protections for Haitians. Ableism
policies Numerous
immigration laws to this day continue to target and violate the rights of
disabled persons by subjecting them to invasive mental and physical examinations. Whether
assessed as likely to become a public charge (therefore tying their value to their ability to
produce), or a threat to persons and property (potentially a burden of the state through carceral
institutions), disabled people who apply for immigration to the US face numerous obstacles to
admission. Furthermore, these discriminatory policies do not simply end at the border.
Undocumented immigrants in the US who are mentally disabled make up about 15 percent of
those in immigration detention. Abuse is rampant and unjust deportations occur often, as the
immigration system does not guarantee an individual's right to due process protections that are
afforded to criminal defendants. The history of immigration to the US has ensured the
fundamental quality of the country as a white supremacist-capitalist state, "protected" from an
influx of disabled and "deviant" people designated as either threats or burdens. The state's
economic power rests on the perpetual existence of a large labour force that can produce at low
costs. This is a process that renders disabled individuals, and particularly black, native, brown,
Asian, Muslim, queer and other multiply marginalised disabled individuals, as inherently
disposable. It is a system that justifies, even celebrates, the banning of people deemed unable
to "produce", "add value" or who might threaten the economy-state as a result of perceived
inferiorities, deficits and deviancies. So, the next time arguments surrounding immigration policy are couched within a
cost/benefit economic analysis, remember that these are ableist arguments made in order to determine who can produce and
therefore whose lives are worthwhile. Furthermore, bear in mind that analyses of immigration history that address policies solely
through a framework of racism are incomplete. Indeed, ableism
is a foundational framework, along with white
supremacy, that has shaped, and continues to inform, US immigration policy.
This social categorization of people with disabilities have marked them as a
dependent caste susceptible to stigmatization and institutionalization—the
binary of able-bodied and disabled perpetuates exclusion, justifying eugenic
Bagenstos 2000 (Samuel R. Bagenstos, “Subordination, Stigma, and ‘Disability,’” Virginia Law Review, JSTOR, Vol.
86, No.3, April 2000, pg. 437-443)//jy
Erving Goffman's notion of stigma is a useful tool here. Although "stigma" refers colloquially to animus and prejudice, Goffman used the term to refer to a broader problem. He
described the condition as an "undesired differentness" from what society deems to be "normal" or expected.153 Under Goffman's approach, the core aspect of stigma occurs
social practices treat particular "undesirable" traits as universally discred- iting. As Goffman
emphasized, those who deal with stigmatized persons "tend to impute a wide range of imperfections on the basis of the original one."154 As a result, people
with stigmatized traits are not considered to be among the "normals" for whom society, and its
institutions, are designed.'55 This stigma is as much racial attitudes as about the traits themselves; even if an individual can
"cure"~ a stigmatized trait, she may still not be accepted in the community of "normals.",156
when prevailing
Goffman's construct of "stigma" provides a useful tool in giving content to my subordination-based understanding of disability rights law for at least two reasons. First,
Goffman's analysis strongly influenced the thoughts of many of the disability rights ac- tivists on whose work I rely.157 Second, that analysis provides a way of connecting the
animus- and stereotype-based discrimination ex- perienced by many people with disabilities with their more systemic neglect in the design of the environment. It therefore provides a way of treating the three basic manifestations of disability discrimination under a single rubric, and it provides a way of predicting which types of impairments are likely
to be associated with systematic deprivation of opportunities. Because Goffman wrote primarily about individual interactions between "the nor- mals" and "the stigmatized," his
notion of stigma most directly helps to describe the prejudice and stereotypes people with dis- abilities experience in such interactions.158 It is especially useful in explaining the
"spread effect," under which an impairment to a particular life function is seen as universally disabling.'59 But Goff- man's analysis of stigma helps to describe the society-wide
neglect of people with disabilities as well.l" In particular, it helps to people with disabilities as well.1" In particular, it helps to explain why people with some impairments are
stigma means that an individual is not considered to be one of "the normals," then people with
likely to be systematically neglected by social decisions, and why those people are likely to be the same people as those who experience animus and stereotyp- ing."'
stigmatized impairments are likely not to be a part of the social "norm" considered by those
who design the social and physical environment. Even if the envi- ronment's "designers" do not
harbor prejudiced or stereotyped thoughts about people with stigmatized conditions, they are
likely not to consider their needs in the same way that they consider the needs of those who are
"normal." Disability rights advocates have long made this precise point about "disability."'62 They have argued that "the entire physical and social
organization of life" is frequently structured as though everyone were physically strong, as though all bodies
were shaped the same, as though everyone could walk, hear, and see well, as though everyone
could work and play at a pace that is not com- patible with any kind of illness or pain, as though no one
were ever dizzy or incontinent or simply needed to sit or lie down.163 This phenomenon is most obvious in the built environment. Ar- chitects design structures with a model of
This "assumption of ablebodiedness as the norm'' 65 can be seen in buildings with unnecessary stairs, doorways that are
too narrow to accommodate wheelchairs, and entrances that fail to provide any detectable
warning for people with visual impairments. But the phenomenon of neglect extends beyond the decisions that
have constructed our physical architecture. It affects our patterns of social organization as well. Among other things, it affects the
the "normal" user in mind, and that model has typically been a person without any dis- cernible impairments.l"
structure of jobs and the means by which businesses and governments deliver services." Why have those who constructed our social and physical envi- ronment failed to
For much
of our his- tory, people with a variety of physical and mental disabilities were "shunted aside,
hidden, and ignored."'67 People with impairments ranging from epilepsy to blindness to mental retardation were segre-gated from the
community in a collection of congregate institutions."6 Such segregation "perpetuate[d]
unwarranted assumptions that per- sons so isolated are incapable or unworthy of participating
in community life."'69 Even among those who were not institutional- ized, people with disabilities frequently did not work, patronize businesses, or use
consider people with disabilities as among the "normal" users? One explanation might look to the very history of prejudice and stereotypes noted by Congress.
government services outside of the home."70 (In some cases, they were required by law to stay at home; as late as 1974, some major American jurisdictions still maintained
"ugly laws" that prohibited "unsightly" people-a category that encom- passed people with disabilities-from appearing in public.171) A person designing a particular building,
production process, or job description could thus be forgiven for failing to think of people with disabilities as potential customers or workers. The designer might have had no
particular negative attitudes toward "the dis- abled." Indeed, it might never have entered her mind that people with disabilities might wish to use her building or work in her
though people with
disabilities have become more and more inte- grated into society at large in the last two
decades, the history of exclusion may have a particularly long "tail." Buildings and proc- esses designed without people
busi- ness; she might simply have had no available model of people with disabilities as ordinary people with ordinary needs and tastes
with disabilities in mind may be used for many years to come. And prejudice and stereotypes- which have themselves been fed by the absence of people with dis- abilities from
The historic exclusion of people with disabilities from "normal"
society has interacted in complex and reciprocal ways with broader ideological currents. Lennard Davis
the larger community'3-may linger even longer."'4
has argued that the notion of "norms" dates only to the development of a science of statistics in the early nineteenth century. 15 Until then, Davis contends, the place now
the newfound "concept of
a norm, unlike that of an ideal, implie[d] that the majority of the population must or should
somehow be part of the norm."'77 Early statisticians made this point expressly: They argued that social institutions should be built around the broad
middle group of persons who fit the social norm.178 As Davis demonstrates, their arguments both provided justification for, and drew strength from, an ideology
that accorded a morally privileged position to the middle class.'79 More darkly, they fed the eugenic ideology that led to the
institutionalization and sterilization of many people whom we now label "disabled."" The nineteenthcentury notion that institutions should be de- signed for the "norm" persists. But our vision of "normal" human attributes has
become increasingly idealized, as the eugenics movement (which sought "to norm the nonstandard""8') may have been the first to demonstrate. Rob
occupied by the "norm" was held by the notion of an "ideal," which was understood to be unattainable by any human.176 But
Imrie's account of modernist architecture points out the effect that such an ideology of the "norm" has had on our built environment. In seeking to make form follow function,
modernists harbored a particularly able-bodied vision of who
"the human being" was."8 Imrie illustrates this vision by pointing to Le Corbusier's "Modular," which "utilized the propor- tions of the (able) body to enable
and to "tie buildings back to the scale of the hu- man being,"
the architect to create the built spaces.""l The "Modular," a diagram of a muscular six-foot tall man, was "the person for whom functionality in building design and form was
being defined."'84 Many inaccessible features of today's build- ings, Imrie argues, trace directly to modernism's exclusion of people with disabilities from its idealized version of
the "norm.As we move to a new millennium, we seem to believe as strongly as ever that everyone should fit an "ideal" body type. Although there are surely a variety of reasons
for this development, the most notable are a consumer/advertising culture that idealizes beauty and a widespread belief in the ability of modem medicine to en- hance our
the ideological currents that exclude people with disabilities from our
notion of the "norm" stubbornly remain with us. The stigma attached to "disability" thus both
represents the leg- acy of a history of exclusion and reflects a series of broader ideological
mental and physical lives.1" As a result,
developments. Whatever the underlying reason for its persistence, however, that stigma can help us to understand the means by which disability-based
subordination is transmitted. More importantly, stigma can serve an evidentiary function: It can help us identify cases where impairments are likely to be associated with
the "disability" category embraces those people who experience
im- pairment-based stigma-that is, those people who, because of present, past, or perceived
impairments, are considered by society to be outside of the "norm." As Carol Gill puts it, "disability is a
marginalized status that society assigns to people who are different enough from majority
cultural standards to be judged abnormal or defective in mind or body.""87 Although I would argue that stigma
systematic deprivation of opportunities. Seen in this light,
identifies and explains-but does not necessarily define-disability- based subordination, Gill's analysis substantially overlaps my own. In this view, "disability" is a group status, but
it is not one de- fined by anything inherent in the members of the group. Rather, the attitudes and practices that exclude people with "disabilities" from many opportunities to
participate in society are the very ones that create the "disability" category. Although individuals braced by the category have vastly different impairments and limi- tations
(indeed, some have no impairment or limitation at all), what is crucial is that society treats them as essentially similar."8 In Wendell's words, "[w]idespread perceptions that
The widespread acts of "discrimination, segregation, and denial of equal opportunity" directed at people with disabilities have
effectively marked that group as a "dependent caste.”
people with dis- abilities are similar in very significant ways create the category, 'people with disabilities."'"89
Disability creates a master trope of disqualification that allows society to
discriminate against certain identities based on aesthetics – this perpetuates all
other forms of structural oppression
Siebers 09 (Tobin Siebers, co-chair of the Michigan University's Initiative on Disability Studies
and V. L. Parrington Collegiate Professor and professor of English language and literature, and
art and design, “The Aesthetics of Human Disqualification,” October 28th 2009, accessed:
7/11/18, Pages 3-10)//DCai
Disqualification as a symbolic process removes individuals from the ranks of quality human
beings, putting them at risk of unequal treatment, bodily harm, and death. That people may be
subjected to violence if they do not achieve a prescribed level of quality is an injustice rarely
questioned. In fact, even though we may redefine what we mean by quality people, for example
as historical minorities are allowed to move into their ranks, we have not yet ceased to believe
that nonquality human beings do exist and that they should be treated differently from people
of quality. Harriet McBryde Johnson’s debate with Peter Singer provides a recent example of the widespread belief in the
existence of nonquality human beings (Johnson). Johnson, a disability activist, argues that all disabled people qualify as persons who
have the same rights as everyone else. Singer, a moral philosopher at Princeton University, claims to the contrary that people with
certain disabilities should be euthanized, especially if they are thought to be in pain, because they do not qualify as persons.
Similarly, Martha Nussbaum, the University of Chicago moral philosopher, establishes a threshold below which “a fully human life, a
life worthy of human dignity,” is not possible (181). In particular, she notes that the onset of certain disabilities may reduce a person
to the status of former human being: “we may say of some conditions of a being, let us say a permanent vegetative state of a
(former) human being, that this just is not a human life at all” (181). Surprisingly little
thought and energy have been
given to disputing the belief that nonquality human beings do exist. This belief is so robust that it supports
the most serious and characteristic injustices of our day. Disqualification at this moment in time justifies
discrimination, servitude, imprisonment, involuntary institutionalization, euthanasia, human and
civil rights violations, military intervention, compulsory sterilization, police actions, assisted
suicide, capital punishment, and murder. It is my contention that disqualification finds support in the
way that bodies appear and in their specific appearances—that is, disqualification is justified
through the accusation of mental or physical inferiority based on aesthetic principles.
Disqualification is produced by naturalizing inferiority as the justification for unequal treatment,
violence, and oppression. According to Snyder and Mitchell, disability serves in the modern period as
“the master trope of human disqualification.” They argue that disability represents a marker of
otherness that establishes differences between human beings not as acceptable or valuable
variations but as dangerous deviations. Douglas Baynton provides compelling examples from the modern era,
explaining that during the late nineteenth and early twentieth centuries in the United States disability identity
disqualified other identities defined by gender, race, class, and nationality. Women were
deemed inferior because they were said to have mental and physical disabilities. People of color
had fewer rights than other persons based on accusations of biological inferiority. Immigrants
were excluded from entry into the United States when they were poor, sick, or failed
standardized tests, even though the populations already living there were poor, sick, and
failed standardized tests. In every case, disability identity served to justify oppression by amplifying
ideas about inferiority already attached to other minority identities. Disability is the trope by
which the assumed inferiority of these other minority identities achieved expression. The
appearance of lesser mental and physical abilities disqualifies people as inferior and justifies
their oppression. It is now possible to recognize disability as a trope used to posit the inferiority of certain minority
populations, but it remains extremely difficult to understand that mental and physical markers of inferiority are also tropes placed in
the service of disability oppression. Before disability can be used as a disqualifier, disability, too, has to be disqualified. Beneath
the troping of blackness as inbuilt inferiority, for example, lies the troping of disability as inferior.
Beneath the troping of femininity as biological deficiency lies the troping of disability as
deficiency. The mental and physical properties of bodies become the natural symbols of
inferiority via a process of disqualification that seems biological, not cultural—which is why
disability discrimination seems to be a medical rather than a social problem. If we consider how difficult
it is at this moment to disqualify people as inferior on the basis of their racial, sexual, gender, or class characteristics, we may come
to recognize the ground that we must cover in the future before we experience the same difficulty disqualifying people as inferior on
the basis of disability. We might also recognize the work that disability performs at present in situations where race, sexuality,
gender, and class are used to disqualify people as physically or mentally inferior. Aesthetics
studies the way that some
bodies make other bodies feel. Bodies, minimally defined, are what appear in the world. They
involve manifestations of physical appearance, whether this appearance is defined as the
physical manifestation itself or as the particular appearance of a given physical manifestation.
Bodies include in my definition human bodies, paintings, sculpture, buildings, the entire range of human artifacts as well as animals
and objects in the natural world. Aesthetics, moreover, has
always stressed that feelings produced in bodies
by other bodies are involuntary, as if they represented a form of unconscious communication
between bodies, a contagious possession of one body by another. Aesthetics is the domain in
which the sensation of otherness is felt at its most powerful, strange, and frightening. Whether the
effect is beauty and pleasure, ugliness and pain, or sublimity and terror, the emotional impact of one body on another is
experienced as an assault on autonomy and a testament to the power of otherness. Aesthetics is the human science most concerned
with invitations to think and feel otherwise about our own influence, interests, and imagination. Of course, when
produce feelings of pleasure or pain, they also invite judgments about whether they should be
accepted or rejected in the human community. People thought to experience more pleasure or
pain than others or to produce unusual levels of pleasure and pain in other bodies are among
the bodies most discriminated against, actively excluded, and violated on the current scene, be
they disabled, sexed, gendered, or racialized bodies. Disabled people, but also sex workers, gay, lesbian, bisexual,
and transgendered people, and people of color, are tortured and killed because of beliefs about their relationship to pain and
pleasure (Siebers 2009). This is why aesthetic disqualification is not merely a matter for art critics or museum directors but a political
process of concern to us all. An understanding of aesthetics is crucial because it reveals the operative principles of disqualification
used in minority oppression. Oppression
is the systematic victimization of one group by another. It is a
form of intergroup violence. That oppression involves “groups,” and not “individuals,” means that it
concerns identities, and this means, furthermore, that oppression always focuses on how the
body appears, both on how it appears as a public and physical presence and on its specific and
various appearances. Oppression is justified most often by the attribution of natural
inferiority—what some call “in-built” or “biological” inferiority. Natural inferiority is always somatic, focusing
on the mental and physical features of the group, and it figures as disability. The prototype of biological inferiority is disability. The
representation of inferiority always comes back to the appearance of the body and the way the body makes other bodies feel. This is
why the study of oppression requires an understanding of aesthetics—not only because oppression uses aesthetic judgments for its
violence but also because the signposts of how oppression works are visible in the history of art, where aesthetic judgments about
the creation and appreciation of bodies are openly discussed. One additional thought must be noted before I treat some analytic
examples from the historical record. First, despite my statement that disability
now serves as the master trope of
human disqualification, it is not a matter of reducing other minority identities to disability
identity. Rather, it is a matter of understanding the work done by disability in oppressive systems. In disability
oppression, the physical and mental properties of the body are socially constructed as
disqualifying defects, but this specific type of social construction happens to be integral at the
present moment to the symbolic requirements of oppression in general. In every oppressive system of
our day, I want to claim, the oppressed identity is represented in some way as disabled, and although it
is hard to understand, the same process obtains when disability is the oppressed identity.
“Racism” disqualifies on the basis of race, providing justification for the inferiority of certain skin
colors, bloodlines, and physical features. “Sexism” disqualifies on the basis of sex/gender as a
direct representation of mental and physical inferiority. “Classism” disqualifies on the basis of
family lineage and socioeconomic power as proof of inferior genealogical status. “Ableism”
disqualifies on the basis of mental and physical differences, first selecting and then stigmatizing
them as disabilities. The oppressive system occults in each case the fact that the disqualified
identity is socially constructed, a mere convention, representing signs of incompetence,
weakness, or inferiority as undeniable facts of nature. As racism, sexism, and classism fall away slowly as
justifications for human inferiority—and the critiques of these prejudices prove powerful examples of how to fight oppression—the
prejudice against disability remains in full force, providing seemingly credible reasons for the belief in human inferiority and the
oppressive systems built upon it. This usage will continue, I expect, until we reach a historical moment when we know as much
about the social construction of disability as we now know about the social construction of race, class, gender, and sexuality.
Disability represents at this moment in time the final frontier of justifiable human inferiority.
Public charge rule continues historical ableism and sexism in immigration
Galusca 9 (Roxana Galusca, PhD in media and cultural studies from the University of Michigan,
Spring 2009, “From Fictive Ability to National Identity: Disability, Medical Inspection, and Public
Health Regulations on Ellis Island”, Cultural Critique, No. 72, University of Minnesota Press,
The assimilation of immigrants according to the ideology of able bodiedness gained renewed
force in the aftermath of the Immigration Act of 1907, a statute that expanded the class of deportable chronic
disabilities to comprise any impairment likely to make the immigrant reliant on the nation's
socio-economic resources (Markel and Stern, 1319). In the early years of the twentieth century, as Markel and Stern
demonstrate, epidemics no longer represent the main reason for rejection at ports of entry; with
the advent of technology, a new set of physical and cognitive "impairments" mushrooms on the
medical charts, from feeblemindedness and illiteracy to constitutional weakness and an endless
list of other conditions that fall under the label of chronic disabilities and render those affected
"public charges" (1316). Under these circumstances, previous epidemic taxonomies change shape and meaning and are
rearticulated to fit the newly ratified category of "liable to become a public charge" a dependency
rhetoric, deployed at ports of entry to reject anyone unable to lead an independent existence
and purportedly to earn a living. According to a disability-informed social critique, the rejection
of dependency not only misunderstands the inherently dependent nature of all social relations
but also imagines independence based on ableist conceptions of the mind and body, thereby
insinuating an exaggerated and untenable ideal of individual autonomy into citizenship norms
and healthcare practices.6 Because of its insistence on autonomy and self-sufficiency, the Ellis Island dependency
rhetoric enforced an ableist approach to civic participation and rendered immigrants ineligible
for landing even when family already in the United States testified on their behalf and promised financial support. The
effects of the Immigration Act of 1907 were immediate and devastating. The percentage of those excluded based on
medical criteria increased from 2 percent in 1898 to 57 percent in 1913 and 69 per cent in 1915, elevating the dependency
rhetoric to the religiosity of a mantra on Ellis Island (Markel and Stern, 1319). The problem, however, did
not lie in the inspectors' frequent recourse to the discourse of individual autonomy; in effect, it
was the equivocal formulation of a verdict such as "liable to become a public charge" that
enabled inspectors to use it randomly and invent diagnoses at a quick glance. The vague
articulation of the dependency casuistry transformed the medical inspection into a flexible and
contingent process whose production of new diagnoses sprang from sociopolitical
circumstances and was inflected by inspectors' prejudices. The inspectors' vulgar epistemologies
operated to reduce the heterogeneous masses of immigrants to the category of the "alien
disabled other" and therefore "a public charge" and deportable, reinforcing a seamless dogma
of normalcy. Under these circumstances, pregnancy, in particular, posed a series of problems for
immigration inspectors because the alleged dependency of women in general and of pregnant
women in particular dubbed them "liable to become a public charge" before landing. In addition, a
pregnancy occurring outside marriage placed pregnant women in the category of morally corrupt outlaws.
National fears of dependent newcomers circumscribed women's bodies within a national
discourse on healthy mothers and pure wives. In the process, women's reproduction and
sexuality entered an imaginary social contract with the receiving nation-state, their own bodies
and gender coded identities becoming public property that could be openly negotiated and
exchanged within the sociopolitical agenda of the state. In the words of Floya Anthias and Nira
Yuval-Davis, "the nation becomes gendered, and women's sexuality becomes nationalized.
Nation is equated with the male subject position, and women's sexuality is reified as the
property of the male nation" (Luibheid, xix). It is not surprising, then, that Catherine Dolan, a pregnant
unmarried woman, found herself deported on charges of being "liable to become a public
charge," guilty of both pregnancy and unguarded sexuality (3-6). Even less extraordinary is immigration
officials' response to the case of Mexican immigrant Alejandra Veles, who arrived in New York by steamship. Alejandra's male
costume and boyish appearance proved to be a ruse when inspectors discovered that she was a young woman. As a consequence of
her scandalous act and appearance, they ordered her immediately deported (11-12). More significantly, the ultimate goal of Ellis
Island inspectors, in close relation to the freshly invented dependency
rhetoric, was to make visible the invisible. If, during
the initial years of Ellis Island, visibility characterized most immigrants' conditions, with the rising concern
for immigrants' dependent status, Ellis Island doctors began to focus on the inconspicuous aspects of
diseases and disabilities. The main strategy was to gaze at immigrants for imperceptible flaws,
peer into immigrants' past lives, and watch intently for any sign of impairment otherwise not
easily noticeable. At the end of this thorough investigation, the invisible was brought to light,
and more often than not, imagined and invented by inspectors, despite immigrants' apparent
healthiness and "normality." From the moment they set foot on the island, the immigrants were under constant scrutiny,
secretly watched by inspectors' well-trained eyes for any sign of physical or cognitive impairment. According to Alan Kraut, the U.S.
Marine Hospital Service physician was "anxious to scrutinize the new-comer under conditions of physical stress such as that
produced by carrying luggage up a flight of stairs. Hands, eyes, and throat were observed. The heart of an immigrant who had toted
even light baggage up the stairs could be easily judged strong or weak, and the exertion would reveal deformities and defective
postures" (54). Sometimes, one could be pulled aside only for looking absent-minded (Ellis Island). The 1913 regulation on the
"Immigrant Examination Procedure at Ellis Island" established the medical gaze as the final authority in deciding the immigrants'
destinies. The document read as a forceful statement that legitimated the medical gaze and transformed
the immigrant
into an experimental immobile site. According to this guide, at the immigrants' approach, the doctors begin to size up
each immigrant. First they survey him as a whole. If the general impression is favourable they cast their eyes at his feet, to see if
they are all right. Then come his legs, his body, his hands, his arms, his face, his eyes, and his head. While the immigrant has been
walking the twenty feet the doctors have asked and answered in their own minds several hundred questions. If the immigrant
reveals any intimation of any disease, if he has any deformity, even down to a crooked finger, the fact is noticed. (Unrau, 548) The
medical inspections on the island, and their promotion of able
bodiedness, illustrate what Rosemarie Garland-Thomson
names, in a different context, the "ability/disability system." This system "produces subjects by
differentiating and marking bodies," limiting in turn the access to resources and power ("Integrating
Disability," 5). Nonetheless, rather than representing a symmetrical power structure, the Ellis Island
encounters between immigrants and physicians replicated a dynamic and asymmetrical network
of power relations, with the immigrant discourses challenging at times their dominant counter
parts. Because the notoriety of the medical inspections had reached immigrants in their own countries, travelers came prepared
to face the medical investigations and deceived the physicians whenever possible. Many times they would rub the chalk marks off
their coats. At other times, they would turn their coats inside out to hide the chalk marks and thus eschew further inspection
(Pegler-Gordon, 203). In their turn, the inspectors were well aware that "the nonchalant individual with an overcoat over his arm"
was "probably concealing an artificial arm," and that "a case of favus may be so skillfully prepared for inspection that close scrutiny
[was] required to detect the evidences of recent cleansing" (203). Moreover, The Book of Instructions for the Medical Inspection of
Immigrants made it the inspector's duty to divulge any attempt at hiding paraplegia in children by taking them from their parents'
arms and making them stand on their feet to see whether they could walk, underscoring the responsibility of the inspector to bring
to light any flaw or impairment in the immigrant (Unrau, 659). The
immigration inspection functioned to erase
immigrants' individuality, collapsing personal lives and feelings onto scientific measurements
and questionnaires. Inspired by the phrenological studies of earlier centuries and prodded by
the eugenic focus on healthy bodies, the inspectors and doctors on the island believed that they could
decode immigrants' bodies as one could decipher some mechanism. They often boasted great expertise in
noticing any signs of invisible impairment. Surgeon Howard Knox shared the belief with some of his colleagues that the
facial characteristics of immigrants could reveal important information about their "nationality, temperament,
occupation, sexual relations and habits, sensuality, drug addictions . . . and such diseases as brain tumor . . . melancholia,
manic depressive insanity, chorea, hydrocephalus, idiocy, imbecility, feeblemindedness, higher feeblemindedness (moron),
moral obliquity, local and other paralyses and atrophies . . . renal disease, appendicitis . . . and impending death" (Kraut, 62).
The temptation to interpret corporeal signs as relevant for immigrants' medical conditions was so high that physicians turned such
judgments into scientific truths. One Ellis Island physician relied heavily on his personal "invention" to identify pregnant women.
According to his method, if the lock of hair on the left side of an immigrant woman's head "hung dull and lifeless over her ear, it
marked her at once as possibly pregnant" (Luibheid, 9). Victor Safford, another Ellis Island doctor, underscored the importance of
the inspector's trained gaze during the medical inspection and, in graphic descriptions, compared
the immigrant to a
worn-out automobile: As one can see on glancing at an automobile at rest that the paint is damaged or a headlight broken
or by closer examination obtain much information regarding the functioning of the carbureter [sic] or the working of the engine, so
one may tell without even troubling to secure good conditions for an inspection that an immigrant has a skin disease or has lost an
eye or on closer examination learn something about the condition of his heart or lungs, but the wise man who really wants to find
out all he can about an automobile, or an immigrant, will want to see both in action, performing as well as the rest, and to watch
both at a distance as well as to scrutinize them close at hand. (244-45)
And…voting negative only feeds into the eugenic gaze that has undergirded
American immigration law writ large – only the plan can provide an effective
stepping stone to dismantle the status quo’s politics of eugenics
Wheeler 14 (Stephanie Kristen – Doctor of Philosophy - Submitted to the Office of Graduate and Professional
Studies of Texas A&M University “The Enfreakment of Language: Disability, Eugenics, and Rhetoric” May 2014
These concepts of “abnormality” that are rooted in ideas of recognizing “civilized” and
“acceptable” bodies carried through to early twentieth century American ideas of immigration.
Whiteness, American, and civilized are largely formed by the logics of eugenics. In attempting to
create and maintain a normality that would be distinctly “American,” systems of power were
designed to identify difference through the enforcement of designated norms, and then remove
those differences. In short, the nationalism of the United States was directly tied to what Étienne Balibar calls “the
obsessional quest for a ‘core’ authenticity that cannot be found’ (60). The eugenicist logic that formed this imaginary authenticity
relied on imagining what the nation was, how it was threatened, and what it could be. By creating an imagined appearance or
phenotype based on genetics and environment to characterize the citizens of the United States, this
example of eugenicist
logic formed the “ideal American.” Immigrants and other undesirable people threatened this
imagined appearance, and from the standpoint of eugenicist logic, threatened the future of the
nation by multiplying that which halted the progress and future of the United States. Measures were
taken to protect what was believed to be the existence of an ideal American citizen. For example, the 1891 Immigration
Act pronounced certain groups unfit to become American citizens, specifically those who risked
becoming a public charge: Be it enacted by the Senate and House of Representatives of the United States of America in
Congress assembled, That the following classes of aliens shall be excluded from admission into the
United States, in accordance with the existing acts regulating immigration, other than those concerning
Chinese laborers: All idiots, insane persons, paupers or persons likely to become a public charge,
persons suffering from a 42 loathsome or a dangerous contagious disease, persons who have been convicted of a felony or other
infamous crime or misdemeanor involving moral turpitude, polygamists, and also any person whose ticket or passage is paid for with
the money of another or who is assisted by others to come, unless it is affirmatively and satisfactorily shown on special inquiry that
such person does not belong to one of the foregoing excluded classes…(Chap. 551, Section 1) What
this law outlines is a
type of eugenicist system, privileging the productive and healthy bodies, and limiting the
existence of unwanted bodies in the name of producing a healthier and more industrious
nation. To begin, the law identifies difference through classes. The use of this term is highly suggestive of a product of what Diane
B. Paul and James Moore call “the Darwinian Context.” First published in 1859, Darwin’s On the Origin of the Species argued that
individuals more suited to the environment would be more likely to survive and reproduce, leaving inheritable traits to future
generations. This, in turn, would lead to the process of natural selection. Distinguishing those that would be more suitable, then,
depended on the methods of classification developed by naturalists. Arguing the relationship between classification and physical
similarities, Darwin uses an example of the physical similarities between the Hottentot people and the “Negro race,” implying that
all races of human beings are evolutionarily linked (424). The consequence of this implication is that of evolutionary human
hierarchy, wherein those more suited for their environments – or for survival – would have progressed further evolutionarily than
those who are unfit for survival. To
use the term classes within the context of this immigration law
suggests that eugenicist logic determined how to define who was wanted and who was
unwanted. Furthermore, the word itself creates a context specific to eugenicst motivation: to say
that “the following classes of aliens shall be excluded admission into the United States,” is to say
that those people who are classed are those who are unwelcome. In other words, those whose difference is recognized and
designated “unwanted” are those who are denied admission into the United States.4 This law also forbade entrance to “all idiots,
insane persons, paupers, or persons likely to become a public charge, [and] persons suffering from a loathsome or dangerous
contagious disease.” This
discrimination of persons with disabilities is coded in medical language:
idiots, insane, disease. The context of this medical language suggests that people with
disabilities are people who are, and should be, feared: loathsome, dangerous, and contagious all
signal the fear of disability, and relate it directly to the health of the nation and its people. To
code ableism in this way is to say that persons with disabilities should be feared on the grounds
that they prevent the evolutionary progress of both the nation, but of the people themselves.
Furthermore, to associate disability and disease within the context of immigration is to also put
those same labels onto the bodies of the immigrants themselves. In other words, because the Immigration
Act describes of what is not wanted and what is considered unhealthy to the nation, it is 4 Chinese laborers were excluded from this
law because the Chinese Exclusion Act of 1882 explicitly forbade Chinese peoples from migrating to the United States between 1882
and 1892, on the grounds that Chinese laborers were a threat to order in certain localities. This law was extended to another ten
years in 1892 under the Geary Act. 44 not insignificant that it opens up with a description of disabled bodies. By
situating what
is unhealthy to the nation within the context of immigration, this act is very clearly implying that
the bodies of immigrants are diseased and unhealthy. The description of who is excluded
continues, denying entrance to those charged with a felony, misdemeanor, or any activity considered in opposition to the beliefs
and standards of society, as well as those whose ticket was paid for by another – suggesting that they could not care
for themselves, or depended on the assistance of others to survive. The attempt to maintain and
protect the “American norm” surfaces in the law, creating a context specific to ideas of what it
means to look, think, and act like an “American.” This requirement to fulfill the role of the ideal American was
extended to the body. Snyder and Mitchell argue that “this period in American history is the first to introduce
disability as disruptive to rationales of national citizenship” (39). Further, in an analysis of Ellis Island as a
rhetorical space, specific to disability, race, and immigration, Jay Dolmage argues that “the social processing that Ellis Island
engendered was all about identifying and sometimes manufacturing abnormal bodies: these elements are out of place; these bodies
are disordered. Ellis Island created a physical space in which abnormality could be arrested or deposited” (26). Ellis Island – the
gateway to the United States for millions of immigrants – served as a type of designating station, wherein bodies were subjected to
a normalizing gaze that determined their level of difference and its relationship to the development of “the norm” in the United
States. Victor Safford, a medical doctor stationed at Ellis Island describes in his memoir the motivation behind the medical
inspection: 45 The scheme as it was maintained in actual operation at Ellis Island during my time there provided an opportunity for
an observer to inspect an immigrant systematically both at rest and in motion at a distance of about twenty or twenty-five feet; for
an observer to inspect or scrutinize the immigrant as he approached the observer, and finally after the immigrant came close at
hand. Somewhere in this inspection process provision was to be made for the close examination of hands, eyes, and, if deemed
advisable, of throat. No attempt was to be made on such an inspection to determine what was wrong. Suspicion that something
might be wrong was alone sufficient justification for turning a person aside. (246) Part of this “scheme” of identifying “deficiencies”
that Safford describes is dependent on bodily ability. From a distance, Safford and others could determine mobility impairments by
observing how an immigrant carries his or her bags, causing him or her to make two right hand turns to determine muscular
coordination, and stamping cards to observe how the immigrant looked at it, signaling any kind of defective vision (247-49). Once
again, eugenicist
logic operates here as the logic that determines the acceptability of bodies
within the context of American nationalism. Indeed, Dolmage calls Ellis Island “the key laboratory and operating
theater for American eugenics, the scientific racism that can be seen to define a unique era of Western era of Western history, the
effects of which can still be felt today” (27). These effects highlight the fears of difference and aberration, yet the existence of this
threat is precisely what maintained the idealized image of the desired American citizen. 46 The existence of terms to guide and
determine the recognition of aberrance or deviance existed only because of the standard of normalcy attributed to those closest to
the ideal citizen. Those deemed unworthy or unable to achieve citizenship or social participation were cast aside, but done so in a
way to exhibit what the “acceptable” citizens were not. This is not unlike the logics of a freak show, wherein those deemed different
or undesirable were put on display for purposes of maintaining ideas of normalcy. Eli Clare writes that “the freak show tells the story
of an elaborate and calculated social construction that utilized performance and fabrication as well as deeply held cultural beliefs”
(86). Indeed, as evidenced by Safford’s description of the medical examination, the bodies of immigrants were subject to a gaze that
reduced them to a social construction that represented cultural beliefs about the future of the country. In The Birth of the Clinic,
Foucault writes, “the
gaze is passively linked to the primary passivity that dedicates it to the endless
task of absorbing experience in its entirety, and of mastering it…The gaze is no longer reductive,
it is, rather, that which establishes the individual in his irreducible quality. And thus it becomes
possible to organize a rational language around it” (xiv). The gaze of the doctor onto the bodies of immigrant
peoples rendered them undesirable and unwanted. Once designated undesirable, the language of deviance was written onto their
bodies, and once named, this
medical model of deviance provided the rationale for the eugenicist acts
initiated by eugenicist logic.
The United States federal government should substantially reduce public charge restrictions on
legal immigration (to the United States).
The United States federal government should remove/eliminate public charge restrictions on
legal immigration (to the United States).
Top Level
Congressional action is necessary to preempt Trump overreach on public charge
De Pena and Hammond 18 (Kristine and Samuel – opinion contributors for The Hill “Congress Can and
Should Stop Trump’s Plan to Banish More Immigrants”
Unless Congress intervenes, the Department of Homeland Security (DHS) is preparing to cause a
massive disruption to current U.S. immigration policy in the guise of protecting the American
taxpayer, according to a newly leaked draft regulation. Under current law, the U.S. government reserves the
right to deport or deny admission to lawful immigrants who are, or are at of risk becoming, a
“public charge.” Historically, a public charge refers to a noncitizen who is “primarily dependent” on programs like cash
assistance or long-term care for subsistence. DHS plans to issue new regulations expanding the definition of
public charge to include non-citizens who are receiving, or likely eligible to receive, one of any
number of means-tested public benefits. Although the regulation primarily purports to address individuals trying to
come to the United States or become U.S. citizens, the guidance will likely guide deportability standards (reasons
someone can be kicked out) as well. DHS spokesman Tyler Houlton asserts that the administration is concerned about taxpayer
dollars, but that is a difficult proposition to swallow. Ever since the 1996 welfare reform, legal immigrants have been prohibited
from receiving public benefits for at least five years after their arrival. And when non-citizens finally do become fully eligible for
programs like SNAP or Medicaid, they use them at substantially lower rates, and in significantly smaller amounts, than their nativeborn counterparts. According to our analysis, the new proposal would expose as many as 1.9 million legal resident immigrants to
deportation risk when they try to become U.S. citizens, merely for having accessed Medicaid or Supplemental Nutrition Assistance
Program (SNAP) within the five year window under one of the exemptions mentioned below. If anything, past administrations have
been more worried about immigrants declining important public benefits for which they’re eligible. Following the enactment of the
five-year waiting period for public benefits, for example, U.S. regulators issued clarifying guidance to put non-citizen’s anxieties at
ease, lest they avoid walking into a public hospital for fear of violating the law. There are also some exceptions to the five-year ban,
added over the years to address unique state and local needs. Following
the reauthorization of the Children’s
Health Insurance Program (CHIP) in 2009, for example, Congress decided to give states the
option of providing temporary Medicaid coverage to non-citizen pregnant women and children,
regardless of their date of entry. As of 2016, the average cost of non-citizens in Medicaid remains far below the cost for
natives. A similar exception was made in SNAP for immigrant households with children under the
age of 18, and for individuals with 40 qualifying quarters (10 years) of work history. Low-income noncitizen
adults and children, including those outside the five-year waiting period, nonetheless receive much less in average annual SNAP
benefits compared to low-income naturalized citizens and the native-born. Even citizen children of noncitizen adults receive nearly
20 percent less in nutritional assistance on average. However the new definition of public charge will be applied, we can be certain
that its impact will fall disproportionately on women and children. Even benefits to U.S. citizen children would be threatened — if
they are the children of immigrants. Across 20
years and four administrations, it has been the position of
the U.S. government that any benefit used for determining a public charge must be considered
in connection with the program’s broader goals. This is because educational, nutritional, and healthcare programs
are seen as serving the interests of the nation as a whole — not leading the recipient to a state of primary dependence. Rather,
provision of these temporary services are often essential to helping low-income families become self-sufficient. Immigrants,
acting legally and in good faith, already feel enormous anxiety and uncertainty living under this
administration. Fortunately, this is a clear case where Congress can act, and should act given
their legislative prerogative. By codifying a more complete definition of public charge into law, lawmakers can
preempt the Trump administration’s overreach before it leaves draft form, and we’re forced to
amend the Statue of Liberty inscription to say, “Give me your tired, your poor, your huddled
masses...” so that they may be sent back from whence they came.
Public charge MUST be eliminated to prevent ableist discrimination
Gomez and Sanchez 13 (Dayana and Jose, reporters for Living Hope Wheelchair Association
& Houston United. Report, January 2013, “Public Charge and Disabilities: Toward a More
Inclusive Immigration Policy” Academia) NREM/Lil’ GBN
Public Charge Relevance in Immigration Policy As previously stated, public charge provisions have a
longstanding history of being attached to immigration policies in order to safeguard public resources
and exclude certain types of immigrants from a path to legalization. However, these types of provisions have not kept up with the
developments in U.S. social policy, which has evolved to address these issues through Welfare Reform, Health Care Reform, among others. Arguably, public charge
provisions in immigration policy have become irrelevant, especially concerning individuals with physical or mental disabilities. Within the
immigration debate one of the most common misconceptions is the idea that immigrants are or will become a public
burden taking advantage of public assistance programs. However, it is important to note that in 1996 with the passage of the Personal
Responsibility and Work Opportunity Reconciliation Act (PRWORA), provisions are already established to reduce and limit the availability of welfare programs to
undocumented individuals. According to the National Association of Social Workers’ summary on the PRWORA , this law cuts approximately $55 billion that comes from reductions in the Food Stamp program, the
Supplemental Security Income (SSI) program that undocumented immigrants would not qualify for.10 Similarly, the estimated 11.2 million undocumented immigrants residing in the U.S. are also ineligible for
Medicaid and other means-tested federal benefits due to PRWORA.11 Although these are just a few examples of the social policies already in place to prevent individuals, especially undocumented immigrants,
outdated provisions also have impacts on the community at large. In its 1999 proposed rule and field guidance on the public charge,
are not only causing them considerable harm, but are also jeopardizing the
general public.”12 Furthermore, immigration and welfare policies also heavily restrict access to federal and
state assistance programs even after an immigrant has gained legal permanent residency. The passage of
from becoming a “public charge” on the state, these
INS noted that “immigrants’ fears of obtaining these necessary medical and other benefits
PRWORA and IIRIRA in 1996 ushered in a new era of unprecedented restrictionism, especially for immigrant communities. Even where eligibility for immigrants was preserved by the 1996 laws or restored by
subsequent legislation, many immigrant families hesitate to enroll in critical health care, job-training, nutrition, and cash assistance programs due to fear and confusion caused by the laws’ chilling effects. As a
the participation of immigrants in public benefit programs has decreased sharply after passage of the 1996
law.13 10 National Association of Social Workers, “Personal responsibility and work opportunity reconciliation act of 1996”. 11 Trends, 2010,
Pew Hispanic Center, Washington, D.C., February 1, 2011, p. 25. 12 64 Fed. Reg. 28676 (May 26, 1999), (accessed on Jan. 10, 2013). 13 Michael
Fix and Jeffrey Passel, “The Scope and Impact of Welfare Reform’s Immigrant Provisions” (Discussion Paper No. 02- 03), Assessing the New Federalism, Washington, DC: The Urban Institute, Jan. 2002. 6
Impacts on Immigrants with Disabilities In the year 2008 there was at least an estimated 15 percent of
individuals in immigration proceedings with existing mental disorders/disabilities.14 This significant percentage
would account for approximately 57,000 individuals. We can infer that with the increased rates of deportation under the Obama administration the percentage of
individuals with disabilities in immigration proceedings has also increased. In the recent years there has been more attention towards the inhumane treatment of individuals within ICE detention facilities and the
lack of representation in the immigration court process for individuals with disabilities. Initial screening is inadequate, the quality of care suffers, and the lack of an electronic records system further exacerbates
these problems.15 The report by Travis Packer indicates that when individuals are in custody of immigration there is a screening process and standards to identify mental disorders, however it is not administered
to every single individual.16 Unfortunately, the undiagnosed or lack of treatment of certain disorder within the immigration detention center cannot only affect negatively the individual’s physical and
case. One of the victories out of exposing the maltreatment of
individuals with disabilities is the initiative ICE has undergone to develop a “risk assessment tool” that will help identify mental disorders and who should be
psychological health, but also the outcome of the immigration
detained and the conditions under which that individual should be detained. 17 While little is known about the assessment tool, it sets a positive precedent and is a step in the right direction to uphold human
Discrimination Under the Law Since the passage of the Americans
with Disabilities Act more than 20 years ago – a landmark civil rights victory thanks to the struggle of disability rights groups – there have been many improvements against discrimination
rights of people with disabilities within the immigration context.
and towards a more inclusive environment for people with disabilities in the U.S. The U.S. government is justifiably proud of the progress it has made in protecting the rights of people with disabilities in the
workplace, healthcare, education and public accommodations .In the immigration sphere, however, the U.S. has yet to provide similar substantive protections through U.S. constitutional law and international
Public charge provisions are inherently discriminatory and fundamentally against the
principles of the Americans with disabilities Act and the struggle of the organizations and individuals who fought for this civil rights victory. Although this
human rights standards.
legislation was approved four years after the Immigration Reform and Control Act, little effort has been made from the U.S. government to update immigration law within this context – further demonstrating the
public charge’s irrelevance. 14Human Rights Watch, Deportation by default: mental disability, unfair hearings, and indefinite detention in the US immigration system, July 2010 15. Packer, T. Esq. (2010). Non-citizens with mental disabilities the need for better care in detention and in court. Immigration Policy Center, American
Immigrant council. 16 Packer, T. Esq. (2010). Non-citizens with mental disabilities the need for better
care in detention and in court. Immigration Policy Center, American Immigrant council. 17 Human
Rights Watch, Deportation by default: mental disability, unfair hearings, and indefinite detention in the US immigration system, July 2010 7 Assessing
“Public Charge” and Other Discretionary Procedures The current restrictions on public charges have changed little since the beginning of the twentieth century. Section 212(a)(4) of the Immigration and Nationality
Act declares that: "Any alien who, in the opinion of the consular officer at the time of application for a visa, or in the opinion of the Attorney General at the time of application for admission or adjustment of
status, is likely at any time to become a public charge is inadmissible."18 The legislation specifies that the factors to be taken into account in determining whether an alien is excludable include age, health, family
status, assets, financial status, and education and skills. However, it is important to note that there has to be a clear definition of public charge as well as specific criteria that would make someone inadmissible. It
is also troubling that the assessment and determination of inadmissibility under public charge is placed on the opinion of one individual that might have special consideration on one case over the other. In
addition, Section 237(5) states that: "Any alien who, within five years after the date of entry, has become a public charge from causes not affirmatively shown to have arisen since entry is deportable."19 While the
Immigration and Nationality Act excludes individuals with physical and mental disabilities, all applicants under immigration proceeding may also qualify for a special rule cancellation of removal under section 309
(f)(10)(A) of IIRIRA if they can establish that their deportation would result in “extreme hardship”. [For a list of “extreme hardship” contributing factors, see Appendix A] While there is a list of what would qualify
for “extreme hardship”, every case must be reviewed on an individual basis in review of all the circumstances that the individual and family might face. The individual must present evidence that the deportation
would cause extreme hardship beyond that associated with the deportation. Limitations of Waivers and Other Discretionary Procedures Each of the above mentioned policies includes “waivers” of inadmissibility
address some of the exclusions due to “public charge” determination or other
grounds for inadmissibility. At the same time, the determination of “public charge” and other
exclusions often rests on the discretion of either the Secretary of Homeland Security, Attorney General, or
which could potentially
other consular level official handling the individual application. However, these types of waivers and discretionary provisions tend to be reactive and come into play only after individual cases have been identified.
The issue with these types of reactive policies is that they create an inconsistent, and arguably less effective, process for reviewing cases (variance depends on individual consular staff or administrator in power)
and also create an increased burden on already vulnerable individuals - having already expended their resources in time and monetary fees throughout the application process. 18 “INA: act 212 – General Classes
of aliens ineligible to receive visas and ineligible for admission; waivers of inadmissibility” (USCIS webpage).
0000ecd190aRCRD&vgnextchannel=fa7e539dc4bed010VgnVCM1000000ecd190aRCRD&CH=act (last visited January 21, 2013). 19 “INA: act 237 – general classes of deportable aliens” (USCIS webpage).
legislators should consider in any discussion of a truly comprehensive immigration policy rooted
in the dignity of immigrants communities. As previously mentioned, this is a preliminary document which includes recommendations based only on existing
immigration policies. However, it is of utmost importance that immigrants with disabilities and other communities directly affected continue
to be part of this discussion and are able to provide their assessment and input into upcoming immigration legislation. Our initial recommendations include :
Eliminating the “Public Charge” Provision Given the expanded explanation of “public charge”
under the Clinton administration coupled with the approval of the 1996 Welfare Reform Act,
any future comprehensive immigration policy which includes a path to legalization and status
adjustment should exclude any “public charge” provision, and instead, enumerate ways in which
individuals with mental or physical disabilities may apply for status adjustment, given the same
considerations as other “able-bodied” individuals
0000ecd190aRCRD&vgnextchannel=fa7e539dc4bed010VgnVCM1000000ecd190aRCRD&CH=act 8 Policy Recommendations The following is a list of initial policy recommendation that
The plan solves – it saves money and resolves uncertainty
Bier 4-19 (David, immigration policy analyst at the Cato Institute’s Center for Global Liberty
and Prosperity. CATO INSTITUTE, 4-19-2018, “The $1/Day Standard & Other Problems with
DHS’s Public Charge Rule”) NREM/Lil’ GBN
First, its public charge definition of a $1 per day is overbroad. Public charge has always meant a level
of support substantially higher than $1 per day (not to mention 50 cents for families). Because the large
majority of immigrants have net positive lifetime effects on government budgets, keeping out
immigrants based on such a low level of predicted support makes little fiscal sense. It will
inevitably end up excluding many immigrants who will contribute to the U.S. Treasury and
economy. DHS should narrow its redefinition to “significantly dependent” on public benefits—
cash or otherwise. Second, DHS’s standard of a $1 per day entirely ignores the degree to which
immigrants support themselves. Historically, “public charge” has always had two elements: 1)
receipt of benefits and 2) inability to support oneself apart from the support. Yet DHS defines
public charge as an absolute amount of benefits—$1/ per day—which could easily account for less
than a percent of a person’s income. This outcome ignores the history of the law and lacks fiscal sense
because it fails to consider the tax revenue and economic growth foreigners who work create.
DHS should assess “significant dependence” based on the amount of benefits relative to the
person’s expected income—at least 20 percent of the person’s annual income. Third, DHS cannot
justify counting welfare use by U.S. citizens in the immigrant’s household against applicants. Not
only would the U.S. citizens receive these benefits even if the immigrant receives no legal status,
denying legal status to a dependent of an immigrant would likely increase their use of public
benefits. DHS should only consider benefits used by dependents if they are noncitizens that they
have brought with them to the United States. Fourth, the rule fails to define what DHS means by “likely” to
use benefits. Likely implies a level of certainty appreciably above 50:50, but DHS never clarifies
this, leaving it up to bureaucrats to decide the threshold on a case-by-case basis. This will lead
to inconsistent adjudications and denials to people who should receive approvals. These false
positive could result in billions of dollars in lost output and federal revenue without offsetting
benefits. A redrafted rule should define the meaning of the word “likely” in accordance with its
accepted meaning—a threshold of 70 percent probability of use—giving clarity to applicants and
adjudicators. Fifth, the rule’s complex weighting system for determining likelihood to use benefits is
entirely arbitrary. Bureaucrats would determine how to weight the factors—such as age, health,
and income—on an ad hoc basis. The process is equivalent to a “merit-based” points system
where applicants do not know the point values, and bureaucrats make them up as they go. DHS
should use careful statistical analysis to create a factor model to estimate the probability of
use precisely. This model would allow immigrants to know whether they qualify in advance of
applying. Sixth, the administration has failed to harmonize DHS’s new rule with State
Department’s separate public charge regulations. This means that immigrants who have received a
visa abroad, which authorizes travel to the United States, could be evaluated against a completely different
standard when they reach a port of entry or, later, when they file additional immigration
applications inside the United States. Such discord would create chaos in the legal immigration
system. DHS should defer to State Department public charge determinations unless a material
change has occurred since State Department approved the immigrant. Seventh, DHS failed to
estimate the major costs of the rule. They only consider the costs associated with filing forms,
not with excluding immigrants from the country or separating U.S. citizens from their families.
DHS needs to calculate the full costs of the rule. To do so, it needs to estimate the number of
immigrants the rule would exclude and estimate the direct and indirect effects of these
exclusions on tax receipts and economic growth. Without these reforms, this rule would exclude
far more contributors to the United States than public charges. If Congress wants to prevent immigrants from
using any welfare at all, it should amend the law to reflect that goal. Until then, DHS should return to the drawing board and
craft a better rule.
The aff clarifies the definition of public charge – creates DHS and DOS
CRS 17 (Congressional Research Service, congress’s super dope and qualified think tank that
provides information on highly controversial debates. 2-6-2017, EveryCRSReport, “Public Charge
Grounds of Inadmissibility and Deportability: Legal Overview”) NREM/Lil’ GBN
The public charge grounds are currently discussed in the regulations of both the Departments of Homeland Security
(DHS) and State (DOS), as well as in DOS's Foreign Affairs Manual. The DOS regulations address only the grounds of
inadmissibility, since consular officers are responsible for the issuance of visas to aliens outside
the United States, but generally play no role in determining whether aliens within the United
States are deportable. DHS officials, in contrast, determine whether aliens arriving at U.S. ports of
entry are to be admitted; whether applications for adjustment of status are to be granted; and
whether aliens within the United States are to be removed. Thus, the DHS regulations address both
inadmissibility and deportability. DHS Regulations and Guidance The INS never finalized the proposed
regulations regarding the public charge grounds, discussed above, and DHS has not proposed or
promulgated similar regulations. Instead, the INS and, later, DHS promulgated specific regulations
regarding the "special rules" used in determining whether certain applicants for adjustment of
status are public charges. For example, DHS regulations currently provide that "special agricultural
workers" who meet certain requirements are subject to the public charge grounds, but may not be excluded if
they have a "consistent employment history" which shows the aliens' ability to support themselves and their families.51 The
regulations further provide that "[p]ast acceptance of public cash assistance within a history of consistent employment will enter
into" public charge determinations for special agricultural workers, with "the length of time an applicant has received [such]
assistance" being viewed as a "significant factor."52 However, the weight given to the acceptance of public cash assistance is
expressly said to "depend on many factors,"53 and the overall analysis is "prospective in that [immigration officials] shall determine,
based on the applicant's history, whether he or she is likely to become a public charge."54 In other words, pursuant to these
regulations, prior receipt of public cash assistance would not necessarily result in an alien being found ineligible for adjustment of
status if other factors suggest that the alien is unlikely to become a public charge in the future. There are similar "special rules" for
other aliens seeking adjustment of status.55 DHS
regulations are currently silent as to the public charge
grounds of deportability. The Pearson memorandum has apparently continued to guide DHS's consideration of public
charge determinations. The U.S. Citizenship and Immigration Service's (USCIS's) 2011 "fact sheet" on the public charge grounds, for
example, defines public charge in the same way as the Pearson memorandum and expressly references the Pearson
memorandum.56 As of February 4, 2017, this fact sheet is publicly available on the DHS website.57 State Department Regulations
and Guidance The current DOS
regulations, in contrast, address the public charge grounds of inadmissibility
more broadly than the DHS regulations do. The DOS regulations emphasize the role that the alien's
"circumstances" play in determining whether an alien is inadmissible, in part, by specifying that: [a]ny
determination that an alien is ineligible [on public charge] grounds must be predicated upon circumstances indicating that,
notwithstanding any affidavit of support that may have been filed on the alien's behalf, the alien is likely to become a public charge
after admission, or, if applicable, that the alien has failed to fulfill the affidavit of support requirement ....58 Consular
are expressly authorized
to issue visas to aliens subject to the affidavit of support requirement, noted above, who
accordance with INA 213 and INA 221(g)," provided that the officer is satisfied that the
giving of such bond or undertaking removes the likelihood that the alien will become a public charge, and
the alien is otherwise eligible for a visa.59 However, consular officers are also required to presume that
aliens not subject to the affidavit of support requirement who are relying solely on personal
income to establish that they are not likely to become a public charge are ineligible for a visa if
they do not demonstrate "an annual income above the federal poverty line" and are without
"other adequate financial resources."60 The DOS guidance in the Foreign Affairs Manual (FAM) largely parallels
that in the 1999 INS proposed regulations and the Pearson memorandum.61 However, the FAM expressly characterizes the types
"giv[e] ... a bond or undertaking in
of public cash assistance for income maintenance considered in public charge determinations as "means tested benefits."62 The
FAM also defines institutionalization for long-term care, which is not defined in the Pearson memorandum, as "care for an indefinite
period of time for mental or other health reasons, rather than temporary rehabilitative or recuperative care even if such
rehabilitation or recuperation may last weeks or months."63 Overall, though, like the Pearson memorandum, the FAM emphasizes
that public charge determinations are to be made based upon the "totality of the circumstances," considering the factors specified
in the INA (e.g., age, health), as well as "any other factors thought relevant by an officer in a specific case."64 Past or current receipt
of cash benefits for income maintenance or institutionalization at public expense "may be factored into" the determination when it
constituted the alien's primary means of subsistence. However, under the FAM, "[a] finding of inadmissibility [on public charge
grounds] cannot be based solely on the prior receipt of public benefits," or on institutionalization at public expense.65 Public
Benefits and the Public Charge Grounds Collectively, the various sources addressing the meaning of public charge suggest that an
alien's receipt of public benefits, per se, has historically been unlikely to result in the alien being deemed removable on public charge
grounds. As previously noted, the INA does not define public charge, or link the public charge grounds of inadmissibility and
deportability with the receipt of public benefits. DHS
and DOS regulations are also silent as to the definition of
public charge and the role that receipt of public benefits may play in public charge
determinations. Other guidance from DHS and DOS does link the INA's public charge grounds with
public benefits, in part, by defining public charge in such a way as potentially to encompass aliens
who receive certain public benefits (i.e., SSI; certain TANF assistance; state and local cash assistance for income
maintenance). However, this guidance also indicates that prior or current receipt of public benefits, in itself,
has generally not sufficed for an alien to be found removable on public charge grounds. This
guidance emphasizes that determinations as to admissibility involve projections regarding
whether the alien is "likely to become a public charge" in the future that are based on the
totality of the circumstances. These circumstances include, but are not limited to, prior receipt of benefits. The guidance
similarly emphasizes that determinations as to deportability are made by applying a three-part test, previously discussed, which
considers whether payment for any government-provided assistance was legally required, was demanded, and could be made.
Public charge deprives people with disabilities the freedom of mobility and
choice on an equal basis with abled-bodies – the plan is key to challenge the
politics of eugenics in immigration law
Weber 16 (Mark C. Weber, professor of law at DePaul University, 6/13/16, “Immigration and
Disability in the United States and Canada,” VI. Conclusion: Evaluation and Prospects For
Reform, page 32-35,
What liberalization has taken place in immigration law with respect to disability-based exclusions may be attributed to a disenchantment with Eugenics
ideas after the horrors of the Nazi era, and a gradual decline in society’s fear of disability. 88
The movement for disability rights,
which gained prominence in North America from the 1960s forward, has stressed integration
and full participation in daily life for people with disabilities.89 The idea is nothing less than a redefinition of the
normal to include disability, and a shift in focus to eliminating barriers to integration and full opportunity.90 There has been a
recognition, most strikingly in the U.S. Americans with Disabilities Act 91 and in the Canadian Charter of Rights
and Freedoms and statutory enactments,92 that people with disabilities belong in the national community and
contribute socially, culturally, and economically to the commonwealth, and that
accommodations ought to be provided to facilitate belonging and contribution. Moreover, in America the
Immigration Act of 199093 completed a reorientation of the U.S. immigration system from a single-minded focus on labour needs towards family
unification concerns. Hence, immigrants’ inability to work due to unaccommodated disability is less important, at least as long as it does not result in a
need for public support. Mixing a metaphor yet stating matters accurately, one source declares that “The
cornerstone of the current
system revolves around family reunification.”94 This situation contrasts sharply with an
immigration policy closely tied to the need for labour,95 although the economy’s labour needs remain a significant
theme in immigration regulation in the United States and are a particularly prominent theme in Canada. One source comments: “Distaste for racial or
national-origin restrictions finally provoked policy change in both countries in the 1960s, but with strikingly different results. The United States chose
family reunification as the major goal of admissions policy; Canadian governments promoted permanent immigration as a path to economic growth.”96
The public charge and excessive demand restrictions remain a significant discriminatory barrier
to entry, and in the United States great problems continue with the evidentiary and procedural aspects of the
administration of the immigration laws in general, as well as the difficulty in navigating the immigration system for
individuals with mental illness or intellectual disabilities. Relaxation of public charge-related
exclusions and adoption of reforms such as more widely available examinations for
incompetency and broader access to lawyers for indigent persons subject to removal would go
far to accommodate people with disabilities striving to obtain the benefit of the recent changes
in the immigration laws. More specifically, in the United States the reforms occasioned by the Franco-Gonzales case represent an
important instance of accommodation for immigrants with disabilities, but the reforms remain at this time a matter of court order in three states and
an ad hoc administrative edict elsewhere. In 2014, Representative Jeffries introduced a bill to provide counsel for unaccompanied immigrant children
and people with mental disabilities in removal proceedings.97 Adoption of this statutory change would make the accommodation secure. In addition,
as noted above, having representation at the competency hearings themselves is a needed accommodation. Consent to removal should not be solicited
or accepted from those who do not fully understand what they are signing. And those individuals who are unlikely ever to become competent must not
be held indefinitely, in accordance with well established United States Supreme Court caselaw interpreting the due process clause. In Canada, and
perhaps someday in the United States, advocates should be able to support their case for reforms with Article
18 of the United
Nations Convention on the Rights of Persons with Disabilities. 98 The Convention mandates both
freedom of movement across borders on a nondiscriminatory basis and accommodations in the
immigration process. It provides that “States Parties shall recognize the rights of persons with
disabilities to liberty of movement, to freedom to choose their residence and to a nationality, on
an equal basis with others,” and that states parties must ensure that persons with disabilities
“[a]re not deprived, on the basis of disability, of their ability to obtain, possess and utilize
documentation of their nationality or other documentation of identification, or to utilize
relevant processes such as immigration proceedings, that may be needed to facilitate exercise of
the right to liberty of movement.”99 To the extent that considerations of public charge and excessive demand correlate with
disability, compliance with the Convention would call for reasonable modifications of those
exclusionary provisions. At the minimum, the obstacles faced by people with disabilities in U.S.
immigration proceedings will need to be addressed if the United States ratifies the Convention and enacts legislation to put it
into effect.100 Finally, at least in the United States, involvement in the criminal justice system is a broad gateway to removal of immigrants with
disabilities. In
the absence of adequate mental health services101 and the presence of criminalization
of behaviours such as sleeping in parks or public transit, begging in prohibited areas, and
possession of small amounts of drugs,102 persons with mental illness will continue to be swept
off the street and into immigration detention. Provision of mental health services and decriminalization of conduct that is
essentially harmless, even if sometimes disturbing to outsiders, is a change that would effectively produce an accommodation for the life challenges of
persons with mental disabilities in the contemporary North American environment. The recent reforms in United States practices regarding
naturalization are a valuable accommodation for immigrants with disabilities yearning for
citizenship. These reforms are worthy of consideration in Canada. At the minimum, Canadian lawmakers might reconsider the recent changes
that have made attaining citizenship more difficult for persons with disabilities. The relaxation of some disability-related immigration restrictions in the
United States and Canada and easing of the required showings for U.S. citizenship illustrate the significant, though incomplete, removal of disabilityrelated barriers in North American law and society.
“Extinction First” claims are the debate equivalent of #alllivesmatter. Privileging
humanity over the disabled is an ontologically suspect position that devalues
humanity as a whole and pushes disability to the margins – reject the cold logic
of utilitarianism
HUGHES ’07 (Bill; “Being Disabled: Towards a Critical Social Ontology for Disability Studies,”
Disability & Society, 22:7)ww
For most people ‘it goes without saying’ that they are human beings For disabled
people in many historical contexts ‘it has to be said’ Writers who appeal to the humanist
nominalism of the human universal namely
humanity in order to stress the ontological
worth of disabled people recognize the myriad ways in which a disabled existence is invalidated,
but do so by abrogating disability as a meaningful subject position
the kind of post-enlightenment humanism in which difference disappears into the abstract
and disability is eclipsed by the notion of a common humanity Particular and concrete existential
status (disability and the experience of oppression that is its accompaniment) is sacrificed on
the altar of an elusive universal (humanity) that upon brief inspection turns out to have no
meaningful political content whatsoever
in the abstract universal argument
disabled people have to make a significant effort to establish their human worth Yet
they have to abandon their particularity in order to do so
Challenging the argument from frailty
mankind or
. Both Turner, on the one hand, and Shakespeare and Watson, on the other, end
up embracing
. Of course there is something
, because it recognizes
this is a massive sacrifice if
. Shakespeare and Watson (2002, p. 27) argued that there ‘is no qualitative difference between disabled
people and non-disabled people, because we are all impaired’ and Turner (2001, p. 262) claimed that ‘frailty is a universal condition of the human species’, which clearly suggests that ‘the ubiquity of impairment is an empirical fact not a relativist claim’ (Shakespeare
disabled people have a peculiar passport to universality that is
incontrovertible in its validity Human life is fragile and disabled people epitomize fragility, ergo
disabled people enter into the siblingship of the human universal on the grounds that they have
the necessary and sufficient qualifications In fact, it turns out that it is impairment that is the
universal If it is frailty that confers humanity, then non-disabled people who fail to recognize
their vulnerability fail to recognize their own humanity
While one might use this argument to get non-disabled people
to think about disability and to recognize ‘the other’ in their own lives
turning the
ontological problem on its head delivers to disabled people struggling against discrimination a
fairly hollow scholastic victory When people feel that they have to make a claim to humanity
they are usually already in big trouble Enlightenment humanism was probably very far from the
minds of slave owners or commandants of Nazi concentration camps
& Watson, 2002, p. 27). Turner and Shakespeare and Watson argued that
. On the other hand, the category of disability has to be disavowed by disabled people because their claim to
universality has come to the fore through their authenticity as representative of the species.
, it seems to me that
. One is reminded of Shylock in The merchant of Venice when he tries to
convince his Christian contemporaries of his human credentials: Hath not a Jew eyes? Hath not a Jew hands, organs, dimensions, senses, affections, passions; fed with the same food, hurt with the same weapons, subject to the same diseases, healed by the same
means, warmed and cooled by the same winter and summer as a Christian is? If you prick us do we not bleed? The eloquent appeal for recognition as a member of the species is, of course, superfluous. Hardly surprising perhaps, since Shylock’s rationalism is greeted
Disability studies would be advised to begin with the social, material reality of
disabled peoples lives and the ‘lived experience’ of disability
rather than with
claims that have roots in a tired, abstract philosophical tradition If we collapse the particularities
of disabled lives into the abstract concept of humanity we end up claiming that disability does
not matter It is inconsequential, superfluous in comparison to one’s generic, species status
In a disablist
society, it does not matter how one defines disability because the qualities ascribed to the
status will always appear negative in comparison with those associated with ‘able-bodied being’
No matter how much we go on about a
common humanity, in everyday life the negative ontology of disability and the particularities of
with prejudice, i.e. with closure of the mind.
(Paterson & Hughes, 1999; Tichkosky, 2005)
. Shylock’s
, tells us something very different. No matter how much he protests his humanity, he is deviant and unworthy of recognition. He is not Christian and, in practice, his religion excludes him.
Normal/abnormal or valid/invalid! It does not matter which particular binary one invokes, the latter term will be the negative to its partner’s positive.
prejudice and oppression tend to reassert themselves Moreover, this sociological claim reaffirms
the hegemony of the ontological view that human worth is closely associated with ability
. I do not have a
quarrel—on empirical grounds—with the view that impairment is ‘the normal condition of humanity’ (Sutherland, quoted in Shakespeare & Watson, 2001, p. 26), but because we are all impaired or will all become impaired does not mean that we are all treated in
the same way. Because we are all impaired does not mean to say that disablement is or even will be the destiny of each and ev ery one of us. The embodied ontology offered by Shakespeare and Watson and Turner lapses into a position in which
biological being ends up as a universal reference point at the expense of what existentialists
call being-in-the-world
is always marked by the social and the body
a particular context that invokes a negative form of recognition
that informs its character
and projects impairment is the vantage point from which disabled people see the world and
how the world responds Their intersubjective and inter-corporeal experience is marked,
ubiquitously, by ‘felt’ processes of socio-ontological invalidation
. In this latter view
, including physical being,
. Further,
. The attempt by Shakespeare and Watson and Turner to normalize disability at an
anthropological level by invoking the empirical universality of impairment ends in a sociological limbo dominated by a pre-social notion of life as limit. The problem with the argument proposed by Turner and Shakespeare and Watson is that it gives way to a
reductionist argument from nature in which the natural, biological aspects of the body are credited with essential efficacy. It embodies the kind of riposte that one might make to Aristotle’s misogynist claim that being a woman means that one is afflicted with
natural defectiveness. This description, so the counter claim goes, is apt in its application to everyone, not just women. De Beauvoir (1972, pp. 15–16) makes great play of the many and tedious philosophical claims in which women’s bodies are interpreted negatively
as a form of imprisonment, in terms of their contrariness or imperfection relative to the gold standard of male physicality. The easiest way to cut through this argument is to make a generic appeal to the common human condition, particularly, as Shylock does, by
invoking universal physiological traits. All of us are trapped by the limits of human existence by frailty and mortality. We all bleed. We all suffer and die. One is dragged into a debate about impairment qua the universals of biology and the theoretical space to debate
the dialectical relationship between impairment and disability quickly closes over. The transformation of the argument that disabled people are ‘defective’ into the argument that we are all ‘defective’ is a triumph of philosophical egalitarianism that leaves the
concept of disability with no teeth and suggests that the concept of impairment is, although not completely devoid of sociological import, most important as a biological dictum that should teach us all to be humbled by our own vulnerability. For Turner and
Shakespeare and Watson it is the ‘species’ and the authenticity of impairment in relation to it that is the focus of the argument. However, ‘in truth a society is not a species for it is in society that the species attains the status of existence’ (De Beauvoir, 1972, p. 68).
From this perspective an argument that rests on the universality of the frailty of the species is
. It is not that Turner and Shakespeare and Watson failed to recognize the importance of cultural context and social factors in the formation of disabled lives. As social scientists they could not do otherwise and as theoreticians who appeal to
the dialectic of impairment and disability they are keen to play down the importance of biology and to avoid the constuctionist pitfall of discursive determinism, but this argument makes concessions to the immutability of human frailty to the extent that species data
is taken to have a meaning that is pre-social and forms a imperturbable fact of being or an ontological verity that is beyond transcendence. It is fair enough to claim that we will all die and that our bodies will break down and to suggest that mortality and impairment
will have meanings that vary with social context, but when the first part of the argument is used to posit a biological infrastructure (impairment) upon which arises a sociological superstructure (disability) then a residual biological reductionism is evident and
impairment becomes the master category upon which the claim to disability rights and social justice for disabled people must be built. In their effort to reject the ‘strong’ social model distinction between impairment and disability (manifest, for example, in Oliver,
1990; Barnes & Mercer, 2003) Shakespeare and Watson were forced to confer ontological privilege upon impairment and to transform it into the dominant category in the field of disability studies. Theoretically, Turner and Shakespeare and Watson have taken the
ontological negativity out of the categories of impairment and disability, but that has not negated the negativity of the lived experience of disability. The perspective of non-impairment continues unabated. ‘This world … that encourages people to perceive disability
It is a normative
construction, a ‘body schema’, a myth that is used to constitute the flawed other and provide a
place of emotional safety from the fear felt by those ‘clean and proper bodies’
that have
deluded themselves into thinking that existence is secure, stable and autonomous
The real problem in this existential mire is not disability but non-disability those normative
and ideal clean and proper bodies
as thoroughly encapsulated by negation’ (Titchkosky, 2005, p. 662) remains undisturbed. The non-disabled body cannot be nor cannot become vulnerable or frail because it is not an empirical body.
(Shildrick, 2002)
. Towards a critical social ontology for
disability studies
that got a mention in the last paragraph. Let me expand this argument by way of a quick detour. In studying the phenomenon of white attraction to black ethnicity and style
bell hooks (1992, p. 29) noted by way of explanation that: ‘One desires a “bit of the other” to enhance the blank landscape of whiteness’. She described this desire as ‘eating the other’ and is critical of it as a form of majority culture guilt for its long historical
involvement in slavery and racism that manifests itself in a desire to consume the exotic. This approach to difference is, in my view, not something that is apparent in the relationship between disabled and non-disabled people, because non-disabled people do not
desire a ‘bit of the disabled other’ and impairment is seldom, if ever, constructed or represented as exotic. Desire for the black ethnos, exemplified by (white) wearers of cornrows and dreadlocks or by WASP rappers, is based, despite its naive romanticism, on
recognition of the value of cultural alterity. There is at least discernable in these kinds of mimetic cultural practices a vision of the other in which her ontological worth is validated and that her ways of being in the world are deserving of respect. Save for a desire to
misappropriate disabled people’s parking spaces, one cannot find a parallel in the relationship between disabled and non-disabled people. The existential landscape of non-disability, no matter how ‘blank’ or uninteresting it may be, has neither room nor time for
Indeed, frailty and vulnerability, the ontological flagships of
non-disabled people’s perceptions of disabled people’s embodiment, are not only not objects
of desire but are regarded as among those very qualities that constitute a risk to ontological
security Frailty and vulnerability are the stuff of Kierkegaardian dread Indeed, if we rip open the
psychological nest of disabling culture to examine the interstices of intersubjectivity between
disabled and non-disabled actors we are likely to discover fear and anxiety
deficit and tragedy, save perhaps to make a charitable contribution towards its elimination.
than the playful admiration and aesthetic mimicry that
hooks (1992) described with such poignant derision. Dread refers to the ‘prospect of being overwhelmed by anxieties that reach to the very roots of our coherent sense of being in the world’ (Giddens, 1991, p. 37). Whilst borrowing from black culture smacks of cool
non-disabled people are very unlikely to open themselves
to the ‘disabled other’, since it raises the question of their own vulnerability and embodied
coherence and illuminates the challenges posed by the very existential questions from which
they try to protect themselves The love of coherence and order, the ‘natural attitude’ that
people adopt to shield themselves from the vicissitudes of existence, particularly in our age of
anxiety, forms a force field that keeps the threat of vulnerability, the approaching stranger, at
bay It is, to put the argument another way, the normative, invulnerable body of disablist
modernity that is the problem Indeed, the invulnerable self is a fantasy and form of selfdeception associated with carnal normalcy It is widely used by non-disabled people to create
and sustain social distance between disabled and non-disabled people
non-disabled people ‘project their fear of death, their unease at their
physicality and mortality onto disabled people, who represent all these difficult aspects of
human existence’ There are two important elements involved in this psychoemotional and
social process that results in the ‘disavowal of disability’ and its invalidation as a worthwhile
and complicates but adorns the self-identity and existential coherence of some white people,
in a similar
. One can use Tom Shakespeare’s work from the mid 1990s to develop
this argument. Shakespeare (1994, p. 298) argued that
existential status One is psychological and the other ontological The first is fear of physical
frailty, bodily difference and social vulnerability that is projected onto the disabled other and
the second is the process by which the social distancing associated with projected fear is frozen
into a binary of being that embodies a hierarchy of existence Ironically, the ontological
insecurity of non-disabled identity is the original sin that pushes disabled people to the
margins of the human community Disability is not an outcome of the infraction of social
norms about ‘normalcy’ but a product of the failure of carnal normalcy to take proper account
of itself, to indulge in ‘bad faith’ and delude itself into thinking that it is exempt from the slings
and arrows of outrageous fortune The problem rests with the normative body that does not
want to be reminded of its own vulnerability or to admit that abjection and death is its fate In
this context the disabled body is troublesome because it exposes the illusion of autonomy, selfgovernment and self-determination that underpins the fantasy of absolute able bodiedness
’ (Thomson,
1997, p. 45). Readers may have noticed in this very preliminary and adumbrated account of what a critical social ontology for disability studies might look like a measure of intellectual affinity with one of the key building blocks of the critique of the individual and
medical model’s of disability (and ergo of the social model of disability), namely ‘personal tragedy theory’ (Oliver, 1990). This concept need not be reduced to issues of compensation, entitlement or therapeutic interventions (Oliver, 1996, p. 131; Kumari Campbell,
2005) but is closely articulated with the negative and invalidating way in which non-disabled people relate to disabled people and the threat that this poses to the ‘psycho-emotional well-being’ of disabled people (Thomas, 1999). Fiona Kumari Campbell (2005, p.
109) argued that, almost without fail in modern discourse, disability ‘is assumed to be ontologically intolerable, that is, inherently negative’ and ‘always present … in the ableist talk of normalcy, normalization and humanness’. The assumption that a disabled life is
ubiquitously, even invariably, blighted and aberrant is spliced into the emotion of pity that underpins disability charity (S mith, 2005), into the ‘practices and effects of the law’ (Kumari Campbell, 2005), into conceptions and practices of care (Hughes et al., 2005), into
the humiliations and violations of institutional life (Malacrida, 2005), into the order of things, into everyday subjectivity. One could go one better, extending the (recently researched) list of realms in which the authenticity of disability is implicitly or explicitly
It is the task of a critical social ontology for disability studies to
claim authenticity for disability whenever it is denied, be it in the cold logic of
or in the most mundane everyday words or
deeds that exclude or invalidate
questioned, the blight of oppression felt and ontological recognition denied.
Peter Singer’s (1995) ‘preference
’ that revokes personhood from those who are unable to engage reflexively with their own temporality
Utilitarianism is messed up and steeped in academic logic that conflicts with
people’s basic moral and ethical values – the negative’s framing is in line with
Singer, who justifies the murder and dehumanization of those with disabilities
Robinson 17, Nathan – PhD student in sociology and social policy at Harvard University, founded Current Affairs in 2015 and
is its editor-in-chief “Now Peter Singer Argues That It Might Be Okay to Rape Disabled People” Current Affairs 4th April 2017
Singer’s casual rationalization of sexual abuse actually offers a useful illustration of why nobody
should subscribe to utilitarian philosophy to begin with. Utilitarians are meticulous and Spock-like in
their deductions from premises, but their impeccable logic inevitably leads toward utterly
horrifying or bizarre conclusions that totally conflict with people’s most basic shared moral values.
Utilitarian reasoning can lead you to believe that there’s no such thing as “good” and “bad,”
only “better” and “worse” (which means that genocide isn’t inherently bad, and in fact could be fine if it’s
the least-worst available option in a certain set of circumstances). It can lead you to believe that
it’s less morally justifiable for a couple to remain childless than it is to murder an elderly
homeless person in their sleep (because failing to create a potential happy long life is worse than
taking someone’s unhappy short remaining life). It can, as Freddie deBoer has pointed out, lead you to
believe that in the Jim Crow South, you should frame an innocent black man for a crime,
knowing he will be lynched, if doing so would calm the resentments of the white community and
thereby avoid having them perpetrate a wave of far more brutal violence. It can also lead you to
be an apologist for sweatshops and factory collapses. Due to the nature of their premises, utilitarians
constantly end up endorsing the moral necessity of an endless number of inhumane acts. It’s a
terrible philosophy that leads to brutal and perverse conclusions, and at its worst, it turns you into Peter
Singer. I suppose that, at this point, nobody can be surprised at Singer, though it really was somewhat unfortunate that he chose to
follow up an argument for granting disabled people their agency with an argument for why sexually abusing them doesn’t cause
harm. But he’s made it clear over his career that he doesn’t care about the consequences of dehumanizing people. Perhaps more
shocking is the fact that the New York Times either didn’t notice what was being argued, or felt that the argument made a legitimate
contribution to debates about consent and disability. Either way, the continued presence of Peter Singer in national dialogue about
disability shows just how far we have to go before people like D.J. will actually be granted their full humanity, by prosecutors and
philosophers alike.
Consequentialism has troubling implications for those with disabilities and can’t
take into account the realities and perspectives of those with disabilities
Albrecht et al. 06, Gary – Guest Professor of Social Sciences, University of Leuven, Belgium and Professor Emeritus of
Public Health and of Disability and Human Development at the University of Illinois at Chicago. “Encyclopedia of Disability Volume 1”
Ethics pg. 621-22//mr
Consequentialism retains the two features of utilitarianism that may have the most
troubling implications for people with disabilities: the aggregation of the good found in
the lives of separate individuals to make an overall outcome assessment—which tends
to treat those individuals as mere sources or receptacles of goodness—and the
commitment to maximizing whatever counts as good—which in effect places a higher
value on those who directly or indirectly con- tribute more good to the total. Although some
philosophers have attacked the aggregative and maximizing features of consequentialism head-on, others have tended to focus on
the criteria for assessing outcomes as good or bad. We will touch on the former concern (which is dealt with at greater length in the
“Justice” and “Health Resource Rationing” entries), but our focus here is on the latter: the
relevance of impairment in
assessing how well a life has gone or is likely to go. Contemporary followers of Aristotle, such
as Martha Nussbaum, reject pain and pleasure as a metric of well-being and tend to assess
outcomes across people by their conformity to a pattern, such as equality, rather than
by their aggregated magnitude. They argue that although there may be many kinds of
life that qualify as valuable, still there are essential human “functional capabilities”
(mobility, pleasure, happiness, cognition, play, health) without which the good life is
unachievable. Because this approach relies on a conception of core or essential human goods, it is often called essentialist.”
Whether one adopts Bentnam's experiential approach or Aristotelian essentialism, the very endeavor to assess
individual well-being, let alone to aggregate the results, is problematic for people with
disabilities. Since impairments are limitations of one capacity to perform actions, tasks,
or social roles, and since they often cause pain, discomfort, or distress, is it inevitable on
any definition of “good life” that the lives of people with disabilities are of less value?
Are any of the “normal” or “standard” functional capacities of human beings essential to
well-being, or are they only contingently related? Does severity of impairment matter? Is there a lower
threshold of functional capacity below which a life lacks value, whatever else may be happening in the person’s life? Are
limitations in cognition or the senses more a threat to living a good life than limitations
in mobility or strength; is a life of physical pain worse than a life of emotional distress?
Does it make any sense to compare impairments in this manner, or to rank them with
respect to their impact on the quality of a person’s life? These are just some of the kinds
of questions that arise when impairment is brought into the domain of moral value in
the analysis of the value or quality of a human life. It is true that classical and modern philosophers have
often assumed without argument or discussion that all impairments substantially reduce quality of life. Similar assumptions of
inherent inferiority have been made on racial, gender, and cultural or religious grounds. Still, the case of impairment may be
different. Even
if we rely on the modern conception of disability as an interaction between
features of an individual’s body or mind and the physical, social, and attitudinal
environment, and insist that it is a person’s environment, as well as or instead of his or her physical and
mental differences, that account for the disability, still impairments have a reality that should
not be ignored or glossed over. We may be confident that the lower quality of life of women is entirely the product
of sexism, but it would be intellectually dishonest to insist either that chronic pain or severe depression has no effect on the value of
a life or, worse yet, that the negative value of pain and depression is somehow “socially constructed.” There are very practical
indeed life or death consequences of this realm of ethical debate for people with disabilities. If
a fetus has a low quality
of life because of congenital or acquired impairments, should that be a reason to abort
it? Should we insist on prenatal screening to make sure that the children that are born
are not disadvantaged from the beginning by a low quality of life? When there is a scarcity of
medical resources, should it matter that one potential recipient is also dis— abled and so would not have as good an outcome as
another recipient who is able-bodied? Should we make it easier for people with severe disabilities to kill them- selves, or be
euthanized, than it is for other people? In
light of these possible implications, some disability scholars
have argued that the notions of “quality of life,” the “good life,” and “well-being” are
dangerous nonsense. Some have insisted that what makes life valuable is entirely a matter for
the individual—with or without a disability—to decide (so-called experts will inevitably judge lives with
disabilities to be worse than individuals with those disabilities think they are). Such radical responses, however, create their own
ethical issues. Eliminating the notions of the good life and quality of life from our ethical lexicon would eliminate important ethical
dialogue: Surely, we want to insist that It IS ethically better to live free, to have our basic needs met, and to enjoy equal
opportunities. We need to agree on what makes a life go well, what improves the quality of our lives, in order to better the lives of
people and reduce what we all perceive as great, undeserved inequalities. What improves or devalues a life. moreover, is not merely
subjective opinion: Not even saints or sages are infallible about what makes their lives go well. We may not want to leave it to
“experts” to decide on the components of human well- being, but that does not mean that every individual must be the ultimate
arbiter of his or her own good; it may be a matter for deliberation and consensus.
Reject impact assessment hierarchies- ableism must be taken into account
beyond disability studies
Wolbring 12 (Gregor Wolbring, professor of Community Rehabilitation and Disability Studies
at the University of Calgary, 2012, “Expanding Ableism: Taking down the Ghettoization of Impact
of Disability Studies Scholars”, Societies,
Abstract: This paper highlights the utility of an expanded ableism
concept beyond how it is used in disability
studies; expanding the concept of ableism so it connects with all aspects of societies and making ableism
applicable to many academic fields. It introduces this expanded form of ableism as a new angle of cultural
research and suggests it to be one possible venue for disability studies scholars to escape the ghettoization of
their impact. Keywords: ableism; ability studies; disability studies; society 1. Introduction The concept of impact is all
around us and influences many discourses [1–3]. We live in an impact assessment society with
culturally constructed hierarchies of impact importance. Academics are expected to have an
impact [4] for example through their publications [5]. The impact of their research is evaluated constantly
[6]. Knowledge translation is a buzzword to describe another expected impact of academic work [7,8]. Universities are seen to
have to change their priorities and cultures ―as a result of the recognition by governments that they are at
the heart of their efforts to build competitive knowledge economies‖ [9]. As academics, we seem to live in a culture of impact. In this
paper, I
will submit impact considerations that an academic disability studies researcher might have to
take into account. The field of disability studies and disabled people activists were the first to look at cultural dynamics and
the cultural impact of ability preferences, coining the term ableism [10] as a cultural concept in the process. I showcase in this paper
the utility of an extended form of ableism which I submit can become a seed for new discourses, perspectives and paradigms that
focus on ability favouritism as a basis for analysing existing and future cultural dynamics. I see ableism as a concept essential
for being able to deal with ability expectation challenges for societies and individuals to come,
especially for those linked to advances in science and technologies [11]. I submit that the extended form of
ableism is a possible way for disability studies scholars to escape among other things the ghettoization of their impact.
Framing – Social Model
The social model is essential to challenge the flaws in the legal system and
create unification in challenging the state
Oliver 13, Mike – British academic, author, and disability rights activist. He is Emeritus Professor of Disability Studies at
the University of Greenwich “The Social Model: Thirty Years On” 22nd July 2013 Disability & Society//mr
The idea behind the
social model of disability stemmed from the Fundamental Principles of Disability document first
published in the mid-1970s (UPIAS 1976), which argued that we were not disabled by our impairments but by
the disabling barriers we faced in society. A couple of years later I was teaching the first master’s course in what has
now come to be called disability studies in the United Kingdom. The course was for qualified social workers and other professionals,
and I wanted to help my students develop a means of translating that simple idea into their everyday work with disabled clients and
their families. So in the early 1980s I introduced both the individual and social models of disability (Oliver 1983) aimed largely at
professionals. I suggested that until that point those working with disabled people had operated largely within a framework based
on the individual model, and that in
order to make their practice more relevant to the needs of disabled
people they needed to re-orient their work to a framework based upon the social model. At no
point did I suggest that the individual model should be abandoned, and neither did I claim that the social
model was an all-encompassing framework within which everything that happens to disabled
people could be understood or explained. Subsequently, however, the social model took on a life of its own and
it became the big idea behind the newly emerging disability equality training. It also soon became the vehicle for
developing a collective disability consciousness and helped to develop and strengthen the
disabled peoples’ movement that had begun to emerge a decade earlier. Armed with the idea that
we needed to identify and eradicate the disabling barriers we had in common, the disabled
peoples’ movement forced the media to change their images of us, transport providers to open
up many of their services to us, public buildings to become much more accessible and the legal
system changed to make it illegal to discriminate against us. Of course there were some barriers that
proved, and continue to prove, much more intractable. The hegemony of special education has barely been challenged in schools,
although in further and higher education some disabling barriers have been removed. The social model has also barely made a dent
in the employment system because, although it has identified many of the disabling barriers in the international labour market and
with the behaviour of employers, the solutions offered have usually been based on an individual model of disability. Almost from the
beginning, critics of the social model began to emerge. Initially these came from the major disability charities and many professional
organisations who felt that their dominance of our lives was under threat. Ironically many of them now see
the social
model as central to their operations and often act as if they invented it in the first place. Some years later, some
disabled people and academics involved in the newly emerging disability studies also began to question the
value and relevance of the social model. It is not my intention to reprise these criticisms here but basically they can
be divided into two main areas of concern. The first of these suggests that there is no place for impairment within the social model
of disability. The second alleges that the social model fails to take account of difference and presents disabled people as one unitary
group, whereas in reality our race, gender, sexuality and age mean that our needs and lives are much more complex than that.
Overall these critics have argued that the social model is only a limited and partial explanation for what is happening to disabled
people in the modern world. In recent years it
has sometimes seemed as if these criticisms have received
more prominence than the social model itself. Many academic papers and some books have been published whose
main concern has been to attack, reform or revise the social model, and reputations and careers have been built on the back of
these attacks. My own response to these attacks has always been fairly relaxed because I
have never seen the social
model as anything more than a tool to improve peoples’ lives and I have been happy to agree that it does
not do many of the things its opponents criticise it for not doing. Indeed, in 1990 I published a book that attempted to develop a
more all-encompassing explanation of what was happening to disabled people in the modern world (Oliver 1990). It is this that is
often referred to as the book which promoted and developed the social model when, in fact, it was only discussed in three pages in
the whole book. Even when I and a colleague updated this text, the social model did not play a significant part (Oliver and Barnes
2012). I can only assume that those who have argued that central to my work has been the promotion and policing of the social
model have based their evidence solely on inaccurate commentaries and that they have not bothered to read what I actually said.
However I, and others, have often pointed out that focusing
on impairment and difference will only depoliticise the social model and will not lead to the development of any approaches or
alternative models that are likely to be useful in developing campaigns to improve or defend
the lifestyles of disabled people. Essentially these arguments between academics and political activists mattered very
little while the global economy was operating in boom mode, but when it went bust things changed very quickly for the vast
majority of people throughout the world, disabled people among them. Just
as we had predicted, emphasising
impairment and difference was a strategy that was impotent in protecting disabled people, our
benefits and services, from the economic firestorm that was raging around us. In fact government
policy has now begun to use these criticisms of the social model by bringing impairment and
difference back into their economic and social policy while steadfastly ignoring the barriers we
still face. Hence cuts in our benefits are being justified on the grounds that the intention is to give
more to those who are severely impaired (and hence deserving) and not to those who are not (and hence
undeserving). Our differences are being used to slash our services as our needs are now being
assessed as being moderate, substantial or critical and many local authorities are now only
providing services to those whose needs are critical. The disabled peoples’ movement that was
once united around the barriers we had in common now faces deep divisions and has all but
disappeared, leaving disabled people at the mercy of an ideologically driven government with
no-one to defend us except the big charities who are driven by self-interest. As a consequence of this,
most of the political campaigning that has taken place in defence of our benefits and services have forced disabled people back into
the role of tragic victims of our impairments and has involved others undertaking special pleading on our behalf. In fact it
taken us back more than 30 years to the time before the social model came into existence.
Those who have talked down the social model while failing to replace it with something more
meaningful or useful must bear a heavy burden of responsibility for this state of affairs.
Remarkably they have been rather silent in speaking out or building alternative models to
address what is happening to disabled people now. Surely it is time to either re-invigorate the social model or
replace it with something else. One thing is for sure; the talking has to stop.
Framing – Posthumanism
Disability debates requires a posthumanist framing- that moots the impact to
human extinction
Goodley 14 (Dan Goodley, Rebecca Lawthom and Katherine Runswick Cole, Dan Goodley is
Professor of Disability Studies and Education at the University of Sheffield. Recent texts include
Dis/ability Studies (Routledge, 2014) and Disability Studies (Sage, 2011). His work engages
critical studies of ableism and disablism to interrogate the gains and losses of those working at
the dis/ability complex. Rebecca Lawthom is Professor of Community Psychology at Manchester
Metropolitan University. Her work engages at the intersections of feminism, disability and
migration. Publications include Community Psychology (Wiley Blackwell, 2011, with Kagan,
Burton and Duckett) and Qualitative Methods in Psychology: A research guide (Open University
Press, 2012, with Banister, Bunn, Burman, Daniels, Duckett, Parker, Runswick Cole, Sixsmith and
Goodley). Katherine Runswick-Cole is Senior Research Fellow in Disability Studies and
Psychology at Manchester Metropolitan University, UK. Her research and publications focus on
the lives of disabled children and their families, this includes Disabled Children’s Childhood
Studies (2013, Palgrave, edited with Tillie Curran) and Approaching disability: Critical issues and
perspectives (2014, Routledge, with Mallett). " Posthuman disability studies", 2014, Subjectivity,
what does it mean to be human in the 21st
Century and in what ways does disability enhance these meanings? In addressing this question we seek to work through entangled
This paper explores the human through critical disability studies and the theories of Rosi Braidotti. We ask:
connections of nature, society, technology, medicine, biopower and culture to consider the extent to which the human might be an outdated phenomenon, replaced by Braidotti’s posthuman condition. We then
Critical disability studies, we argue, are perfectly at ease
with the posthuman because disability has always contravened the traditional classical humanist
conception of what it means to be human. Disability also invites a critical analysis of the posthuman. We examine the ways in which disability and
posthuman work together, enhancing and complicating one another in ways that raise
important questions about the kinds of life and death we value. We consider three of Braidotti’s themes in relation to disability: I. Life
introduce disability as a political category, an identity and a moment of relational ethics.
beyond the self: Rethinking enhancement; II. Life beyond the species: Rethinking animal; III. Life beyond death: Rethinking death. We conclude by advocating a posthuman disability studies that responds directly
to contemporary complexities around the human whilst celebrating moments of difference and disruption. (1) Introduction: Have you ever been human? ‘Not all of us can say, with any degree of certainty, that we
have always been human, or that we are only that. Some of us are not even considered fully human now, let alone at previous moments of Western social, political and scientific history (Braidotti, 2013: 1). This
The human, as it is classically
understood, is a self-aggrandising, abstract ideal and symbol of classical humanity that was born
in Europe ‘predicated on eighteenth and nineteenth-century renditions of classical Antiquity and
Italian Renaissance ideals’ (Ibid: 13) and shaped, more recently, through modernist and
capitalist mouldings. ‘Humanity’ Braidotti (2013: 24) notes, ‘is very much a male of the species:
it is a he’. Moreover, ‘he is white, European, handsome and able-bodied’ (Braidotti, 2013: 24),
‘an ideal of bodily perfection’ (Ibid: 13), ‘implicitly assumed to be masculine, white, urbanized,
speaking a standard language, heterosexually inscribed in a reproductive unit and a full citizen of
a recognised polity’ (Ibid: 65), ‘a rational animal endowed with language’ (Ibid: 141). This means that
while all citizens are humans ‘some or more mortal than others’ (Ibid: 15) and, conversely, some
are more disposable than others. This humanism has a Eurocentric core and Imperialist
tendencies, meaning that many of those outside of Europe (including many in the colonies)
became known as less than human or inhuman. To this, of course, critical disability studies scholars would add humanism’s convenient relationship with
quote kick-starts Rosi Braidotti’s text and initiates a key task of her book: to target/secure the problem/possibility of the post/human.
medicalisation and psychologisation as colonizing tendencies of the body and psyche. ‘The disabled’ and the ‘Non-Europeans’ (grouped as homogeneous categories) become known in terms of what they are not.
Humanism’s arrogant centering of classical ‘man’ fitted directly with what Lacan (1977) would
term a mis-recognition of selfdetermination and authority. And this authoritative humanist ideal is one that people rarely match up to you.
Nevertheless, Braidotti acknowledges a number of emancipatory offerings of humanism. These include
civil rights based upon definitions of humanity; normative legal systems respecting the right to
live as a human being and pan-national declarations cherishing this phenomenon called the
human. We could cite here, for example, the opportunities for humanist recognition offered by the United Nations Convention on the Rights of Persons with Disabilities. Braidotti does,
though, remain antagonistic towards humanism’s rigidity and narrowness, which invites some
into its fold whilst banishing others. We share this view. She aligns herself with poststructuralists (like Foucault and Derrida), postcolonialists (Fanon and Shiva) and
feminist philosophers (including Irigaray, Kristeva and Butler) and shares their deconstructive desires to destabilise humanist man. One way in which she differs from these thinkers is her tendency to think
what productive alternatives might emerge in response to
the oppressive nature of humanism? Deconstructing existing frames of humanity need not lead
to despair nor nihilism but an affirmative positionality. This stance is rooted in her accessible
and politicised use of Deleuze and Guattari (e.g. 1987) and carried forward in reference to (and dialogue with) contemporaries such as Donna Haraway,
Elizabeth Grosz and Achille Mbembe. Braidotti acknowledges risks but also, crucially, identifies theoretical, political and artistic opportunities. She is clear, humans are not so easily
recognisable today; they have to find their selves in the ‘complexity of contemporary science,
politics and international relations’ (p2) which include debates, developments and controversies
relating to ‘robotics, prosthetic technologies, neuroscience and bio-genetic capital … [through
to] fuzzier new age visions of trans-humanism’ (Ibid: 2). Like it or not; new technologies mean that we live in very different times to those of our ancestors.
affirmatively rather than negatively. Instead of identifying hopelessness she asks;
These new times we might define as ‘the posthuman condition’, times that ‘urge us to think critically and creatively about who and what we are actually in the process of becoming’ (Ibid: 12). This condition, she
accepts, ‘provokes elation but also anxiety … about the possibility of a serious decentring of ‘man’; the former measure of things’ (Ibid). Like poststructuralists and postmodernists before her, Braidotti is clear:
the old modernist idealisation of the unitary, rational, independent, dislocated, solitary, ablebodied human subject has been revealed as a fiction. The self, subject, person, citizen, the human – each of these individualised entities – is now
firmly interconnected, plugged into and caught up in the ever growing whirlpool of capital, technology, communication that shift us through real and virtual places and spaces. The 21st Century citizen is a
‘knowing subject’ with the potential to ‘free us from the provincialism of the mind, the sectarianism of ideologies, the dishonesty of grandiose posturing and the grip of fear’ (Ibid: 11). A recurring anxiety
expressed by Braidotti, throughout the text, is that social theory is in danger of lagging behind the many posthuman transformations already occurring everyday across the globe. And they all leave from a point of
departure: humanism. Braidotti (2013: 29) acknowledges that ‘one touches humanism at one’s risk and peril’ (Ibid: 29) and ‘rejecting the enlightenment legacy would be inherently contradictory for any critical
project (Ibid: 36). Humanism, she acknowledges, has supported liberal notions of autonomy, responsibility, self-determination, solidarity, community-bonding, social justice and principles of equality (Ibid: 29).
These practices remain important, especially for those groups of society who have, in the words of Braidotti, never been known as human.
Disabled people have historically
been excluded from the category of the human and continue to demand inclusion into this category. Hence, we are not suggesting in this paper to give up
on the functional utility of human rights nor the social justice of liberal principles of equality in our fight to challenge disablism (the exclusion of people with impairments from mainstream society). There is of
course a time and place for humanism: especially when such a register remains the commonsensical and dominant way of thinking about the human. We will return to this consideration later on in the paper. We
This epistemic
violence of humanism, which reduces certain non-Western others to sub-human status, ‘is a
constitutive source of ignorance, falsity and bad consciousness for the dominant subject who is
responsible for their epistemic as well as social dehumanization’ (Ibid: 28). It is also a common practice of Global North social scientific
research (Teo, 2010). ‘Humanism’s universalism, primacy of rationality, the unitary subject’ (Braidotti, 2013: 31) is the
white man’s burden where women ‘were assigned to the pole of un-reason, passions and emotions, keeping them in the private sphere’ (Ibid: 34). The humanist subject defines himself as
also recognise, though, that these humanist offerings come at a price: they are hegemonically enshrined through a marking of those that count as human and those that do not.
much by ‘what he is excluded from’ and defends himself through a violent and belligerent reaction to ‘the sexualised, racialised and naturalised others that occupied the slot of devalued difference’ (Ibid: 144). For
some of these others (or perhaps we should say Others), being human already feels alien; ‘because my sex, historically speaking, never quite made it into full humanity, so my allegiance to that category is at best
negotiable and never to be taken for granted’ (Braidotti, 2013: 81).
We see similar parallels with the historical disavowal of disabled
people. ‘For me’, Braidotti reflects, ‘it is impossible, both intellectually and ethically, to disengage the positive elements of Humanism from their problematic counterparts: individualism breeds egotism
and selfcentredness; self-determination can turn to arrogance and domination; and science is not free from its own dogmatic tendencies’ (2013: 30). We seek to take up the challenge set by Braidotti’s (2013:153)
to ‘find the courage to move beyond an exclusive concern for the human … and to embrace
more planetary intellectual challenges’. This not only means shifting how we understand the
human but also rethinking our relationships with our environments, our world and human and
non-human inhabitants of our planet. And doing this rethinking through disability. The shift back and forth
between humanism and anti-humanism has endlessly occupied theorists and activists. Instead, Braidotti demands, we need to think again: to desire ‘posthumanism as a move beyond these lethal binaries’ (Ibid:
Posthuman ways of being and becoming reshape the identity of humanistic practices by
‘stressing heteronomy and multi-faceted relationality, instead of autonomy and self-referential
disciplinary purity’ (Ibid: 145). Disability, too, encourages such reshaping.
Adv – Status Quo
Top Level
The Trump Administration is barring immigrants with disabilities from obtaining
LPR status
Davis 18 (Michelle R. Davis, Disability Scoop, 4/30/18, “Trump Administration Seeks To Bar Immigrants with
The Trump administration is moving to make it more difficult for immigrants with disabilities
and their families to get a visa or attain permanent residency in the United States. A proposal from
the U.S. Citizenship and Immigration Services, part of the Department of Homeland Security, would alter how immigrants are evaluated as they seek the
right to permanent residency — the step before citizenship. The use, or potential use, of public services by immigrants or
their family members are considered “heavily weighted negative factors” in the draft document. Some of the
examples cited as negatives include high-cost medical conditions and many uses of social services, like
food assistance, Medicaid, unemployment and disability benefits. The category “mental disorders” is
on a list of the five most expensive health conditions contained in the draft regulations. Advertisement - Continue Reading Below
Disability rights groups have raised concerns about the proposed changes and said that even though the proposal has yet to be adopted, it is already
having an impact in the disability community. “People are very scared,” said Michelle Garcia, the Latino community organizer for Access
Living, a Chicago-based disability advocacy organization. “They’re scared of going to a hospital or getting support and
services” because it may negatively impact their immigration status. Garcia said she works with immigrant
clients who have children with disabilities who are American citizens. However, they’re not seeking services for their children, out of
fear it could lead to their own deportation or count against them in their efforts to stay in the
country. “Already people are being told that if their child seeks services, then they as a parent may not be able to fix their (residency) status later on,” Garcia said.
According to the draft document, the goal of the proposed changes would be to make sure those seeking a visa
or residency would be self-sufficient and less likely to use public services. Those who may need such services are
defined as a “public charge” in the proposal. The proposed changes would primarily impact immigrants who are
applying for a green card through a family-based petition. “This rule will have a disproportionate and discriminatory impact on
people with disabilities,” said Julia Bascom, executive director at the Autistic Self Advocacy Network, in a statement. “Disability or need for supports and services should never
impact someone’s immigration status.” The proposal seeks to update existing federal guidance that’s been in place since 1999, said Gabrielle Lessard, senior policy attorney for
That guidance only considered two benefits as negatives, she said: cash
assistance and long-term hospitalization care. The proposed regulations expand that list to a
wide range of social services, including most government-funded health care, Lessard said. “Everyone should be
concerned about this,” Lessard said. “This is asking people to make cruel choices between getting assistance with
health and nutrition and being able to join their family members.” A spokeswoman for DHS’s Citizenship and Immigration
the National Immigration Law Center.
Services office said she could not comment on the proposed rule because the rulemaking process is not complete. She noted that the proposed rule will soon be published in the
Federal Register and public comments are encouraged. At the same time the United States is pursuing this change, Canada is moving in the opposite direction. For decades, the
Canadian government had rules in place that allowed the government to reject permanent resident applications from people with disabilities or medical conditions who would
. The Canadian government announced
April 16 that it will update its definition of social services for immigration purposes to delete language
referring to special education, social and vocational rehabilitation services and personal support
services as services that would allow the government to reject a permanent residency petition.
The changes “are a major step forward in ensuring our immigration system is more inclusive of
persons with disabilities, and reflects the values of Canadians,” Ahmed Hussen, the country’s minister of immigration, refugees and citizenship said in a
be likely to use government-funded social services, or with family members who fall into that category
Public charge inadmissibility will be expanded to exclude “potential/future” use
and non-monetary benefits
Miroff 18 (Nick Miroff, journalist for the Washington Post since 2006, master’s degree in
journalism from UC Berkeley, 3/28/18, “Trump proposal would penalize immigrants who use tax
credits and other benefits”,
Immigrants who accept almost any form of welfare or public benefit, even popular tax
deductions, could be denied legal U.S. residency under a proposal awaiting approval by the
Trump administration, which is seeking to reduce the number of foreigners living in the United
States. According to a draft of the proposal obtained by The Washington Post, immigration
caseworkers would be required to consider a much broader range of factors when determining
whether immigrants or their U.S.-citizen children are using public benefits or may be likely to do
so. Current rules penalize immigrants who receive cash welfare payments, considering them a “public charge.” But the
proposed changes from the Department of Homeland Security would broaden the government’s
definition of benefits to include the widely used earned-income tax credit as well as health
insurance subsidies and other “non-cash public benefits.” The changes would apply to those
seeking immigration visas or legal permanent residency, such as a foreigner with an expiring work visa. While
they would make little difference to those living here illegally, it could affect immigrants protected by the Deferred Action for
Childhood Arrivals program — whose termination has been blocked by federal courts — if they attempt to file for full legal
residency. Immigrants
and their families facing a short-term crisis could have to forgo help to avoid
jeopardizing their U.S. residency status. The proposal would also require more immigrants to
post cash bonds if they have a higher probability of needing or accepting public benefits. The
minimum amount would be $10,000, according to the DHS proposal, but it could be set higher if
an applicant is deemed at greater risk of neediness. DHS officials say the proposal is not finalized. But the
overhaul is part of the Trump administration’s broader effort to curb legal immigration, and
groups favoring a more restrictive approach have long insisted that immigrants are a drag on
federal budgets and a siphon on American prosperity. “The administration is committed to enforcing existing
immigration law, which is clearly intended to protect the American taxpayer by ensuring that foreign nationals seeking to enter or
remain in the U.S. are self-sufficient,” DHS spokeswoman Katie Waldman said in a statement. “Any proposed changes would ensure
that the government takes the responsibility of being good stewards of taxpayer funds seriously and adjudicates immigration benefit
requests in accordance with the law,” she added. DHS
officials say the agency is preparing to publish the
proposed rule changes in the Federal Register and invite public comment, but they have not set a date.
Reuters reported on the proposed changes in early February, and Vox has published excerpts of a draft. But a more recent,
223-page version obtained by The Post shows that the proposal is more extensive than
previously reported. “It’s striking that after strong public criticism of a leaked draft rule, the
administration seems to be considering a version that goes even further, and they’re actively
considering whether to use this rule to create new grounds for deporting legal immigrants,” said
Mark Greenberg, a senior fellow at the Migration Policy Institute, which has been critical of
Trump policies. One notable aspect of the proposal indicates that native-born Americans use public benefits at roughly the
same rate as the foreign-born population. Out of the 41.5 million immigrants living in the United States, 3.7
percent received cash benefits in 2013, and 22.7 percent accepted noncash benefits including
Medicaid, housing subsidies or home heating assistance, according to statistics compiled by U.S.
Citizenship and Immigration Services. Those figures were nearly identical to the percentage of
native-born Americans who get the same forms of assistance. Of the 270 million nonimmigrants, 3.4 percent
received cash welfare that year, USCIS research found, and 22.1 percent received noncash benefits. U.S. authorities have
long had the ability to deny residency and other benefits to noncitizens who are dependent on
public assistance. Concerns about such dependency were partly the basis for the family-based
immigration model in place for the past half-century, requiring sponsors to assume financial
responsibility for relatives they wish to bring into the country. Trump blames that model for
facilitating what he calls “horrible chain migration.” One of the most radical changes outlined in the proposal
would consider refundable tax income credits, including the earned-income tax credit created to help working families with low and
moderate incomes. According to recent estimates, it is used by nearly one-fifth of American taxpayers, particularly those who work
in relatively low-paid service industries. Under the proposed changes, immigration
caseworkers would not consider
benefits derived from service in the armed forces or some other government jobs, as well as
disability, workers’ compensation and Medicare, unless the premiums are fully paid by the
public. It would also exclude elementary and secondary public education and early childhood
development programs in the Head Start Act. But children would be considered a negative factor for caseworkers
evaluating whether an immigrant is likely to use public assistance or benefits. “An applicant’s family status is a factor that must be
considered when an immigration officer is making a public charge determination,” the proposal states. “DHS
will consider
whether the alien being a dependent or having dependents . . . makes it more or less likely that
the alien will become a public charge.” The proposal notes that “the receipt of noncash benefits tended to increase as
family size increased in 2013.” Jonathan Withington, a USCIS spokesman, said the proposed changes will be published in 2018, but
he said he couldn’t discuss the contents and that no final decision has been made. “While DHS reviews the proposed change, any
draft documents circulating internally are considered pre-decisional and have not been approved for submission to the Office of
Management and Budget,” he said. A person with knowledge of the deliberations said the draft is essentially complete and awaiting
final approval by Homeland Security Secretary Kirstjen Nielsen. The proposed rule appears to have generated consternation among
some USCIS employees. At a recent town-hall-style staff meeting, one worker challenged Director L. Francis Cissna, according to a
recording of the encounter shared with The Post. “On a personal level, I think I can say with confidence that my destitute and
illiterate great-grandparents would not have been welcomed in this country under something like the very ill-conceived public
charge rule that is currently in the process of development,” the staffer said. He told Cissna that such
changes were
hurting employee morale. “Given that neither the headquarters nor the policy environment
seem likely to change in the next three years, what will you do to maintain and retain, I should say, a motivated and
engaged headquarters workforce?” he asked Cissna. “Administrations change. Policies change,” Cissna replied, according to the
recording. “I’ve had to implement all sorts of things . . . that I didn’t like. But we do our job.” “I
think that we all have to
remember we are civil servants, and we all serve the president,” Cissna told his staff. “We’re
going to follow his directives.”
Public charge expansion to deny LPR status discriminates against immigrants
Gupta 18 (Prachi Gupta, senior reporter at Jezebel, 3/28/18, “The Department of Homeland
Security Has Found a New, Horrific Way to Punish Immigrants”, The Slot,
The Department of
Homeland Security Has Found a New, Horrific Way to Punish Immigrants The Department
of Homeland Security, eternally committed to finding new and creative ways to screw immigrants
and people of color in the United States, is threatening to deny residency to immigrants who
use virtually any public benefit—including claiming common tax credits. The Washington Post obtained a
copy of a new DHS policy proposal that will, per the Post, punish immigrants “who accept almost any form
of welfare or public benefit, even popular tax deductions” by denying immigrants visas, visa
extensions, or permanent residency status if officials deem that they receive, or are likely to
receive such benefits. While media outlets previously reported on the proposal, the full draft shows how far Trump’s
administration is willing to go to deny immigrants basic public services and increase their
vulnerability to deportation—regardless of status. Currently, DHS’s U.S. Citizenship and Immigration Services
considersnon-citizens inadmissible if they are seen as a “public charge”—that is, if they are “likely to become primarily dependent on
the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or
institutionalization for long-term care at government expense.” In the new proposal, DHS
outlines that individuals
applying for residency must prove they are “not likely at any time to become a public charge”:
The Department of Homeland Security (DHS) proposes to change how it determine whether an alien is inadmissible to the United
States because he or she is likely at any time to become a public charge consistent with section 212(a)(4) of the Immigration and
Nationality Act (INA). Aliens who are seeking adjustment of status or an immigrant visa, or who are applicants for admission, must all
establish that they are not likely at any time to become a public charge. Moreover, DHS will require aliens seeking an extension of
stay or change of status demonstrate that they are not using or receiving, nor likely to use or receive, public benefits. However,
DHS is sneakily trying to expand the definition of “public charge” to include additional
government programs, including health insurance subsidies, the Earned Income Tax Credit—
claimed by an estimated 20 percent of all Americans—and other “non-cash public benefits.” The
Post describes the changes: Under the proposed changes, immigration caseworkers would not consider
benefits derived from service in the armed forces or some other government job, as well as
disability, workers’ compensation and Medicare, unless the premiums are fully paid by the
public. It would also exclude elementary and secondary public education and early childhood
development programs offered under the Head Start Act. But children would be considered a negative factor
for caseworkers evaluating whether an immigrant is likely to use some form of public assistance or benefit. “An applicant’s family
status is a factor that must be considered when an immigration officer is making a public charge determination,” the proposal states.
“DHS will consider whether the alien being a dependent or having dependents . . . makes it more or less likely that the alien will
become a public charge.” It’s worth noting, too, that according
to USCIS, immigrants use public assistance at
the same rates as U.S. citizens—so this new policy isn’t just an overreaction to immigrants
using public benefits. It’s simply a reaction to immigrants existing in America.
Trump increasing public charge requirements- means applicants, immigrants
and children face negative health and financial consequences along with fear of
Altman 18 (Drew Altman, PhD in political science from MIT, President of the Henry J. Kaiser
Family Foundation, journal on public heath, honorary doctorate from the Morehouse School of
Medicine, member of the Council on Foreign Relations and the Institute of Medicine, former
Director of the Health and Human Services at the Pew Charitable Trusts, former Vice President
of the Robert Wood Johnson Foundation, February 2018, “Proposed Changes to “Public Charge”
Policies for Immigrants: Implications for Health Coverage”,
A draft version of a proposed
rule by the Trump Administration would make changes to “public charge”
policies that govern how use of public benefits may affect individuals’ immigration status. This fact
sheet provides an overview of the proposed changes and their implications for health and health coverage.  Individuals who
are determined to be a “public charge” can be denied lawful permanent residence or entry into
the U.S., and, in very limited cases, deported. Under current policy, individuals may be determined a
public charge if they rely on or are likely to rely on public cash assistance or government funded
long-term institutional care. Current policy does not allow the federal government to consider the use of non-cash
benefits, such as health and nutrition programs, in public charge determinations.  Under the draft proposed policy,
the federal government could consider previously excluded health, nutrition, and other non-
cash programs in public charge determinations. In addition, the changes would newly allow the
federal government to take into account use of programs by citizen children and other family
members in making a public charge determination.  The changes would likely lead to decreased
participation in Medicaid, the Children’s Health Insurance Program (CHIP), and other programs
among legal immigrant families, including their citizen children. The primary group affected by the changes
would be individuals seeking a green card through a family-based petition. However, the changes would likely increase
fear and confusion among all legal immigrant families, leading to decreased participation in
health coverage and other programs for themselves and their children. Decreased participation
in these programs would contribute to more uninsured and negatively affect the health and
financial stability of families as well as growth and healthy development of their predominantly
U.S.-born citizen children. A draft version of a proposed rule by the Trump Administration would make
changes to “public charge” policies that govern how use of public benefits may affect
individuals’ immigration status. This fact sheet provides an overview of the proposed changes and their implications for
health and health coverage of legal immigrant families and their predominantly U.S.-born citizen children. The proposed changes to
public charge policies would primarily affect immigrants who are applying for a green card through a family-based petition. The
draft changes would affect lawfully present immigrants seeking to become LPRs or “green card” holders and individuals
seeking to immigrate to the U.S. 1 Most individuals seeking to adjust to LPR status or seeking to immigrate to the U.S.
are immediate relatives of U.S. citizens or have a family-based sponsor. In 2016, 1.2 million individuals obtained LPR status, including
over half a million who were already present in the U.S.2 Some immigrants remain exempt from public charge determinations under
law, including refugees, asylees, and certain other groups. Public charge policies do not apply to LPRs seeking to obtain citizenship.
However, obtaining LPR status is a key step toward citizenship for immigrants seeking naturalize. The proposed changes would likely
increase confusion and fear among all legal immigrant families about using public programs for themselves and their children
regardless of whether they are directly affected by the policy change. In 2016, there were 23 million noncitizens residing in the U.S.
About six in ten noncitizens were lawfully present immigrants, who include LPRs, refugees, asylees, and other individuals who are
authorized to live in the U.S. temporarily or permanently.3 In addition, over 19 million or one in four (25%) children live with an
immigrant parent, and nearly nine in ten (86%) of these children are U.S.-born citizens.4 Individuals
who are determined
likely to become a “public charge” can be denied lawful permanent residence or entry into the
U.S. Under longstanding policy, if authorities determine that an individual is “likely to become a
public charge” (i.e., a person dependent on the government for subsistence), they may deny
that person’s application for lawful permanent residence or their entry into the U.S.5 Becoming
a public charge may also be a basis for deportation in extremely limited circumstances.6 Certain immigrants,
including refugees and asylees, are exempt from public charge determinations under law. Under current policy, the federal
government does not consider use of Medicaid, CHIP, or other non-cash benefits in public charge determinations. Historically, there
has been confusion about whether use of Medicaid or CHIP and other non-cash programs apply in public charge determinations. 7 In
1999, the Immigration and Naturalization Service (now part of the Department of Homeland Security) issued clarifying guidance
specifying that acceptance of cash assistance for income maintenance as well as government funded long-term institutional care
may be considered in conjunction with other factors in public charge determinations. 8 Use of Medicaid, CHIP, or other supportive
programs cannot be considered in public charge determinations, with the exception of use of Medicaid for long-term institutional
care.9 The guidance noted that this clarification was necessary because ongoing confusion about public charge policies has,
“deterred eligible aliens and their families, including U.S. citizen children, from seeking important health and nutrition benefits that
they are legally entitled to receive. This reluctance to access benefits has an adverse impact not just on the potential recipients, but
on public health and the general welfare.” 10 Under current policy, use of benefits by family members, including citizen children, is
not considered in public charge determinations. The guidance specifies that officers should not attribute cash benefits received by
children or other family members to the individual for purposes of making a public charge determination, except in cases in which
the family is reliant solely on that assistance. The
draft proposed rule would substantially broaden the
programs that the federal government could consider in public charge determinations to include
health, nutrition, and other non-cash programs. The draft proposed rule defines a public charge as a person who is
dependent on public benefits or likely to become dependent on public benefits at any time. It specifies certain health and nutrition
programs as public benefits, including Medicaid, CHIP, and subsidies for Marketplace coverage as well as the Supplemental Nutrition
Assistance Program (SNAP) and the Women Infants and Children (WIC) program (Table 1). Cash assistance for income maintenance,
including Supplemental Security Income (SSI), the Temporary Assistance for Needy Families (TANFI) program, and state and local
general assistance continue to count as public benefits. The draft proposed rule also specifies certain types of assistance that the
federal government may not consider in public charge determinations, including emergency disaster relief and school lunch
programs. The draft proposed rule would newly allow the federal government to consider use of benefits by citizen children and
other family members in making public charge determinations. The draft proposed rule notes that the federal government may
consider whether the individual is receiving any public benefit, has received any benefit within the last two years, and whether
dependent family members, including a citizen child, has received benefits. In
making a determination, use of public
benefits would be considered as part of the totality of an individual’s circumstances and
weighed against other factors, including age; health; family status; assets, resources, financial
status; and education and skills. However, the draft proposed rule notes that current use of public benefits or having
received benefits for more than six months within the previous two years would be a heavily weighted negative factor in
determinations. Certain health circumstances also would be a heavily weighted negative factor. These
example, an individual having a costly medical condition and being unable
would include, for
to show proof of unsubsidized health
insurance or means to pay for treatment without government funds. Today, Medicaid and CHIP help fill gaps in private coverage
for lawfully present immigrants, providing them access to needed care and financial protections that support their ability to work
and the growth and healthy development of their children. Medicaid
and CHIP provide families access to
preventive and primary care, including prenatal care, as well as care for chronic conditions. In
addition, the coverage provides families financial protection from high medical costs. By
enabling families to meet their health care needs, Medicaid and CHIP support families’ ability to
work and promote growth and healthy development of their children. The majority of lawfully present
immigrants live in a family with at least one full-time worker (83%), a rate equal to that of citizens.11 However, lawfully present
immigrants are more likely than citizens to live in low-income families and often work in jobs and industries that do not offer health
coverage. Reflecting
their lower incomes and limited access to private coverage, one in four
nonelderly lawfully present immigrants has Medicaid or CHIP coverage.12 However, among the lowincome nonelderly population, lawfully present immigrants are less likely than citizens to have Medicaid
or CHIP coverage, reflecting eligibility restrictions for immigrants. 13 Lawfully present immigrants may
qualify for Medicaid and CHIP, including the Affordable Care Act (ACA) Medicaid expansion to low-income adults, but many must
wait five years after obtaining lawful status before they may enroll. In addition, many eligible lawfully
present immigrants are not enrolled due to multiple enrollment barriers, including fear. The proposed changes would likely lead to
decreased participation in Medicaid, CHIP, Marketplace coverage, and other programs among immigrant families, including their
citizen children. Despite
broad efforts to assure the immigrant community that Medicaid and CHIP
could not be used in public charge determinations under current policy, many eligible lawfully
present immigrants did not enroll themselves or their children because they feared it could
negatively affect their status. This policy change would amplify these fears because use of
Medicaid and CHIP and other programs could now have negative repercussions on immigration
status. Further, the Administration’s increased focus on immigration enforcement and
restriction has led to growing fears among legal immigrants about the stability of their status. 14
Increased fears would likely extend beyond individuals directly affected by the policy to the
broader immigrant community. Due to increased fears, it is likely that fewer eligible individuals
would enroll themselves and their children in health coverage and that individuals who are
currently enrolled in programs would disenroll themselves and their children. Participation in
nutrition programs, like SNAP and WIC, would also likely decrease. Decreased participation in
Medicaid, CHIP, and Marketplace coverage would increase the uninsured rate among immigrant
families, negatively affecting their health and financial stability and the growth and healthy
development of their children. Without Medicaid, CHIP, or Marketplace coverage, more lawfully present
immigrants would become uninsured, widening the disparity in coverage they already face. As
of 2016, 17% of lawfully present immigrants were uninsured compared to 9% of citizens.15
Coverage losses would lead to reduced access to care for families, contributing to worse health
outcomes over time. Moreover, these effects would likely be compounded by reduced
participation in nutrition and other support programs. Decreased participation in these
programs would negatively affect the financial stability of families and the growth and healthy
development of children in these families, who are predominantly U.S. born citizens.
Adv – Health
Top Level
Public charge criminalizes access to healthcare, perpetuating the cycle of
poverty among low-income immigrant women
Park 1 (Lisa Sun-Hee Park, Assistant Professor in the Ethnic Studies Department and the Urban Studies and Planning
Program at the University of California, Hein Online, EBSCO Host, 2001, “Perpetuation of Poverty Through ‘Public
Charge,’” Conclusion, Denver University Law Review)//jy
emergence of these highly nationalistic and ethnocentric policies signifies a society
that is opposed to a sizable foreign-born population in their midst.(FN52) The continued "browning" of America is
certainly evident in the recent numbers provided by the U.S. Census Bureau. From July 1, 1990, to July 1, 1999, the nation's Asian and Pacific Islander
population grew 43% and the Latino (or Hispanic, as defined by the Census Bureau) population grew 38.8%.(FN53) These
policies and
associated programs particularly target immigrant women who are pregnant or of child-bearing
age. This was evident in the profile of individuals targeted for Medi-Cal fraud investigations at
the Port of Entry Detection program. The federal INS and state DHS agencies collaborated in devising a method to slow down the
rate of population increase among Latinos and Asians. By targeting immigrant women with children, it appears that
they attempted to interrupt the flow of immigration as well as the likelihood of more childbirth
by immigrant women. However, recent immigration numbers show that these policies have not
worked as intended.(FN54) Sassen writes: Recent reforms in immigration law, ostensibly designed to rationalize immigration policy, have not only
failed to slow immigration but threatens to do harm both to our own society and to the immigrants themselves.... The combination of
such sanctions and a regularization program that excludes a large number of undocumented
workers will contribute to the formation of an immigrant underclass that is legally as well as
economically disadvantaged.(FN55) These programs perpetuate the cycle of poverty among lowincome immigrant women. By criminalizing access to health care, immigrant women are
reluctant to receive prenatal care that may alleviate potentially costly future health problems.
Low-income immigrant families' already tenuous financial situation becomes more stressed as
they seek other means to recover a public benefit for which they are ineligible. The recent welfare reform
measure sends a clear message against the use of public benefits in the United States. Those who argue for stricter immigration
laws view the use of public benefits as an indication of declining "quality" of immigrants
admitted.(FN56) It is apparent that immigrants are well aware of this anti-immigrant message. It is apparent that, within
contemporary social welfare discourse, welfare dependence and not poverty or unemployment
is viewed as the social ill that is the appropriate target for state action.(FN57) The threat of public charge, or the
potential dependence on welfare benefits, has made it clear that immigrant women are undeserving and unwanted.
Econ Scenario
“Chilling Effect”
Public charge destroys trust between immigrants and their health care
providers, deterring them from using benefits despite having legal access
Park 10 (Lisa Sun-Hee Park, “Challenging Public Charge Policy: Coalitional Immigrant Community Strategies, “Project
Muse, Journal of Asian American Studies, Volume 13, Number 3, pg. 381-382, October 2010)//jy
As important as clarification is from a policy standpoint, it did not resolve all public charge issues nor did it increase an overall sense of free- dom or
security for Asian and Latino/a immigrant families. One advocate recalled her disappointment from “just peeling off one layer of issues [to find] that
there were other issues that remained.” Perhaps the
biggest source of continued confusion for immigrant families
is that public charge law still exists, just in more prescribed terms. Pressing questions remain,
including what kinds of benefits recipients are obligated to repay, and what, if any, avenues of
appeal or legal waivers are possible. However, a policy analyst cautioned against rushing into a situation that would make things
worse for those for whom they are advocating. Peeling back all layers of a policy at once may not be the best strategy. The analyst explained, “The
policy that was passed in 1996 is so horrible that quite frankly we don’t know what a clarification would look like and whether or not the government
would come out with something that again would scare people away from accessing things they’re entitled to.” Perhaps
one of the most
profound lessons learned from this policy clarification effort is how difficult it is to regain the
trust of immigrant communities once it is broken. Many public health workers, community clinics, and safety-net hospitals
in California have worked diligently for years to ensure that they achieve their mandate of serving the health care needs of their communities. Given
the high concentration of foreign-born populations in California, Asian and Latino/a immigrants comprise a sig- nificant portion of potential
constituents for many health care providers. In addition, many safety-net health care providers depend upon Medi-Cal reimbursements for caring for
low-income residents. This has meant that many health care facilities have worked very hard to reach out to these communities and develop bonds of
trust. The
public charge test deeply debilitated this trust between immigrants and their health
care providers. Since immigrants were initially told that it was safe to use publicly funded health
care, the public charge scare led to questioning the reliability of the doctor’s reassurance and
raised the possibility that prenatal care was another “trap” for immigrants. One advocate said, “The main
lesson is 382 • JAAS • 13:3 that once you destroy the community’s trust, people are not going to give it back
to you easily. You have to work to get it back. You misinformed them in the past. People aren’t stupid.” Trust is a
hard-earned sentiment given the level of reticence and the fear of accessing public benefits
experienced by immigrants. Given the political climate of growing nativism, many immigrants
report endur- ing a sense of siege and would rather avoid undue scrutiny. Those areas reporting a strong
sense of trust despite these fears are in places where the community feels in touch with known clinic staff who have specialized, local knowledge and
policy expertise. However, even these clinics found themselves in a very difficult situation trying to retain a meaningful level of trust with their
immigrant patients. A policy analyst working with a strong immigrant collaborative on issues of welfare and health care de- scribed a community event
to disseminate news regarding the clarification of public charge: The day after the clarification, some of our L.A. partners pulled together a press
conference to announce the public charge clarification as a way to get a word in the community that it’s no longer a problem.
People should
feel safe to access benefits. They invited a woman community member who herself had been in the position of not enrolling her kids or
herself in any health care programs because she thought it would be an issue. They talked to her several times beforehand and invited her to speak.
She was great. She really spoke to the impact the policy had had prior to the clarification. The funny thing is, afterwards, some of our folks said, “Thanks
for speaking at the press conference. Are you going to enroll in health programs now?” She said, “No, no way.” While
the community
member intellectually understood the importance of health insurance and encouraged others to
access Medi-Cal, the fear of future punitive governmental action kept her away. Dissemination
of public policy change in this political environment poses a formidable challenge. Adding to this
challenge is the state of California’s refusal to disseminate news of this legal clarification. In our interviews with key informants a year after clarification,
many immigrant health advocates and health care providers had no idea this had even happened.
Trump’s imminent expansion of public charge inadmissibility and deportability
causes to immigrant and child fear, discrimination and poverty- impacts disease
spread and economic collapse
Kearney et al. 18 (Gavin Kearney, former director of the Environmental Justice Program at
New York Lawyers for the Public Interest, former Director of Research and Programs at the
Institute on Race & Poverty at the University of Minnesota Law School, Madison Hardee, Senior
Policy Analyst for
Center for Law and Social Policy, Gabrielle Lessard, senior policy attorney at the National
Immigration law Center, Sonya Schwartz, Research Fellow at the Georgetown University
McCourt School of Public Policy’s Center for Children and Families, former director at the
National Academy for State Health Policy, May 2018, “The Trump Administration’s Next Attack
on Immigrant Families”, Sargent Shriver National Center on Poverty Law,
Any day now the Trump administration is expected to issue draft regulations that would further
its attacks on immigrant families and people living in poverty. These regulations would
jeopardize the status of millions of immigrants who use—or whose children use—health,
housing, nutrition, and other key services and supports. It would do this by radically altering the
way in which federal officials evaluate whether certain immigrants are—or are likely to
become—a “public charge.” The mere threat of these rules, which have been leaked to several
national news publications, has already contributed to the climate of fear and stress faced by
immigrant communities today.1 Adoption of the rules by the Trump administration could make this anxiety much worse.
Advocates throughout the country have joined together to create the Protecting Immigrant Families, Advancing Our Future
Campaign to fight these impending draft rules. The campaign is co-led by the National Immigration Law Center and the Center for
Law and Social Policy (CLASP). The Sargent Shriver National Center on Poverty Law is an active member. The Protecting Immigrant
Families Campaign is working to oppose enactment of these rules through coordinated action on several fronts. To be successful, we
need all hands on deck, and meaningful opportunities to contribute are available even for those with limited bandwidth. Here we
describe public-charge provisions in current immigration law and the proposed changes, the impact they could have, and the
opportunities for the advocacy community to advance this important fight. Xenophobic
Attacks and Harm to
Immigrant Communities and Children The public-charge proposal is yet one more action in a
persistent attack on immigrant families. On the campaign trail and in the White House, Pres.
Donald Trump has routinely expressed racist, xenophobic, and classist vitriol.2 He and his
administration have backed up this rhetoric with repeated efforts to harm immigrant
communities and people living in poverty. In the 15 months since he took office, President Trump has tried to ban
immigrants from Muslim countries and terminate the Deferred Action for Childhood Arrivals program.3 He has ended Temporary
Protected Status for hundreds of thousands of immigrants and issued an executive order to expand immigration enforcement
activities throughout the United States.4 Some in Congress have joined in with other anti-immigrant efforts such as the RAISE Act,
which would cut the number of green cards issued annually by 50 percent and cap the number of refugees for whom the United
States offers safety from persecution.5 The
cumulative effect of this rhetoric, along with these threats and
actions, has created a chilling effect in immigrant communities. Families have withdrawn from
their communities and avoid leaving home because of increased immigration enforcement and
the fear of being taken away from their families.6 They are choosing not to enroll themselves or
their U.S.-citizen children in critical programs such as Medicaid or Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC) despite being eligible because they
are afraid that enrollment will undermine their ability to remain in the United States.7
Immigrant parents have likewise been removing their children from child care and early
education programs.8 And families who choose to remain in early childhood programs are
increasingly reluctant to accept referrals to other important services such as health and
developmental screenings, vision screenings, and immunization services.9 The public-charge
proposal is yet one more action in a persistent attack on immigrant families. Immigrant attacks
are affecting the well-being of children in immigrant families.10Through interviews and focus groups with
more than 150 early-childhood educators and parents in six states throughout the United States, CLASP found that
children as young as 3 years were worried that their parents would be taken away.11 It also
found negative behavioral effects on young children manifesting in increased aggression,
separation anxiety, and withdrawal.12 One preschool director described a 5-year-old child with such severe anxiety
that he was biting his fingertips until they bled.13 Providers also reported increased instability in the children’s lives as parents
changed jobs and housing at increasing rates.14 Immigrant
families, including those with lawful status, are
experiencing high levels of fear and uncertainty, and racism and discrimination, including
bullying of children, have significantly increased since the 2016 election, the Kaiser Family
Foundation found.15 Parents reported children having problems sleeping and eating and mental
health problems such as depression and anxiety that negatively affected their performance in
school and will have lifelong consequences.16 These trends will cause significant and permanent harm to children,
families, and communities. Ample research establishes that family instability, stress, and anxiety have negative long-term
consequences for children.17 These
consequences are exacerbated by parents’ increasing reluctance to
avail themselves and their children of important services that could mitigate some of these
harms. The scale of this problem is vast—more than one-in-four children in the United States
live in a family with at least one foreign-born member (94 percent of these children are U.S.
citizens).18 Children in immigrant families do not live in isolation. They live and grow up in
communities where their individual success is critical to the strength of the country’s future
workforce and collective economic security. The ripple effects of our current anti-immigrant
rhetoric and policies will be felt broadly and long-term. Public Charge Under Current Law The concept of
“public charge” first appeared in U.S. immigration law in the Immigration Act of 1882, which prohibited any immigrant “unable to
take care of himself or herself without becoming a public charge” from being admitted to the United States.19 Since 1903, the
Immigration and Nationality Act has included public-charge considerations in two contexts: (1) whether immigrants seeking entry to
the United States or seeking legal permanent residency are at risk of becoming a public charge and thus deemed inadmissible and
(2) whether immigrants who have been admitted to the United States have become a public charge within five years of entry. The
Act does not define “public charge,” but in each context a public-charge analysis has developed through case law and agency
guidance. Note that a number of immigrants are not subject to any public-charge analysis. This includes humanitarian immigrants
such as refugees; asylees; survivors of domestic violence, trafficking, and certain other categories of crimes; certain individuals
paroled into the United States; and certain other categories of noncitizens. Neither are permanent residents (i.e., green card
holders) subject to a public-charge determination when they apply for citizenship.20 Current Public-Charge Grounds for
Inadmissibility Section 212 of the Immigration and Nationality Act states that “[a]ny alien who … is likely at any time to become a
public charge is inadmissible.”21 This provision applies to intended immigrants seeking visas at consulates and ports of entry and to
immigrants within the United States seeking to become legal permanent residents. When
evaluating whether an
individual is likely to become a public charge, immigration officials must consider certain factors:
age; health; family status; assets, resources, and financial status; and education and skills.22
Immigration officials are authorized to consider an affidavit of support submitted on behalf of an intended immigrant, and such an
affidavit is required for family-based visas and certain employment-based visas. The U.S. Immigration and Naturalization Service
proposed regulations in 1999 that would guide immigration officials considering public-charge questions.23 Although
regulations were never adopted, field guidance was issued at the same time, and that guidance
continues to be used by officials today. Under this guidance, an immigrant is considered a public charge if the
immigrant is likely to “become primarily dependent on the government for subsistence, as demonstrated by either (i) the receipt of
public cash assistance for income maintenance or (ii) institutionalization for long-term care at government expense [other than
imprisonment for conviction of a crime].”24 The guidance specifies the benefits that may be considered when making a publiccharge determination: Supplemental Security Income (SSI), Temporary Assistance for Needy Families cash assistance, state and local
cash-assistance programs, and long-term institutionalized care, paid for by government programs such as Medicaid.25 The guidance
clarifies that not all cash assistance—only assistance for basic income maintenance—is to be considered and that having received
benefits is only one factor in a forward-looking analysis considering the “totality of circumstances” surrounding an application.26
The guidance also specifies a number of benefits—including Medicaid and other health insurance programs, nutrition programs,
child care services, housing benefits, educational assistance, and energy assistance—that “may not be considered for public charge
purposes.”27 According to the guidance, the limited focus on cash assistance is intended to reflect “broad public policy decisions
about improving general public health and nutrition, promoting education, and assisting working-poor families in the process of
becoming self-sufficient. Thus, participation in such non-cash programs is not evidence of poverty or dependence.”28 The guidance
also notes that a “healthy person in the prime of life cannot ordinarily be considered likely to become a public charge.”29 Current
Public-Charge Grounds for Deportability Section 237 of the Immigration and Nationality Act states that “[a]ny alien who, within five
years after the date of entry, has become a public charge from causes not affirmatively shown to have arisen since entry is
deportable.”30 The 1999 field guidance uses the same definition of public charge for deportability as it does for admissibility, but it
applies a much stricter analysis for determining whether an admitted immigrant has become a public charge and is thus deportable.
Specifically an immigrant is deportable on public-charge grounds only if (1) the immigrant receives a benefit under a program that
legally obligates the administering agency to seek reimbursement; (2) the agency makes a demand for repayment; and (3) the
recipient refuses to make payment.31 Moreover, the guidance states that the agency must take all available actions to collect
payment, including obtaining and taking all necessary steps to enforce a final judgment in a court of law, before a public-charge
determination can be made.32Even where these circumstances are met, an immigrant still has the opportunity to demonstrate that
the circumstances causing the immigrant to become a public charge arose after admission, and the guidance acknowledges that
public-charge deportations are likely to be “rare.”33 Steps Toward Dramatic Changes in Public-Charge Policy Since
early last
year, the Trump administration has signaled that it may seek to expand the types of benefits
that can be considered in the public-charge determination. The goal behind this change is
twofold: (1) to make it harder for immigrants who might use public services—such as health and
nutrition programs—to come to the United States and settle here permanently and (2) to force
families to choose between the food, housing, and health care they need and being with the
people they love. A draft executive order leaked in January 2017 was the first signal of this threat. While the draft
order was never signed or released, it (combined with other hostile immigration policies and
rhetoric) led to many immigrants choosing not to enroll themselves or their citizen children in
critical programs despite their being eligible. Then, this past winter, the threat became even more urgent. In
December 2017 the Unified Regulatory Agenda included a notice that a public-charge Notice of Proposed Rulemaking was in the
works. In January 2018 the U.S. Department of State revised its instructions to consular officials on public charge; it added that the
use of any public benefit by a person seeking a visa to enter the country—or the use of benefits by the applicant’s family or
sponsor—could be part of the public-charge consideration. What effect these changes will have is too early yet to tell, but the
changes will be felt primarily by immigrants seeking to reunite with their immediate family members in the United States. In
February and again in March 2018 media outlets published a leaked draft Notice of Proposed Rulemaking on public charge. The draft
indicated that the administration would now attempt to alter public-charge policy through the formal rulemaking process. Proposed
Radical Expansion of Who Is Considered a Public Charge Several versions of
the Trump administration’s
damaging new approach to public charge have leaked since last year, stoking fear among
immigrant communities. The latest and most comprehensive version was reported by the Washington Post on March 28,
2018.34The Post also made the leaked draft available online.35 The next day, the Department of Homeland Security officially
submitted for review proposed changes in public-charge rules to the Office of Information and Regulatory Affairs of the Office of
Management and Budget.36 Submission to the Office of Information and Regulatory Affairs is a routine rulemaking step that
precedes formal publication of draft rules in the Federal Register. Although review by the Office of Information and Regulatory
Affairs does not have a fixed time limit, this submission suggests that publication of the draft rules, and the public comment period
that will follow, are imminent. The text of the proposed rules submitted to the Office of Information and Regulatory Affairs is not
publicly available yet, and how closely the submitted new rules mirror what was in the leaked version reported by the Washington
Post is unknown. Given the timing, however, advocates would be reasonable to assume significant similarities. As
leaked, the
draft rules would radically alter the public-charge determination in a number of important and
harmful ways. The rules would expansively redefine what being a “public charge” means. Whereas
current guidance focuses on whether an intended immigrant is likely to become primarily dependent on benefits for subsistence,
the leaked rules would define a public charge to be a person “who is likely at any time to use or receive one or more public
benefits.”37 The rules would expansively redefine what being a “public charge” means. The leaked rules would also greatly expand
the benefits considered when making a public-charge determination. As noted earlier, programs currently considered for
admissibility purposes are few—subsistence-oriented cash assistance programs, SSI, and long-term institutionalization. The
leaked rules would consider any government assistance in the form of cash, checks or other
forms of money transfers, or instrument and non-cash assistance in the form of aid, services, or
other relief, that is means-tested … or intended to help the individual meet basic living
requirements such as housing, food, utilities, or medical care.38 This would include federal,
state, and local benefits. The leaked rules, while noting that the list is not exclusive, specify a
number of programs to be considered for public-charge purposes. The listed programs include
Medicaid and any “subsidized health insurance,” including premium tax credits in the health
insurance marketplace; Supplemental Nutrition Assistance Program (SNAP); WIC; State
Children’s Health Insurance Program (CHIP); housing assistance; means-tested energy benefits
such as the Low Income Home Energy Assistance Program; and the earned income tax credit.39
With such an expansive definition of public charge, benefits considered could include virtually
any program not specifically exempted that is means-tested or helps participants meet basic
needs. Note, however, that, as leaked, the rules would not apply retroactively in the case of benefits not previously considered
for public-charge purposes.40 With these two drastic changes—redefining public charge to include any
use of public benefits and greatly expanding the programs considered for public-charge
purposes—the Trump administration would abandon the important and well-documented
policy consideration that access to benefits is good for the long-term health and selfsufficiency of families and good for the overall well-being of our society. With such an
expansive definition of public charge, benefits considered could include virtually any program
not specifically exempted that is means-tested or helps participants meet basic needs. The
leaked rules would also direct immigration officials to consider whether an applicant’s
dependents have “sought, received, or used, or [sic] any public benefit.”41Currently officials consider
only whether the applicant has used specified benefits. The leaked rules define “dependent” very broadly to
include not only dependents as listed on a tax return and other persons whom the applicant is
legally required to support but also “[a]ny other Person who lives with the alien, and who is
being cared for or provided for by the alien, and benefits from but does not contribute to the
alien’s income or financial resources, to the extent such person is not claimed on the alien’s tax
return.”42 As noted earlier, millions of U.S.-citizen children live in households with a foreign-born parent. Including
benefits that these children might seek or receive in the public-charge determination would
force parents to decide between keeping their families together and ensuring that their children
have access to critical services such as health care, nutrition, immunization, behavioral health
assistance, and so on. The leaked rules’ expansive definition of dependents would further undermine family and community
by putting immigrants at risk should they care for their elderly parents, a niece or nephew, the children of friends who may be in
crisis, and others who may seek or use any one of a host of federal, state, and local benefits programs. The leaked rules would also
set forth standards for immigration officials to consider when evaluating statutorily required criteria such as age, health, and
education. The rules essentially direct that each factor should be considered solely for its bearing on whether the intended
immigrant is immediately able to work.43 The rules would negatively consider applicants who are limited in English, on the ground
that this is a barrier to employment.44 The rules would negatively consider applicants who are limited in English, on the ground that
this is a barrier to employment. The leaked rules identify specific factors that are to be “heavily weighed” in a public-charge
determination. Heavily weighed negative factors—factors that “will generally weigh heavily in favor of a finding that an alien is likely
to become a public charge”—include whether the applicant is currently using or has “used or received one or more public benefits
within the last 36 months.”45 Another heavily weighed negative factor is whether the applicant “has a medical condition and is
unable to show evidence of unsubsidized health insurance.”46 The only heavily weighed positive factor is whether the applicant can
demonstrate income, assets, and resources that put the applicant at 250 percent or more of the federal poverty level.47 In essence,
the leaked rule creates a new income standard for family-based immigration at 250 percent of the federal poverty level, or $62,750
for a family of four in 2018. A very significant unknown at this time is how the proposed rules that are ultimately published will
handle public charge in the deportability context. As noted above, pursuant to Section 237 of the Immigration and Nationality Act,
an immigrant is deportable within five years of admission if the immigrant becomes a public
charge for reasons that existed at the time of admission. Given the significant hardship of deportation, current guidance takes a
very narrow approach to this question—the person in question must have received a benefit that requires repayment under law; the
agency administering the benefit must have received a final judgment compelling repayment and exhausted collection options; and
the person must still refuse repayment. The leaked rules include placeholder language for Section 237 evaluations under the
heading “Deportable Aliens [FOR DISCUSSION WITH DOJ]” and a subheading that reads, “Public
charge deportability
criteria. [TO BE INSERTED].” Of concern, however, is that the leaked draft states that the expansive definitions of “public
charge” and “public benefit” discussed above would also apply in the deportability context.48 Effects of the Leaked Public-Charge
Rules The Trump administration’s changes in public-charge policy could have severe consequences. Before considering their impact,
we must reiterate a few considerations, particularly given the stress and fear that the threat of these rules has created among clients
and community members. First, the rules governing public-charge determinations in the United States have not yet changed. The
notice of proposed rulemaking has not been published in the Federal Register. Once it is published, the public will have an
opportunity to comment, and the Department of Homeland Security must respond to comments before finalizing any new
regulations. The application for adjustment to lawful permanent residence in the United States already asks about any public
benefits applicants have received. Thus disenrolling from programs at this time may offer little or no advantage. Second, under the
statute, which cannot be changed by regulation, public charge applies only in certain specific immigration contexts. Many
immigrants are not subject to a public-charge evaluation. Third, as leaked, the draft rules would expand the public-charge doctrine
prospectively. Use of benefits newly considered for public-charge purposes prior to adoption of the rule would not count against an
applicant.49 Even if the rules change, applicants will still be able to show why they are not likely to become a public charge in the
future. Public-charge rules along the lines of those that have leaked would severely harm families and communities in the United
States. Still, public-charge
rules along the lines of those that have leaked would severely harm families and
communities in the United States. The Department of Homeland Security acknowledges as
much in the preamble to the leaked rules: “[T]he action has the potential to erode family
stability and decrease disposable income of families and children because the action provides a
strong disincentive for the receipt or use of public benefits by aliens, as well as their household
members, including U.S. children.”50 As discussed earlier, the mere threat of these rules, combined with other hostile
immigration policies and harmful rhetoric, has caused immigrant families to disenroll from vital health, nutritional, and other
services because of fears that enrollment will harm their immigration status or their future opportunities. Low-income children with
foreign-born parents are already less likely than children with U.S.-born parents to receive SNAP or Medicaid. And one million Latino
children are eligible for Medicaid or CHIP but not enrolled.51 Any policy
forcing millions of families to choose
between the denial of immigration status and food or health care would exacerbate serious
problems such as hunger, unmet health needs, child poverty, and homelessness, with lasting
consequences for families’ well-being and long-term success and community prosperity. A wealth of
research supports the notion that children do better when they have access to benefits. For example, research
demonstrates that children who are able to access Medicaid lead longer, healthier lives and are
more likely to finish high school and college.52 Conversely, people without access to health
insurance are less likely to receive a diagnosis in the early stages of a disease, more likely to die
from acute conditions, and more likely to suffer from an undiagnosed chronic condition that
could be controlled with appropriate care.53 A wealth of research supports the notion that children do better when
they have access to benefits. Similarly positive, long-term effects have been found with respect to other benefits programs. For
example, children with access to nutritional assistance are more likely to graduate from high school and less likely to experience
health problems such as diabetes and heart disease than children who are of similar economic backgrounds and do not receive
nutrition benefits. Likewise,
studies of economic benefits such as the Earned Income Tax Credit have
found that these benefits lead to positive outcomes such as higher test scores, higher
educational attainment, and higher lifetime earnings.54 These benefits have ripple effects for
future generations who are more likely to grow up in economically stable households. These
benefits contribute to a healthy society. The instability and stress that result from lack of access
to important services and from the current toxic anti-immigrant environment, inflict long-lasting
harms on children: Persistent and substantial exposure to fear and anxiety—sometimes called
“toxic stress”—can do immense damage to children’s health. This level of stress can interfere
with young children’s physical brain development, altering how they learn and their ability to
manage their emotions. It can also lead to physical and mental health problems that last into
adulthood.55 As noted above, citizen children with immigrant parents were already manifesting
harmful stress-related behavioral changes such as difficulty eating and sleeping, psychosomatic
symptoms such as headaches, and increased depression and anxiety. These effects, which are
likely to worsen if public-charge rules are formally proposed and ultimately adopted, are likely
to lead to poorer health outcomes, developmental limitations, and other adverse effects for
children in America.56
Trump’s plan to expand the public charge to include healthcare would decrease
participation in those programs and cause financial instability among immigrant
KFF 18 (Henry J Kaiser Family Foundation, Filling the need for trusted information on national
health issues, “Proposed Changes to “Public Charge” Policies for Immigrants: Implications for
Health Coverage,” [KFF], February 13th 2018, accessed: 7/10/18,
What are the Implications for Health and Health Coverage? Today, Medicaid
and CHIP help fill gaps in private
coverage for lawfully present immigrants, providing them access to needed care and financial
protections that support their ability to work and the growth and healthy development of their
children. Medicaid and CHIP provide families access to preventive and primary care, including
prenatal care, as well as care for chronic conditions. In addition, the coverage provides families
financial protection from high medical costs. By enabling families to meet their health care
needs, Medicaid and CHIP support families’ ability to work and promote growth and healthy
development of their children. The majority of lawfully present immigrants live in a family with at least one full-time
worker (83%), a rate equal to that of citizens.11 However, lawfully present immigrants are more likely than citizens to live in lowincome families and often work in jobs and industries that do not offer health coverage. Reflecting their lower incomes and limited
access to private coverage, one
in four nonelderly lawfully present immigrants has Medicaid or CHIP
coverage.12 However, among the low-income nonelderly population, lawfully present immigrants are less likely
than citizens to have Medicaid or CHIP coverage, reflecting eligibility restrictions for
immigrants.13 Lawfully present immigrants may qualify for Medicaid and CHIP, including the
Affordable Care Act (ACA) Medicaid expansion to low-income adults, but many must wait five
years after obtaining lawful status before they may enroll. In addition, many eligible lawfully present
immigrants are not enrolled due to multiple enrollment barriers, including fear. The proposed changes would likely
lead to decreased participation in Medicaid, CHIP, Marketplace coverage, and other programs
among immigrant families, including their citizen children. Despite broad efforts to assure the immigrant
community that Medicaid and CHIP could not be used in public charge determinations under current policy, many eligible lawfully
present immigrants did not enroll themselves or their children because they feared it could negatively affect their status. This
policy change would amplify these fears because use of Medicaid and CHIP and other programs
could now have negative repercussions on immigration status. Further, the Administration’s
increased focus on immigration enforcement and restriction has led to growing fears among
legal immigrants about the stability of their status.14 Increased fears would likely extend beyond
individuals directly affected by the policy to the broader immigrant community. Due to
increased fears, it is likely that fewer eligible individuals would enroll themselves and their
children in health coverage and that individuals who are currently enrolled in programs would
disenroll themselves and their children. Participation in nutrition programs, like SNAP and WIC,
would also likely decrease. Decreased participation in Medicaid, CHIP, and Marketplace
coverage would increase the uninsured rate among immigrant families, negatively affecting
their health and financial stability and the growth and healthy development of their children.
Without Medicaid, CHIP, or Marketplace coverage, more lawfully present immigrants would
become uninsured, widening the disparity in coverage they already face. As of 2016, 17% of lawfully
present immigrants were uninsured compared to 9% of citizens.15 Coverage losses would lead to reduced access to care for
families, contributing to worse health outcomes over time. Moreover, these effects would likely be compounded by reduced
participation in nutrition and other support programs. Decreased
participation in these programs would
negatively affect the financial stability of families and the growth and healthy development of
children in these families, who are predominantly U.S. born citizens.
Political reform solves economic costs, chilling effect and unjust denial to
vulnerable immigrants
Moore 17 (Andrew F. Moore, Associate Professor of Law at the University of Detroit, 2017,
CARE”, Albany Law Review, LexisNexis)/CWB
The current administration's approach is tragic, given the very good arguments recommending a return to full
immigrant coverage, including undocumented coverage. n325 Poor immigrant health leads to spillover economic
costs because there are risks to public health for untreated immigrants. For example, pregnant
immigrant [*115] mothers have particular needs while giving birth to U.S. citizen children, there
is a chilling effect on immigrants who are otherwise authorized under the law to receive
benefits, and there are particularly vulnerable groups such as the elderly and immigrants who
already suffer from mental health issues, whose denial of coverage is unjust. n326 There has been
good scholarship advocating for the expansion of publicly-financed health benefits, including mental
health benefits for undocumented children. n327 The particular vulnerability of children has been highlighted,
since children are covered by a separate federal program, the Children's Health Insurance Program ("CHIP"),
which also has a five-year bar for immigrants. n328 What is needed is a re-framing of the issue in
a political context likely to respond to the counter-narrative that it is sound public policy to
extend coverage.
Public charge is in line with Trump and democratic resistance is non-existent
London 3-31 (Eric, reporter for WSWS. World Socialist Web Site, 3-31-2018. “Democrats
green-light Trump’s escalating war on immigrants”) NREM/Lil’ GBN *modified for racial language –
we do not endorse it. Used as a quote, not endorsed by the author
Without any opposition from the Democratic Party and little attention in the corporate media, President Donald Trump
and his fascist advisors are quietly carrying out the most dramatic rightwing shift in US immigration policy in a century. They are laying the
basis for mass roundups and the brutalization of hundreds of thousands of immigrants in an expanding network of internment camps nationwide.
The Trump administration announced a series of new policies on Thursday. The first policy change targets the poor and working class by blocking
immigrants who have used a broad array of social programs from receiving legal permanent
residency. While immigrants were previously denied permanent residency if they had used cash programs, Immigration and Customs Enforcement (ICE) announced a change on Thursday
that adds almost all forms of government support to the list of banned services, including noncash programs such as food stamps, Medicaid, the Children’s Health Insurance
Program (CHIP), food programs for women and infants (WIC), school lunches, housing and heating assistance, health care
subsidies, and the earned income tax credit, which is used by about 20 percent of the population. Any immigrant who uses a social
program will be labeled a “public charge” and found ineligible for legal status. Immigrant
parents will be penalized even if their US citizen children use social programs to which they are legally entitled. As a
result of this policy change, hundreds of thousands or millions of workers will go without food, health care,
housing and other basic needs for fear of deportation. The Trump administration’s strategy is to create a permanent
underclass of deeply impoverished people who can be scapegoated for society’s ills. The administration also announced Thursday
that it will require all visa applicants to submit their social media records dating back five years to determine if they are admissible for entry to the US. This policy will allow immigration
officials to deny visas to applicants with left-wing political opinions. The administration also announced plans last week to include a
question on the 2020 US census requiring people to state whether they are citizens. This change will give the police, military and deportation agencies a map of where undocumented people live, raising the
specter of mass, coordinated raids to round up immigrants. The administration is also enacting a series of policy changes that systematize abuse in the immigration detention system. On Thursday, ICE announced
Trump administration fought to deny detained
immigrants access to abortion, even in cases where the immigrant was raped by smugglers. According
that it will detain pregnant immigrants captured by ICE or Customs and Border Protection (CBP) agents. Last fall, the
to official counts, 506 pregnant women have been detained since December 2017. The administration has also split detained families by moving immigrant parents and children to different facilities. Trump has
unleashed fascistic elements within ICE and CBP who are engaged in widespread mistreatment of detained immigrants. In December, ICE shackled 92 Somalis together by their wrists, legs and waists on a
deportation flight for over 40 hours, forcing them to urinate on themselves. According to a March 4 report in the Intercept, ICE agents beat and threatened the immigrants. When the Somali government refused
to accept the deportees, agents brought the immigrants back to immigration detention centers in Florida and continued to beat them, calling them “nigger” and “boy” and promising to “send you back to the
jungle.” A recent report by a group of nonprofits documented routine beatings and sexual abuse of immigrants at a detention center in West Texas. One immigrant said he was “placed in solitary confinement,
where I was forced to lie face down on the floor with my hands handcuffed behind my back while I was kicked repeatedly in the ribs by the warden…When I told him, ‘I’ll get a lawyer to sue you,’ the warden
responded, ‘We’ve got enough money.’” When World Socialist Web Site reporters visited the West Texas Detention Facility, a local business owner boasted that local police “let us shoot immigrants and roll their
joined Republicans in passing a $1.3 trillion spending bill that strengthens the framework for
mass detention and deportation, including: · A 10 percent ($641 million) increase in funds for ICE. · Granting the
Trump administration the right to allocate funds to expand the number of beds at immigrant
detention centers “as necessary to ensure the detention of aliens prioritized for removal.” · $1.6 billion for wall construction and border
militarization, including $251 million to build a second wall in San Diego and $263 million for “planning, design and technology” for futuristic militarized walls. · Hiring hundreds more CBP agents.
Democrats voted for the bill 39-8 in the Senate, compared to Republicans who barely supported it
(voting 25-23), on the grounds that it was not sufficiently reactionary. The deal included no protection for the 1.8 million people eligible for protection from deportation
under the Deferred Action for Childhood Arrivals (DACA) program. Though the program expired on March 5, beneficiaries can renew their DACA protections while litigation plays out in the federal courts.
bodies into the riverbed.” The US Supreme Court ruled this year that immigrants have no right to bail, meaning thousands more will face indefinite detention in these hellholes. In March,
Democrats explicitly refused to include DACA as a demand in the budget negotiations. Since March 6, the day after DACA’s expiration, the Democrats have made a deliberate decision to ignore the issue. In the
Democrats’ claims to support immigrants are a sham. The Democratic Party expressed its real
priorities during the budget negotiations in February in a letter to the Republican leadership
signed by Pelosi, Schumer, Steny Hoyer and others. Referring to the “Russian president and his operatives,” the Democrats’ letter claimed, “The most
hundreds of Twitter posts by Democratic leaders Charles Schumer, Nancy Pelosi, Barack Obama, Bernie Sanders, Elizabeth Warren and Joe Biden since March 6, only two tweets reference DACA.
essential elements of America’s democracy are under attack by a foreign adversary and Congress must respond immediately.” The Democrats demanded $300 million for the Federal Bureau of Investigation (FBI)
“to counter the influence of hostile foreign actors operating in the US, especially Russian operatives operating on our social media platforms”—in other words, to censor the Internet and ban left-wing and antiwar
information and opinions.
Care Access
Immigration reform should stop denial of health care due to public charge
requirements based off immigrant status- key to the economy
Perriera and Ornelas 11 (Krista M. Perreira, PhD in health economics from UC Berkley,
professor of social medicine at the University of North Carolina, faculty fellow in the Carolina
Population Center, studies immigrant children health for the Anne E. Casey Foundation, Robert
Wood Johnson Foundation and the U.S. Department of Health and Human Services, published in
Demography, the Journal of Risk and Uncertainty, JAMA, NEJM, American Journal of Public
Health, Social Science and Medicine, Journal of Social Issues, Social Forces, former policy analyst
for FHI 360, the Migration Policy Institute, the Rand Corporation, the Urban Institute, and the
U.S. Government Accountability Office, India J. Ornelas, professor of health services at the
University of Washington, PhD in health education from the University of North Carolina, Spring
2011, “The Physical and Psychological Well-Being of Immigrant Children”, The Future of
Children, Volume 21, Number 1, published by Princeton University, Project Muse)/CWB
Health status is a vital aspect of human capital. Unhealthy workers are less productive, more
costly for employers, and earn less over their lifetimes. A growing literature links adult ailments
to childhood experiences. For example, childhood asthma and obesity rates are associated with a myriad of chronic
illnesses in adulthood (such as diabetes, hypertension, and coronary disease). For the children of immigrants, poverty,
the stresses of migration, and the challenges of acculturation can substantially increase their risk for the
development of physical and mental health problems. This article documents the evidence about differences in
the health status of immigrant youth, including systematic variation in health-compromising behavior and access to health services.
It concludes with a discussion of policy implications and strategies to reverse the troubling trends. Numerous
document the human capital cost of poor health in adulthood. Obesity, psychiatric disorders, and substance
use, for example, affect large numbers of Americans and have all been shown to reduce adult employment and earnings
significantly.1 Largely because of technical challenges and data limitations, fewer studies have examined the human capital costs of
poor health in childhood. Nevertheless, evidence that poor
childhood health negatively influences adult
education, employment, and socioeconomic status has begun to accumulate. Early research into the human
capital costs of poor childhood health evaluated the educational consequences of teenage childbearing and substance use,
especially alcohol and illicit drug use. Results were mixed, with some analysts finding significant reductions in educational
attainment—lower rates of high school graduation, college graduation, and years of schooling—related to illicit drug use. Other
studies found small or insignificant reductions in educational attainment related to alcohol use or teenage childbearing.2 More
recent studies have examined the consequences of childhood illnesses, nutrition, physical activity, excessive weight, and mental
health for educational attainment, measured by grade completion and graduation, and for achievement, measured by grades and
test scores. These analyses demonstrate that the negative consequences of poor childhood health are apparent as early as
kindergarten and continue into adulthood.3 Childhood asthma and other illnesses result in frequent emergency room visits,
hospitalizations, and school absenteeism, and consequently lower math and reading achievement.4 Childhood mental health or
behavioral problems such as depression and hyperactivity negatively influence performance on standardized math and reading
scores in elementary school. Mental health and behavioral problems also increase the likelihood of dropping out of high school and
not attending college.5 In contrast, good nutrition and regular physical activity in elementary school can improve school attendance,
engagement in school, and academic performance.6 Even when studies find that child health or health behaviors have only a small
influence on educational outcomes, the economic costs of poor child health and health behaviors can be high. The
effects of poor health in childhood can persist and accumulate over time. Therefore, adults with
poor childhood physical or mental health or unhealthy behaviors can experience lower rates of
labor force participation, employment, and, ultimately, earnings.7 Subsequently, the low socioeconomic status of these
adults contributes to poor childhood health outcomes among their children. As a result, poor childhood health perpetuates socioeconomic inequalities across family
generations.8 This cycle can be particularly pernicious for low-income minority populations such as the children of disadvantaged immigrants and, because of the rapid growth
in the numbers of immigrant children, for the nation as a whole. The Role of Migration in Shaping Children’s Health Migration and the subsequent acculturation experiences of
children growing up in immigrant families increase the potential vulnerability of these children and can profoundly shape their health. The concept of acculturation describes the
process of cultural change and adaptation that occurs when two or more ethnic groups come into contact with one another. The concept of enculturation describes the
opposite—the process of retaining distinct cultural identities, beliefs, and norms of behavior that distinguish one ethnic group from another. Both influence child development
and health outcomes. Cultural-ecological theories argue that the resources in children’s families, schools, and neighborhoods influence their lifestyles, daily experiences, and
developmental outcomes.9 Because migration exposes children to unique developmental demands and stressors associated with acculturation, it reshapes their normative
development. To adapt, immigrant children and their families choose different combinations of acculturation and enculturation strategies. A modified version of Carlos Sluzki’s
framework for the stages of migration provides a template for understanding sources of stress throughout the migration process and the health consequences of these
stressors.10 In the pre-migration stage, children’s parents decide to leave their home country. These decisions typically reflect economic hardships in their home countries,
political unrest and persecution, or the desire to reunify with family already living in the United States. This background sets the stage for children’s subsequent migration and
acculturation experiences and their influence on children’s health. The migration stage captures the mobility process of migrating, including whether the children walk, drive, fly,
or come by ship; whether they travel with a trusted family member or friend or are smuggled into the country; and whether they experience hardships during travel such as
detainment in a refugee camp, assault, or hunger. The post-migration stage pertains to the settlement experiences of children; the process of navigating life in a new country;
and the realization of changes in family economic situations, dynamics, and social roles. Premigration and migration influences are critical to children of immigrants, whereas
postmigration influences are critical to second and later immigrant generations as well. In this article the term “first-generation immigrant children” refers to foreign-born
children with foreign-born parents. The term “second-generation immigrants” refers to U.S.-born children with at least one foreign-born parent. The term “children of
immigrants” refers to both first- and second generation immigrants as a whole. U.S.-born children with U.S.-born parents are considered “native,” or third generation and
higher. Pre-Migration Experience and Health Poverty, family separation, and political violence can substantially influence the health of children who immigrate to the United
States. Yet few studies of immigrant health examine these pre-migration influences. For example, in less developed countries, the prevalence of excessive weight (overweight
and obesity) tends to increase with socioeconomic status—higher incomes are associated with the adoption of highcalorie diets and an increase in sedentary activities such as
watching television. Thus, low-income children who migrate from these countries are more likely to be at risk of malnutrition and stunting than of being overweight. To
demonstrate the importance of pre-migration poverty, Jennifer Van Hook and Kelly Balistreri examined differences in body mass index (BMI) by levels of economic development
in children’s country of origin.11 They found that the BMIs and BMI growth rates were lower for low-income children of immigrants (aged five to eight) from less developed
countries than for children of immigrants from high socioeconomic backgrounds in the same countries or for children of immigrants from more developed countries. In another
study of 385 young children of immigrants (aged nine to fourteen), Carola Suárez-Orozco and others found that as many as 85 percent of these children had been separated
from one or both parents for a few months to a few years.12 Central Americans and Haitians experienced the highest family separation rates (96 percent), whereas Chinese
children had the lowest rates (37 percent). These family separations placed children and their mothers at risk for depressive symptoms. A study focusing on children in Mexico
whose primary caregivers had migrated found that these children were more likely than children in nonmigrant households to have frequent illnesses (10 percent versus 3
percent), chronic illnesses (7 percent versus 3 percent), emotional problems (10 percent versus 4 percent), and behavioral problems (17 percent versus 10 percent).13 Thus, as
Nancy Landale, Kevin Thomas, and Jennifer Van Hook also highlight in the article in this issue on living arrangements, separation from a parent or primary caregiver who has
migrated is associated with poor emotional and physical health among the children left behind. Although a relatively small population (21,713 children under age eighteen in
2008) the children of refugees can experience additional hardships.14 Studies focusing on refugee populations and forced migration find that 80–90 percent of refugee children
have experienced extreme hardships such as witnessing murders or mass killings, enduring forced labor, or going without sufficient food for long periods of time.15 Others
survive combat experiences as child soldiers, life in refugee camps, and, for children who migrate to the United States to seek asylum and who do not have a guardian, long waits
in detention centers or juvenile jails. Studies of adolescent Cuban and Cambodian refugees have found a high prevalence (50–60 percent) of both post-traumatic stress disorder
and depression for up to two years after they arrive in the United States. In addition to exposures that threaten their emotional health, refugee children often have endured
diarrheal disease, malnutrition, fractures, and other acute physical health problems, and experience chronic health problems after resettlement. Latent tuberculosis infections,
fungal and parasitic infections, and lead poisoning are just a few of the physical health ailments common to refugee children. These risk factors (poverty, family separation, and
political violence), together with low rates of health insurance coverage and health care use, should lead to poorer health among foreign-born children than among U.S.-born
children. Nevertheless, researchers consistently find an immigrant health advantage across a variety of medical outcomes. Three causes partially explain this paradox. First,
foreign-born immigrant children engage in a variety of more positive health behaviors than their U.S.-born peers. They smoke less, drink less, and eat more nutritional and fewer
snack foods. Second, foreign-born children tend to live in two-parent and multigenerational households with high levels of family support and other social support that can
who immigrate may be a selectively healthy
group. Parents whose children have physical or emotional health problems could be less likely to
immigrate or bring their children to the United States or more likely to send ill children back to their home countries. Although
skeptics abound, research provides weak support for the selective migration of healthy adults.17 But to our
mitigate stress, especially during the initial settlement period.16
Third, children
knowledge, no studies have examined the selective migration of children. In addition, most studies of health selection have focused
on Mexican populations, and selection effects may vary by country of origin or even by regions within a country. Migration
Experience and Health Few quantitative survey data exist about the nature of youths’ migration experiences, but ethnographers and
journalists have written extensively about these experiences. For documented children, migration to the United States may involve a
relatively short plane trip and little trauma. For undocumented children, the migration journey can take months and involve severe
physical and emotional hardship. Enrique’s Journey, the true story of a sixteen-year-old boy’s perilous trip from Honduras in search
of his mother, typifies the physical and emotional trauma that at least some first-generation children experience on their way to the
United States.18 In one mixed-methods study, 59 percent of Latino adolescents, aged twelve to eighteen, who had recently
immigrated to North Carolina told researchers that the migration experience was somewhat to very stressful.19 Although only 8
percent of these youth traveled alone or with a smuggler, 46 percent of the adolescents surveyed were concerned for their safety
during their travels, 4 percent were robbed, 1 percent were physically attacked, 11 percent were accidentally injured, and 16
percent fell sick. Many of these migrants arrived in the United States injured, emotionally distressed, and in need of either physical
or mental health services. Post-Migration Experiences, Acculturation, and Health Most of the research on the well-being of firstgeneration children focuses on their post-migration experiences. These experiences include a large number of acculturation
stressors such as learning a new from a parent or primary caregiver who has migrated is associated with poor emotional and
physical health among the children left behind. Nevertheless, researchers consistently find an immigrant health advantage across a
variety of medical outcomes. Language, coping with changes in family roles and responsibilities, protecting one’s legal status or the
legal status of family members, and encountering racism or discrimination. Although these stressors are common, their influence on
a child’s health can vary tremendously depending on the length of time the child has lived in the United States, the broader social
context of settlement, and the child’s age or developmental stage at migration.
Studies measuring the influences of these
post-migration stressors on the health of Hispanic children typically use stress inventories such as the Hispanic
Stress Index and the Societal, Attitudinal, Familial, and Environmental Acculturative Stress Scale. Nearly all of these studies
focus on the strong negative relationship between stressors and children’s emotional well-being.
Researchers have not yet evaluated relationships between acculturation stressors and physical health
outcomes; acculturation stress inventories have not yet been developed for use among Asian populations; and many analyses
using stress inventories fail to differentiate the consequences
of various sources of acculturative stress such
as discrimination, family conflict, language skills, or legal status. The current evidence does clearly
indicate a link between racial discrimination and health. Youth who experience or perceive discrimination report more anxiety,
more depressive symptoms, more risky health behaviors, lower self-esteem, and reduced academic motivations and expectations.20 Moreover, researchers have begun to link
racial discrimination to a variety of physical health outcomes in minority children, including elevated blood pressure, elevated levels of glucocortisol hormones in the blood
stream, and insulin resistance—conditions associated with high rates of coronary heart disease and inflammatory disorders.21 Evidence also shows a strong link between
immigrants’ family environments and health. On the one hand, familism—the strong family ties, trust, loyalty, and spirit of mutual support cultivated by many immigrant
parents—and family responsibilities such as language brokering for adult parents can positively influence youths’ emotional wellbeing.22 On the other hand, family conflict,
parent-child acculturation gaps, and numerous family obligations can add to the stress experienced by children of immigrants and compromise their well-being.23 Much of the
acculturation literature uses first- and second-generation immigrants’ preferences for reading, writing, and interacting with friends in English rather than a foreign language as a
primary measure of acculturation. These studies find that linguistically more acculturated youth have poorer health and engage in more risky health behaviors. In contrast,
researchers know less about how age of migration, legal status, and the institutional and social contexts of reception influence children’s health. Children who immigrate at
younger ages have greater language acquisition and better educational outcomes than children who immigrate at older ages, especially after puberty. However, their health risk
profiles are more similar to children born in the United States to foreign-born parents. These young migrants find themselves caught between two worlds—the cultures of their
parents and the cultures of their new communities. As they struggle to adapt, they tend to adopt more risky health behaviors such as alcohol use, smoking, and early sexual
activity than their peers who immigrate at older ages.24 In addition, they face a higher risk of psychiatric disorders such as depression.25 Living in a liminal state between
countries and without legal status can create daily hassles and become a source of chronic stress for children and their parents. A recent study of U.S.-born and foreign-born
children of immigrants (from birth to age eighteen) whose parents had been arrested, detained, or deported during workplace raids by immigration officers sheds some light on
26 It found that children in these families experienced feelings of
abandonment, fear, social isolation, and anger. Moreover, family friends and teachers noticed changes in these children’s behaviors
the health consequences of legal status.
immediately after the raids. Finally, the influence of each of these stressors may vary by an immigrant’s state of residence. Several researchers have begun to evaluate the link
between how well immigrants are received in an institutional and social context and health outcomes. 27 Historically, immigrants settled in six traditional gateway states—
California, Florida, Illinois, New Jersey, New York, and Texas. Since 1990 immigrants have begun settling in new destination states across the Midwest (such as Indiana, Iowa, and
Nebraska) and the South (such as Georgia, North Carolina, and Tennessee). These new destination states lack many of the institutional resources and multilingual professionals
who help new immigrants settle and navigate complex U.S. health systems. Immigrants settling in these states also have smaller co-ethnic networks on whom they can rely for
assistance and who can reinforce positive cultural norms and health behaviors for their children. Consequently, these immigrants have less access to health care and can be at
greater risk of worsening health with time in the United States.28 Promoting Physical Well-Being in Immigrant Children Pre-migration, migration, and post-migration stressors
have the potential to harm the well-being of children of immigrants. Yet for a number of health indicators, foreign-born children experience better outcomes than do children in
U.S.-born families. Foreign born immigrant children typically have lower mortality and morbidity risks than both U.S.- born children of immigrants and U.S.-born children of
natives within their same racial ethnic group;29 they have fewer specific acute and chronic health problems; and they have a lower prevalence of accidents and injuries than
U.S.-born children.30 Over time and across generations, however, the health advantage of immigrant children fades. In this section, we summarize prevalence data on two key
physical health indicators—obesity and asthma. These are two leading childhood health conditions in the United States with increasing prevalence among children of immigrants
and long-term consequences for adult well-being. Because of the paucity of research on European and African children of immigrants, this summary focuses on Asian and
Hispanic populations. To the extent that data are available, we highlight differences across immigrant generation and country of origin. In general, much of the research on Asian
populations focuses either on Southeast Asians such as Vietnamese and Cambodians, Chinese, or Filipinos. Research on Hispanics focuses on Mexicans and Puerto Ricans.
Overweight and Obesity Over the past three decades, the prevalence of excessive weight among children (aged six to nineteen) has increased from 5–7 percent to 17–18
percent.31 Likely to become overweight adults, overweight children are at increased risk of developing serious health conditions, including diabetes and cardiovascular disease.
Studies comparing foreign-born and U.S.- born adolescents (aged twelve to twenty-six) have found that the share of adolescents who are overweight or obese is lowest for
foreign born youth, but these shares grow larger for each generation and increase rapidly as youth transition into adulthood.32 Among children aged ten to seventeen whose
parents or grandparents are immigrants, Hispanics are most at risk of being overweight or obese, whereas non-Hispanic whites and Asians are the least at risk. Among all youth,
third generation blacks have the highest rates of excessive weight (figure 1).33 These findings parallel those identified in studies of younger children (aged five to ten).34 As with
adolescents, second-generation Hispanic boys are at greater risk of being overweight or obese than second-generation children of any other racial or ethnic background. Diet
significantly contributes to excessive weight among children and adolescents. As immigrants become more acculturated to U.S. society, they adopt American diets, which
typically include greater amounts of fat, processed meats, snack foods, and fast foods than the diets in their countries of origin.35 Although these changes in dietary intake
among immigrant adults are well documented, studies among youth are more limited.36 One study using the National Longitudinal Study of Adolescent Health (also known as
Add Health) found that foreign-born Hispanic youth aged twelve to eighteen had generally healthier diets than Hispanic youth born in the United States.37 A second study using
the 2001 California Health Interview Survey found that Asian and Latino foreign-born youth aged twelve to seventeen drank fewer sodas and ate more fruits and vegetables than
non-Hispanic white U.S.-born children.38 But Latinos’ fruit and vegetable consumption decreased and their soda consumption increased over time. while Asians’ fruit, vegetable,
and soda consumption stayed constant. Thus Asian children tended to maintain a lower risk of being overweight or obese than Latino children. Low levels of physical activity
further contribute to overweight and obesity among children. Rates of physical inactivity are high among foreign-born children.39 Eighteen percent of foreign-born immigrant
children aged six to seventeen do not get any vigorous exercise in a typical week, and 56 percent do not take part in any team sports or games. By comparison 11 percent of
U.S.-born children with U.S.-born parents do not exercise regularly, and 41 percent do not participate in organized sports. Compared with foreign-born Asian children, Hispanic
foreign-born children had triple the rates of physical inactivity (22.5 percent to 7.4 percent); two-thirds of the Hispanic children did not participate in sports, compared with
slightly more than one-third of the Asian children (66.6 percent to 37.6 percent). Asian children’s higher rates of physical activity may also contribute to their reduced risk of
obesity. Immigrant families may not be fully aware of the physical and mental health benefits of physical activity, may place a higher value on family or school activities, or may
discourage participation in physical activities and sports. Most importantly, the structure of their daily lives (such as parents’ work schedules) and their living conditions
(neighborhood environments and access to recreational facilities, for example) may limit immigrant children’s ability to engage in physical activities.40 Asthma In 2008, nearly
one of every ten U.S. children up to age seventeen had asthma, a leading chronic childhood disease, and rates of asthma are increasing worldwide. Patterns of asthma
prevalence vary considerably by racial and ethnic group, with Asians having the lowest prevalence (4 percent), followed by Hispanics (7 percent), whites (9 percent), and blacks
(16 percent).41 Although few studies have disaggregated the prevalence of asthma by country of origin or nativity, evidence suggests that across all racial and ethnic groups the
children of immigrants have a lower lifetime prevalence of asthma than native children.42 Among Hispanic groups, Puerto Rican children have one of the highest rates of
childhood asthma (19.2 percent in 2007), whereas Mexican children, whether immigrant or not, have one of the lowest rates (6.0 percent in 2008).43 Prevalence rates among
Asian children aged two to seventeen vary from 4 percent for Asian Indians, to 5 percent for Chinese, to 11 percent for Filipinos.44 Because a diagnosis of asthma requires a visit
to a health care provider, and because immigrants have less access to the health care system than nonimmigrants, rates among these groups may be underreported. Moreover,
barriers to accessing health care can contribute to higher rates of hospitalization for asthma and poor asthma management among Hispanic children, immigrants, and other
minority groups.45 In a recent study of Hispanic children aged five to twelve in New York City, asthmatic children from Spanish speaking families were less likely to have an
asthma diagnosis than children from English speaking families but were twice as likely to be hospitalized for asthma (9.4 percent to. 4.4 percent).46 Another study of families in
California found that asthmatic children of immigrants aged one to eleven were more likely to lack a usual source of care, report a delay in medical care, and report fair or poor
health status than asthmatic children in nonimmigrant families.47 Protecting Emotional Well-Being in Immigrant Children While first- and second-generation children fare well
on many aspects of physical wellbeing, this advantage relative to their native peers does not always translate into good mental health. Immigrant families experience a number
of stressors that can affect the psychological well-being of all family members. These stressors affect children’s emotional well-being, both directly and indirectly, by hindering
parents’ capacities to nurture their children’s socioemotional development.48 As examples of how immigration influences children’s emotional well-being, we look specifically at
patterns of substance use, internalizing behavioral problems such as anxiety and depression, and externalizing behavioral problems such as hyperactivity, aggression, and
conduct disorders. According to the U.S. Surgeon General’s most recent report on mental health, these are the most common mental health concerns for children and
adolescents.49 Substance Use When they first arrive in the United States, children tend to participate in fewer risky health behaviors than those born in the United States.50
However, risky behaviors among foreign-born children increase with time spent in the country, especially during adolescence. Among these behaviors, patterns of substance use
are particularly well documented among foreign-born adolescents aged twelve to seventeen. According to data from the 1999 and 2000 National Household Survey on Drug
Abuse (NHSDA), rates of substance use (including cigarette, alcohol, marijuana, and other illicit drug use) were lower among foreign-born adolescents (9 percent for cigarettes,
12 percent for alcohol, and 4 percent for marijuana), in particular those who had been in the United States less than five years, than among U.S.-born adolescents (15 percent
for cigarettes, 17 percent for alcohol, and 8 percent for marijuana).51 Prevalence estimates for foreign-born adolescents in the United States for ten or more years were not
significantly different from estimates for U.S.-born youths, with one exception. U.S.-born youth had higher rates of heavy alcohol use than foreign-born adolescents. Several
studies examining substance use among Latino adolescents aged twelve to eighteen in Add Health found that second generation youth were more likely to smoke cigarettes and
use alcohol and marijuana than first-generation youth (figure 2).52 U.S.-born Hispanic youth were more likely than foreign-born Hispanic youth to report associating with
substance-using peers, and peer substance use was directly associated with increased substance use.53 Few studies have assessed the impact of acculturation on the substance
use of Asian children of immigrants. Asian American adolescents tend to have lower rates of smoking, alcohol, and drug use than other racial and ethnic groups. However,
despite low rates overall, there are major differences by Asian ethnic group. Pacific Islander adolescents have higher rates of substance use, including alcohol, marijuana, and
illicit drug use, compared with youth of other Asian ethnic groups.54 One smaller study of Asian first- and second-generation adolescents aged fourteen and fifteen showed
increases in substance use with length of time in the United States and interactions with substance-using peers.55 Depression and Suicide Although no psychiatric
epidemiological studies of children in the United States have been conducted, smaller community based studies and studies of symptom-level psychopathology indicate that
anxiety and depression are the most prevalent conditions affecting the emotional well-being of children.56 In any given year, approximately 13 percent of children aged nine to
seventeen experience symptoms of anxiety and 10–15 percent experience symptoms of depression. In addition, the vast majority of children and adolescents who commit
suicide have experienced either anxiety or depression. Although not conclusive, current research suggests that exposure to culture-related stressors and acculturation to the
U.S. mainstream increases the risk of anxiety and depression among children of immigrants. In contrast, adherence to heritage cultures, a sense of belonging to their ethnic
groups, and a number of family influences protect the children of immigrants from developing symptoms of anxiety and depression. Thus, mainstream integration may be
problematic only when it is not coupled with the retention of one’s cultural heritage, ethnic identity, and family strengths.57 For example, one study of Chinese immigrant
families found that twelve- to fifteen-year-olds whose levels of acculturation were different from their fathers were more likely to report depressive symptoms.58 But another
study of Chinese immigrant families found that a strong sense of family, measured by family obligations, was associated with decreased depressive symptoms among thirteento seventeen-yearolds.59 Similarly, data from Add Health suggest that social support from family, friends, and neighbors attenuates the risk of depressive symptoms and
enhances the likelihood of positive well-being for all first- and second-generation adolescents aged twelve to eighteen.60 Parental closeness and the absence of parent-child
conflict reduce the risk of poor mental health outcomes for second- and third-generation adolescents. At its most extreme, poor mental health can lead to suicidal ideation and
suicide among children of immigrants. Suicide is the third-leading cause of death among all fifteen to twenty-four-year-olds. Although the 2007 Youth Risk Behavior Survey
(YRBS) does not contain information on immigrant generation or acculturation, its data indicate that Hispanic students were as likely to have seriously considered suicide in the
past year as other racial and ethnic groups but that more Hispanic youth reported making a suicide plan.61 Hispanic youth (both boys and girls) were also more likely to have
attempted suicide (10 percent) than non-Hispanic white (5.6 percent) or black (7.7 percent) youth. A study using YRBS data from 1991 to 1997 found that Asian and Pacific
Islander youth were less likely than Hispanics and more likely than either non-Hispanic white or non Hispanic black students to have made at least one suicide attempt.62 Those
studies with specific data on immigrant generation or acculturation have found that acculturative stress is positively associated with suicidal ideation among Latino youth.63 In
addition, the risk of attempted suicide among Latino adolescents doubles between the first and second generations (see figure 2). Research among Asian immigrant youth is
much more limited, but results support acculturative stress theory. Under conditions of high parental-child conflict, less acculturated Asian adolescents report higher levels of
suicidal behavior than do more acculturated youth.64 Attention-Deficit/Hyperactivity Disorder Whereas internalizing behavioral problems such as depression tend to be most
prevalent among females, externalizing symptoms associated with hyperactivity and conduct disorders are most prevalent among males.65 Furthermore, rates of attentiondeficit/ hyperactivity disorder (ADHD) and conduct disorders are increasing among children and adolescents in the United States. Although no national studies have assessed
patterns of ADHD and conduct disorder 7 among immigrant families, the prevalence varies significantly by racial and ethnic group. Data from the 2008 National Health Interview
Survey showed that among three- to seventeen-year-olds, Hispanics were roughly half as likely as non-Hispanic whites or blacks to have been diagnosed with ADHD.66 Only
Asians reported fewer cases of ADHD than Hispanics, but the data are too imprecise to report. Once again, however, ethnic differences in diagnosed cases may reflect access to
regular sources of medical care rather than true differences in prevalence rates. Even after receiving a diagnosis, both Hispanic and Asian children (aged three to eighteen)
to health care
substantially influences the physical and emotional health status of children of immigrants. Less
likely to have health insurance and regular access to health care services, immigrant parents
delay or forgo needed care for their children. When children finally receive care, it is often in the emergency room
after an urgent or lifethreatening condition has developed. Health Insurance In 2008, nearly 45 percent of noncitizen
U.S. residents, 18 percent of naturalized citizens, and 13 percent of U.S.-born citizens lacked health insurance
coverage.68 Because most children depend on their parents to obtain health insurance, parental
citizenship and immigration status can influence children’s health insurance status (figure 3).
Foreign born parents and their children are more likely to be uninsured because parents are
frequently self-employed or working for employers who do not offer health insurance, have
lower incomes limiting their capacity to purchase insurance in the private market, and face
restrictions on eligibility for public insurance programs.69 When offered insurance coverage by their employers, roughly
receive fewer medical care services than non-Hispanic whites.67
Improving Access to Health Insurance and Health Care Access
85 percent of employees take up this coverage, and there are no differences in take-up rates between citizens and noncitizens.
Immigrants’ eligibility for public health insurance is dependent on federal and state policies.
Coverage rates among legal immigrants have declined over the past decade as a result of 1996
welfare reforms that prohibited foreign-born children from receiving federally funded Medicaid
and state Children’s Health Insurance Program (CHIP) coverage until they had been in the
country for at least five years. To fill this coverage gap, some states provided public insurance coverage using state-only
funds. In the interest of promoting the health of newborns, several of these states also provided prenatal coverage to immigrant
women regardless of their immigration status. In early 2009 the federal Children’s Health Insurance Program Reauthorization Act
updated the funding rules for CHIP and provided federal matching funds to states that covered eligible legal first-generation
immigrant children and pregnant women regardless of their date of entry into the United States. However, states are not required
to provide access to CHIP and can choose not to take advantage of the new option. As of February 2010, thirty states and the District
of Columbia had chosen to provide public health insurance coverage to at least some qualified legal immigrants (figure 4).70 In these
thirty states, nearly one of every five children is a child of an immigrant. Still, many
children of immigrants (56
percent of children with two immigrant parents and 66 percent of children with one foreign
born and one U.S-born parent) eligible for public health insurance do not enroll.71 Approximately 81
percent of children (up to age eighteen) in immigrant families were born in the United States and are U.S.
citizens. But an estimated 30 percent of children of immigrants are unauthorized or living with a parent who may not be living in
the United States legally.72 Thus, parents of U.S. citizen children may forgo public health insurance
and other services because of their own legal status and mistaken fears that they will be
deemed a “public charge” if their children receive public health insurance benefits.73
Immigrants deemed a public charge can be denied U.S. citizenship or prohibited from
sponsoring the immigration of a family member. In addition to concerns regarding their legal
status, immigrant parents face financial and language barriers that can limit their capacity to
enroll in both private and public health insurance programs. Health Care Use Without health insurance and
even with insurance, families sometimes forgo critical preventive, diagnostic, and treatment services for their children. Among
noncitizen children up to age seventeen, 37 percent lacked a usual source of care and 30 percent had not seen a medical doctor in
the past year. Only 5 percent of citizen children lacked a usual source of care; only 9 percent had forgone an annual doctor’s visit.
Because they use less care, annual medical expenditures per capita were substantially lower for noncitizen children and their
parents ($1,797) than for citizens ($3,702) in 2005.74 Both financial and nonfinancial
barriers compromise the
ability of immigrant parents to obtain access to medical care.75 Financial impediments include not only outof-pocket costs for services and prescriptions but also the lack of paid sick leave or the ability to leave work to take their children to
appointments during standard office hours. Language is one particularly important nonfinancial barrier for the children of
immigrants and their parents. Immigrants with limited English proficiency report lower satisfaction with care, less knowledge of their
medical condition, and difficulty understanding instructions on medication usage. Additionally, low levels of health literacy limit
immigrant parents’ abilities to use health services effectively or to act as advocates for their children in health care settings. When
immigrants face challenges obtaining physician-based medical care, they may turn to complementary and alternative medical
providers such as acupuncturists or spiritual healers. Data from the California Health Interview Survey show that more than 22
percent of Latino and 23 percent of Asian adults reported using alternative medicine providers, and almost 20 percent of Latinos and
50 percent of Asians reported using traditional or herbal remedies.76 In addition, uninsured immigrants turn to health care
providers working in federally qualified community health centers (FQHCs)—public and private nonprofit organizations serving
populations with limited access to care.77 In 2008 FQHCs provided care to 17 million patients. Of these, 25 percent primarily spoke a
language other than English, 36 percent were children, and 38 percent were uninsured.78 Uninsured immigrants, however, are less
likely to use emergency rooms. Only 13 percent of adult and 12 percent of child noncitizens report an emergency room visit in the
past year compared with 20 percent of adult and 22 percent of child citizens.79 Despite this lower frequency of use, emergency
room expenditures are three times higher per capita for foreign-born children than for U.S.-born children.80 Thus, at least for
children, delaying medical care can have substantial costs. Moreover, because immigrant parents cannot build long-term
relationships with providers in these settings, their children may receive lower-quality care. Strategies to Promote Health To
better promote the health of immigrant children, health researchers and reformers must improve their
understanding of these children’s unique experiences, reduce barriers to medical insurance for immigrant populations, and
improve access to care and the capacity of providers to work with multilingual and multicultural populations.
Public charge reform to allow health coverage helps the economy and prevents
undocumented immigration of disabled relatives
Caldwell 14 (Joe Caldwell, PhD in disability studies from the University of Illinois at Chicago,
Director of Long-Term Services and Supports Policy at the National Council on Aging, former
Kennedy Fellow with the Senate HELP Committee, former policy analyst for the Association of
University Centers on Disability, Adjunct Assistant Research Professor at the University of Illinois
at Chicago, co-principal investigator of the Family Support Research and Training Center, cochair of the National Quality Forum workgroup on Home and Community-Based services, serves
on the boards of the Consortium for Citizens with Disabilities and National Alliance for
Caregiving, 4/7/14, “Immigration Reform: Key Issues for People with Disabilities and Older
Short of full eligibility for Medicaid, there are a number of incremental policy options that could
be considered to improve access. The 5-year bar for lawful permanent residents could be
eliminated or the time during provisional status could be counted as applying to the 5-year bar.
Another option could be to provide states with the flexibility to provide Medicaid coverage to
immigrants with disabilities and seniors. A similar option exists for pregnant women and 3 children, and
approximately half of states have elected this option. While some of these ideas were considered as amendments in the Senate,
none were voted on or adopted. Finally, the Senate bill denies credit for Social Security contributions made by immigrants while they
Not only will this significantly limit SSDI for working immigrants who become
disabled, it also will limit access to Medicare for individuals with disabilities and older
immigrants approaching retirement age. Full access to Medicare Part A (which covers hospital, nursing home, home
were unauthorized.
health, and hospice service) is based upon work history. Without enough work credits, individuals must purchase Part A at a cost of
up to $441 a month in 2013, which is simply unaffordable for many older immigrants and immigrants with disabilities. Strengthening
the Direct Care Workforce Immigration
reform holds great potential to help stabilize and strengthen
the direct care (or personal assistance) workforce that provides long-term services and supports
to seniors and people with disabilities. Due to the aging of the U.S. population, the number of individuals who need
long-term services and supports will more than double in the coming decades, from 12 million to 27 million by 2050.7 Individuals
who need long-term services and their families currently struggle to find and retain direct care workers. A severe shortage of future
workers is projected that will create even more difficulties for individuals and families. Conservatively, approximately 1.6 million
additional direct care workers will be needed by 2020 and 3 million by 2030.8 Immigration reform is part of the solution to
addressing this projected shortfall of workers. Nationally, approximately 26% of the current direct care workforce is foreign born. In
some states, the percentage is much higher: NY (63%), NJ (50%), DC (46%), CA (45%), and FL (42%).9 Approximately half of these
workers are naturalized citizens and others have legal status, but a portion is estimated to be unauthorized.10 Providing a pathway
to citizenship for direct care workers will help stabilize the workforce, ensure protections for workers, and improve the quality of
services and supports. For example, legal status would allow for improved background checks of workers, ability of workers to drive
legally, opportunities for training and career advancement, and development of registries to assist individuals in locating workers.
Moreover, the Senate bill establishes a new “W” nonimmigrant visa for low-skilled workers. This would allow for low-skilled workers
to enter the U.S. and work for registered employers in occupations with labor shortages for a limited period of time. The program
would start at 20,000 visas, increasing to 75,000 or more annually based on shortages in the labor market. While the number of visas
for low-skilled workers is modest, this would be an important step forward in helping to address the projected gap in available direct
care workers. Access to Family Visas Dating
back to the Eugenics movement, “public charge” policies
remain in law and practice.11 The term “public charge,” as defined by the U.S. Citizenship and
Immigration Services (USCIS), refers to an individual who is likely to become “primarily
dependent on the government for subsistence, as demonstrated by either the receipt of public
cash assistance for income maintenance or institutionalization for long-term care at government
expense.” An individual who perceived as likely at any time to become a public charge is
inadmissible to the U.S. and ineligible to become a lawful permanent resident. These outdated
policies counter decades of progress in U.S. and international disability policy that have sought
to remove barriers, open opportunities, and promote inclusion. Public charge policies prevent
family unification. Immigrants who have become citizens are unable to petition for their children
or other relatives with disabilities. These policies also lead to sheltering individuals with
disabilities at home for fear of deportation. While the Senate bill promotes an inclusive road to citizenship for
unauthorized immigrants, it does nothing to remove barriers to entry for individuals with disabilities. The
Senate bill also makes a number of major changes to the current visa system. It eliminates the sibling category for family visas and
establishes a new “merit-based” system to reduce the substantial backlogs. Siblings play important support roles in the
lives of people with disabilities. For individuals with lifelong intellectual and developmental disabilities, siblings frequently assume
family caregiving roles when aging parents pass away or are no longer able to provide support. The
merit-based system,
which awards points that are heavily weighted toward academic and employment criteria, could
pose barriers to reunification with siblings and low-income family members. Economic Benefits of
Immigration Reform There are numerous economic benefits from immigration reform that directly
and indirectly benefit seniors and people with disabilities. While many unauthorized immigrants currently
contribute to Social Security, immigration reform would increase the percentage of immigrants paying into Social Security and
increase contributions due to higher earnings. Because the population is young, they will pay hundreds of billions of dollars more in
Social Security taxes than they will receive in benefits over the next 36 years, strengthening the trust fund. 12 Similarly, the net
positive contributions of young, working immigrants paying into Medicare would extend the solvency of the Medicare Part A Trust
Fund.13 Finally, bipartisan economists and policy experts have estimated that comprehensive immigration reform would contribute
to 4.8% growth in the U.S. economy and reduce the federal deficit by $1.2 trillion over the next 20 years. 14 Reducing the deficit
would allow for investments in underfunded aging and disability programs, particularly as needs increase with the aging of the U.S.
population. Conclusion Immigration reform holds the promise of establishing a new social contract for a more just and caring society
across generations. A comprehensive approach is needed that fully includes individuals with disabilities, older adults, and their
families. Comprehensive reform can help strengthen the direct care workforce and help fill projected shortages of workers who
assist individuals to age with independence and dignity. An
influx of younger workers contributing to the
economy can produce numerous economic benefits, help reduce the federal deficit, and
strengthen programs such as Social Security and Medicare. However, as a matter of equity,
hardworking immigrants, paying taxes and producing these economic benefits, should have fair
access to a basic safety net of health care and long-term services and supports.
Disease Scenario
Uniqueness - Vaccines
Vaccinations are on the decline now among immigrants- healthcare is key
Haston and Pickering 18, (Julia C. Haston, M.D., Faap and Larry K. Pickering, M.D., Fidsa,
Fpids, Faap, Young children of immigrants may be behind on vaccines, 7-9-2018, AAP Gateway,
Since introduction of routine vaccination in the U.S., there has been a substantial decrease in morbidity and mortality related to
many vaccine-preventable illnesses, including but not limited to diphtheria, measles, mumps and pertussis. However, a
level of vaccination coverage must be maintained for a community to benefit from the public
health impact of indirect protection. This occurs when vaccinated people block the chain of
disease transmission, which protects unvaccinated and under vaccinated people by limiting
spread. A recent study from the Centers for Disease Control and Prevention (CDC) reports that vaccine coverage in
children under 3 years of age may vary depending on the birth country of a child’s parents. Since children of
immigrants are the fastest-growing population of children in the U.S., this requires consideration not only
at the state and national levels, but also by all providers caring for immigrants and/or children of immigrants. Assessing
immunization status The Minnesota Department of Health (MDH) used state vaccination registries to assess how many children 2-36
months of age were up-to-date on immunizations in 2016 based on U.S. vaccine recommendations. Using a sample of 97,885
children, the MDH found that children
with at least one foreign-born parent were overall less likely to
have received all recommended vaccines at 2, 6, 18 and 36 months of age when compared to children of two U.S.born parents. However, status of up-to-date children varied significantly based on parents’ birth country. Maternal birth country was
used to categorize children into nine regional groups: United States, Asia, Eastern Europe, Western Europe/Canada, Africa (excluding
Somalia), Central/South America/Caribbean, Mexico, Oceania/other and Somalia. Of the total sample, 22% of children had at least
one foreign-born parent. Children with mothers born in Central and South America/Caribbean, Mexico and Africa (excluding
Somalia) had higher rates of vaccine compliance compared with children of two U.S.-born parents at all ages, while the lowest
percentage of up-to-date children had mothers born in Eastern Europe and Somalia (see figure). Nearly all regional groups showed
higher rates of up-to-date children at 36 months of age when compared with 2, 6 and 18 months of age. Most of this catch-up in
vaccinations appears to occur between 18 and 36 months of age. The most
alarming vaccination rates were
among children with Somalian mothers, with only 10% of children up-to-date at 18 months of
age and only 44% at 36 months of age. The reasons for variation in vaccination status are incompletely
understood but may include lack of public health education programs, misunderstanding of vaccination safety, inadequate
access to health care, and economic and social factors surrounding emigration. Understanding factors influencing a child’s
vaccination status can have major public health implications. For example, in a 2017 measles outbreak in Minnesota, 82% of
confirmed cases involved children of Somali descent. This outbreak was partially attributable to concerns about the safety of the
measles-mumps-rubella vaccine among Somali parents living in Minnesota. Diseases
of high infectivity, including
measles, have the potential to affect large numbers of people in communities with high rates of
unimmunized children. These vaccines should be encouraged for all eligible children. Tools for health
care professionals Although multiple factors likely influence vaccination decisions among immigrant populations, it is health care
professionals’ responsibility to educate parents/patients about the safety and importance of vaccines. As stated in the Red Book,
“The Immigration and Nationality Act (INA) of 1996 requires all people immigrating to the United States as legal permanent
residents (i.e., green card holders) to provide ‘proof of vaccination’ with vaccines recommended by the ACIP before entry into the
United States.” The
required vaccines are those that protect against pathogens that have the
potential to cause an outbreak and those that are in the process of eradication in the U.S. Only
written documentation should be accepted for proof of vaccination. These rules do not apply to refugees, so these children may
require catch-up vaccines at their first visit with a health care professional in the U.S.
AT: No Disease Impact
Lack of equal access to health care threatens global health and magnifies
pandemics which causes extinction
Martin 18 (Sean Martin, Express, 2/15/18, “Pandemic capable of wiping out THE population is on its way, says
health organization,”
A DEVASTATING illness which could wipe out large swathes of humanity is on the horizon, according to senior officials at the World Health Organisation
(WHO). One
disease which could kill up to 100 million people in a pandemic similar to the Spanish
Flu is long overdue, according to the shock announcement. This is according to Tedros Adhanom, director general at WHO. Speaking at the
World Government Summit in Dubai, Mr Adhanom said the world is not prepared for such a pandemic and he also
states that it could pop up in any country. Mr Adhanom said: "This is not some future nightmare scenario. "This is what
happened exactly 100 years ago during the Spanish flu epidemic. "A devastating epidemic could start in any
country at any time and kill millions of people because we are still not prepared. The world remains vulnerable. " The absence of universal
health coverage is the greatest threat to global health. "The benefits of universal health coverage go far beyond health.
Strong health systems are essential to strong economies. "We do not know where and when the
next global pandemic will occur, but we know it will take a terrible toll both on human life and
on the economy.” Mr Adhanom made the bold claims just as the US, which is in the midst of a severe flu season that are causing one in 10
deaths in the US, and the Centers for Disease Control and Prevention (CDC) announced it would be cutting their epidemic prevention programs back by
80 percent. According to the Washington Post, programs for preventing infectious diseases such as Ebola are being diminished in 39 of the 49 countries
they were rolled out in. In the UK, the Universal healthcare system, the NHS, is constantly facing cutbacks which will “ultimately put patient safety at
risk”, according a recent report from the Continuing Healthcare (CHC).
Disease undermines the global economy and regional democracy- U.S as a
global commerce and travel hub means it’s key to global spread of pandemics
Gannon 2000 (John C. Gannon, National Intelligence Officer for Economics and Global Issues,
"The Global Infectious Disease Threat and Its Implications for the United States", 1-16-2000, No
Implications for US National Security As a major hub of global travel, immigration, and
commerce with wide-ranging interests and a large civilian and military presence overseas, the
United States and its equities abroad will remain at risk from infectious diseases. Emerging and
reemerging infectious diseases, many of which are likely to continue to originate overseas, will
continue to kill at least 170,000 Americans annually. Many more could perish in an epidemic of
influenza or yet-unknown disease or if there is a substantial decline in the effectiveness of
available HIV/AIDS drugs. Infectious diseases are likely to continue to account for more military hospital admissions than
battlefield injuries. US military personnel deployed at NATO and US bases overseas, will be at low-to-moderate risk. At highest risk
will be US military forces deployed in support of humanitarian and peacekeeping operations in developing countries. The infectious
disease burden will weaken the military capabilities of some countries--as well as international peacekeeping efforts--as their armies
and recruitment pools experience HIV infection rates ranging from 10 to 60 percent. The cost will be highest among officers and the
more modernized militaries in Sub-Saharan Africa and increasingly among FSU states and possibly some rogue states. Infectious
diseases are likely to slow socioeconomic development in the hardest-hit developing and former
communist countries and regions. This will challenge democratic development and transitions
and possibly contribute to humanitarian emergencies and civil conflicts. Infectious disease-related
embargoes and restrictions on travel and immigration will cause frictions among and between developed and developing countries.
The probability of a bioterrorist attack against US civilian and military personnel overseas or in
the United States also is likely to grow as more states and groups develop a biological warfare
capability. Although there is no evidence that the recent West Nile virus outbreak in New York City was caused by foreign state
or nonstate actors, the scare and several earlier instances of suspected bioterrorism showed the confusion and fear they can sow
regardless of whether or not they are validated. Figure 1 Leading Causes of Death, 1998 Discussion Patterns of Infectious Diseases
Broad advances in controlling or eradicating a growing number of infectious diseases--such as
tuberculosis (TB), malaria, and smallpox--in the decades after the Second World War fueled
hopes that the global infectious disease threat would be increasingly manageable. Optimism
regarding the battle against infectious diseases peaked in 1978 when the United Nations (UN) member states signed the "Health for
All 2000" accord, which predicted that even the poorest nations would undergo a health transition before the millennium, whereby
infectious diseases no longer would pose a major danger to human health. As recently as 1996, a World Bank/World Health
Organization (WHO)-sponsored study by Christopher J.L. Murray and Alan D. Lopez projected a dramatic reduction in the infectious
disease threat. This
optimism, however, led to complacency and overlooked the role of such factors
as expanded trade and travel and growing microbial resistance to existing antibiotics in the
spread of infectious diseases. Today: Infectious diseases remain a leading cause of death (see figure 1). Of the estimated
54 million deaths worldwide in 1998, about one-fourth to one-third were due to infectious diseases, most of them in developing
countries and among children globally. Infectious diseases accounted for 41 percent of the global disease burden measured in terms
of Disability-Adjusted Life Years (DALYS) that gauge the impact of both deaths and disabilities, as compared to 43 percent for
noninfectious diseases and 16 percent for injuries. Although there has been continuing progress in controlling some vaccinepreventable childhood diseases such as polio, neonatal tetanus, and measles, a White House-appointed interagency working group
identified at least 29 previously unknown diseases that have appeared globally since 1973, many of them incurable, including
HIV/AIDS, Ebola hemorrhagic fever, and hepatitis C. Most recently, Nipah encephalitis was identified. Twenty well-known diseases
such as malaria, TB, cholera, and dengue have rebounded after a period of decline or spread to new regions, often in deadlier forms
(see table 1). These
trends are reflected in the United States as well, where annual infectious
disease deaths have nearly doubled to some 170,000 since 1980 after reaching historic lows that
year, while new and existing pathogens, such as HIV and West Nile virus, respectively, continue
to enter US borders.
Increasing pandemic threat- US not prepared- prevention over response
Shinkman 17 (Paul D. Shinkman, national security reporter for U.S. News & World Report,
5/4/17, “If a Pandemic Hits, the U.S. Isn’t Ready”,
THE THREAT OF A GLOBAL pandemic is growing at a time when the U.S. government is not
adequately prepared to respond to one, according to a recent study. Misinformation about vaccines, the absence of a
clear plan for coordination among federal agencies such as the U.S. Agency for International Development and the Defense
Department, and a need to improve public awareness about the threat
posed by a biologic outbreak are among the
factors that make the possibility of large and deadly pandemics increasingly likely, according to the
study from Texas A&M University's Scowcroft Institute of International Affairs. "Unfortunately it's been
a series of pickup games," says retired Gen. Mark Welsh, the U.S. Air Force chief of staff from 2012 to
2016. He now serves as dean of the university's Bush School of Government and Public Service, which contributed to the
study. "We've lacked the overarching leadership, the national plans." As a member of the Joint Chiefs of Staff at the time, Welsh
oversaw the military's contributions in responding to the Ebola epidemic that peaked in 2014 in West Africa and
threatened to expand across the globe. That scenario showed the U.S. government's ability to overcome a lack of
planning, and to deploy experts and support staff to affected areas to contain and mitigate the virus' spread. However, the
military and its civilian overseers didn't learn enough from that lesson, Welsh says. "You generally have a
lack of a feeling there is a coordinated response that's on the shelf, ready to go in case something like this happens elsewhere in the
world," he says. "And you certainly
don't get the feeling there is an international community, even a national
community, that is ready and fully prepared with the required memos of understanding and
agreements in place to make a response happen." As past outbreaks become further and
further removed, more pressing priorities take precedence over future preparations, he says. "From
a pandemic perspective, we can't afford to look at this that way, because the danger levels are rising. The risk factors
are increasing and we can't afford not to be ready," Welsh says. Among factors the study points to as contributing
to the threat of a pandemic is America's anti-vaccine movement, which includes people who believe in a debunked link between
vaccines and autism. President Donald Trump himself has indicated he questions the science behind vaccines. Public-school
populations in states like Washington and Texas, meanwhile, are in danger of falling below what the study calls "herd immunity," in
which the number of vaccinated people in a particular community is enough to provide protection for those who have not been
vaccinated. The study also stresses the need to have uniform vaccination requirements for immigrants and refugees coming to the
U.S. The analysis additionally highlights the importance abroad of USAID, which it says should be tasked with overseeing the entire
government's response to pandemics. Unlike the military, this agency already has the authority to carry out such a mission, as well
as funding that could be used for it. USAID also should help developing countries in improving their health care hiring systems, the
study says. Not only could this lessen the chances of future pandemics, but it could save the U.S. money – the government spent
$2.4 billion in response operations just to the Ebola outbreak. "This
reactive method of disease response is not
sustainable and does little to prevent the emergence of infectious diseases at their source," the
study states. The Trump administration signaled an intent to cut USAID funding through its 2018 "skinny budget" proposal, and
reportedly has considered folding the agency into the State Department amid concerns such a move would strip the federal
government of the agency's specialized expertise. "We're not turning our lessons observed in Ebola into lessons learned," says Gerry
Parker, a strategic adviser to the Texas A&M-headquartered Institute for Infectious Animal Diseases. The 26-year Army veteran
previously served in the Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and
Response. Citing
the recent spread of the Zika virus, Parker says it's inevitable there will be far worse
and more serious pandemics in the near future. "We'd just better be prepared," he says. "And
we're not today."
Even if disease doesn’t cause extinction, it causes recession, poverty, and
increases healthcare costs
Bloom 05 (Eric Bloom, Vincent de Wit, and Mary Jane Carangal-San Jose, "Potential Economic
Impact of an Avian Flu Pandemic on Asia", November 2005, ERD Policy Brief No. 42, Economics
and Research Department, Asian Development Bank,
Scenario 2 assumes that the
psychological impact of the outbreak lasts longer and seriously affects
demand for four quarters with another four quarters with a smaller exogenous shock to
consumption and export of services. This contraction affects Asia both directly as Asian consumers reduce their
activity, and indirectly as the rest of the world reduces its consumption, impacting trade and investment. Here, the economic
impact would be more severe and would likely force the world into a recession. The estimated loss
would be $282.7 billion, around 6.5 percentage points of GDP (Table 2). The demand effect would swamp the
supply effect. Since the epidemiological assumption is the same, the impact of the supply shock is the same at $14.2 billion.
Growth in Asia would virtually stop, with a regional GDP growth rate of 0.1 percent. Global GDP will
shrink 0.6 percent. The global trade of good and services will contract around 14%, the equivalent of
$2.5 trillion. As an endogenous response, gross investment will drop in most countries for 2
years, along with industrial production and trade. Likewise, unemployment will increase. Commodity
prices (including the price of oil) will drop, bringing down consumer prices. As can be seen, some countries are more affected than
others. Two factors stand out. First, open economies are more vulnerable to international economic shocks. Second, economies that
are significant exporters of services are hard-hit. In Hong Kong, China and in Singapore, trade accounts for a significant share of total
GDP and these two countries are major exporters of services. Malaysia and Thailand also are also significant exporters of goods and
services. The Appendix summarizes the contribution of trade in Asian economies. These
estimates do not include the
cost of health expenditures, which will be substantial. Long-run Impact Although the analysis has focused on the
immediate impact of the pandemic, the economic impact of the pandemic will be felt for years to come. A
flu pandemic will lead to a reduction of both human and physical capital. Investment will drop significantly, and
remain low possibly over a long time. Deaths caused by avian flu will reduce the work force and lower the region’s
human capital. Even 5
years after the pandemic, in scenario 2 the region’s GDP growth will be lower
by 3.6 percentage points than in a case without a pandemic. The pandemic will impact the region in other
ways that cannot be easily modeled. The psychological impact of the disease may be long-lasting. Much of the Asian boom
is built on confidence in the region’s growth potential. A pandemic could shake that confidence
and lower future investment. Business losses will be significant as importers, exporters, and service industry see a
significant drop in demand. This will force many businesses to close, also lowering future investment
and employment. A pandemic will push households below the poverty line and may increase
inequality if poor households are more affected. Studies show that households that experienced HIV/AIDS7 were
more likely to suffer long-term poverty (Greener 2004). Many poor households never recover their initial
income because of lost family members and sales of assets to pay health care costs (Cohen 1997).
AT: ACA Solves
ACA was a step in the right direction, but our impact’s linear- the less people
uninsured the better or pandemic response and national security
Kahn 17 (Laura H. Kahn, research staff of Princeton University’s Program on Science and Global
Security, author of One Health and the Politics of Antimicrobial Resistance, co-organizer of the
Carnegie Corporation’s “Biodefense Challenge”, former anaging physician for the New Jersey
Department of Health and Senior Services, former medical officer for the Food and Drug
Administration, 6/5/17, “Why access to health care is a national security issue”,
Early last month, US House Republicans rammed through the American Health Care Act, a remarkably regressive piece of legislation
that, among other flaws, would be disastrous for pandemic planning and preparedness. The bill eliminates funding for the
Prevention and Public Health Fund, which was created under the 2010 Affordable Care Act to invest in vaccination programs,
electronic laboratory reporting of infectious diseases, and infection-prevention programs.
Vaccines are an important
preventive strategy against deadly pandemics, while electronic lab reporting facilitates a rapid
response to disease. In other words, these are precisely the funds that will be needed to prevent the next Ebola or
Zika virus from turning into a national catastrophe. In late May, the Congressional Budget Office delivered its
projections on the House bill’s costs and impacts, finding that it would leave an estimated 51 million people under the age of 65
uninsured by 2026—23 million more than the estimated 28 million who will be uninsured under the current law. A Senate version of
the bill may not pass, which would end Congressional Republicans’ umpteenth attempt to undermine or reverse the Affordable Care
Act. But we can be sure their fight will continue, and that has important
national security implications even
beyond slashing emergency-planning funds (which, by the way, Trump’s proposed federal budget also does). Cutting
the Prevention and Public Health Fund, which deals directly with planning for bioterror attacks and pandemics, was only the most
obvious way in which the House bill attempted to undermine American security. Over the long term, there is also a movement afoot
to put basic
health care out of reach of many Americans. Simply making healthcare unaffordable
may seem less dramatic than slashing an emergency-preparedness budget, but doing so also undermines
security. As the Congressional Budget Office report suggests, the American Health Care Act would make healthcare essentially
unaffordable for people with pre-existing conditions, because it would allow insurance companies to dramatically increase their
premiums. Ten years ago, I wrote about the security impact of the uninsured during the George W. Bush presidency. In 2005, almost
47 million people (about 16 percent
of the total US population) were uninsured. Thanks to the Affordable Care Act
dropped to a low of 11 percent, according to a Gallup polltaken
during the first quarter of 2016. The Affordable Care Act was a big step in the right direction, but it didn’t
close the gap, and the national security and public health challenges of having a large fraction of
the population uninsured remain as relevant today as they were a decade ago. Uninsured
people delay seeking health care. Once they seek it, often in a busy emergency room, they are typically given less
attention than people with insurance. This failure to get care becomes a danger not only for the individual
but for the public at large when the problem is a deadly infectious disease. We saw this scenario
play out in Dallas during the Ebola crisis of 2014 and 2015. A poor Liberian man, infected with the virus, presented
passed under the Obama administration, that number
himself to Texas Health Presbyterian Hospital with severe abdominal pain and a high fever. He was examined and sent home with a
bottle of antibiotics. Amazingly,
he did not set off an Ebola outbreak in his community, though the risk
that he could have was significant and the wider public shouldn’t count on being so lucky next
time. Before dying, he infected two nurses who had received inadequate training and equipment to protect themselves. During
the anthrax crisis of 2001, in which spores of the deadly disease were sent through the US mail, many people infected were federal
employees with health insurance. If these postal workers hadn’t had easy access to health care, the death toll might have been
higher than only five; 17 more were infected but survived thanks to timely medical attention. Anthrax spores do not spread from
person to person, but it’s no
stretch to imagine a different scenario: Suppose a future attack involves
smallpox, a highly communicable virus, and that the initial victims are uninsured childcare
workers or food handlers. The initial signs of smallpox include fever, chills, and headache.
Uninsured victims would likely delay trying to get care, hoping for the symptoms to pass. By
waiting they would certainly expose others to the virus, potentially setting of a pandemic.
Countries like Canada, which has universal health coverage and a well-funded public health
infrastructure, are much better prepared to handle deadly epidemics. In 2003, Canada confronted Severe
Acute Respiratory Syndrome (SARS), which originated in China. A physician from Guangdong province inadvertently infected a
number of tourists with the SARS virus, setting off a global pandemic after everyone returned to their home countries. Among the
infected travelers was an elderly Canadian woman who returned to Toronto after a 10-day vacation in Hong Kong. Over the course
of about four months, the Canadian health system worked hard to contain the virus, treating 400 people who became ill and
quarantining 25,000 Toronto residents who may have been exposed. Ultimately, 44 people died from the disease in Canada, but the
result would have been much worse without a quick and well-organized response. The Canadian government’s response had its
glitches—primarily in the form of poor political leadership. Mel Lastman, the mayor of Toronto and a former furniture salesman,
became angry when the World Health Organization (WHO) issued a travel advisory against his city. He railed against the WHO’s
decision on television, revealing his complete lack of knowledge about either the organization or public health in general. As a result
of Lastman’s poor leadership, he was ultimately relegated to a secondary role as the deputy mayor took his place. Lastman’s
credibility and legitimacy never recovered from the SARS outbreak. Likewise, US leaders will be judged by how they handle a
bioterrorist attack or pandemic. Unlike Canada, America’s piecemeal healthcare and public health systems are inherently less able to
handle such crises. The
Affordable Care Act helped fill in the gaps, but really, the only way to prepare
for the eventuality of pandemics or bioterrorist attacks is with a single-payer government-run
system that covers everyone. The United States might consider modeling its health care system after the one in Israel, a
country that, given longstanding threats, takes every terrorist risk very seriously. In 1994, it established universal health coverage for
all citizens. The country’s Ministry of Health monitors and promotes public health, oversees the operations of the nation’s hospitals,
and sets healthcare priorities. As a result, Israel’s public health, emergency response, and hospital systems are state-of-the-art,
highly efficient, and coordinated—a necessity when responding to terrorist attacks. The preamble to the US Constitution states the
goals to “provide for the common defense” and “promote the general Welfare.” The
US government won’t fulfill either
of these duties if it fails to protect its citizens against pandemics and bioterrorism. The mandate
requires a robust public health infrastructure and a universal healthcare system that covers all
Americans. The Trump Administration and Congressional Republicans threaten to undermine this
essential function of government, unnecessarily jeopardizing American lives.
Healthcare access interlinked with sustainable growth- life expectancy, training,
institutional performance and worker mobility
Frenk 4 (Julio Frenk, Mexican Minister of Health and Chair of the 2004 meeting of OECD Health
Ministers, May 2004, “Health and the economy: A vital relationship”,
Healthcare performance is strongly dependent on the economy, but also on the health systems themselves. This
link should
not be underestimated. Investment in health is not only a desirable, but also an essential
priority for most societies. However, our health systems face tough and complex challenges, in part
derived from new pressures, such as ageing populations, growing prevalence of chronic illnesses, and
intensive use of expensive yet vital health technologies. Moreover, we must deal with higher expectations of
citizens and resolve persistent inequities in access and in health conditions among different groups.
Little wonder that the issue of how to ensure the financial sustainability of health systems, while making a positive contribution to
macroeconomic performance, has moved to the top of the policy agenda across the OECD area. Much of the work undertaken in the
OECD Health Project has aimed at providing policymakers with the evidence they need
to promote more value for
money in the health sector, while ensuring universal access, equity and raising quality of care. We
have learned a lot, though there is more to discover. A basic message has emerged: investments in health and the design of health
financing policies should be addressed in terms of the interaction
between health and the economy. Just as
growth, income, investment and employment are a function of the performance and quality of
the economic system, its regulatory frameworks, trade policies, social capital and labour
markets, etc, so health conditions (mortality, morbidity, disability) depend not just on standards
of living, but on the actual performance of health systems themselves. Let us go over some of these
interactions. Health performance and economic performance are interlinked. Wealthier countries have
healthier populations for a start. And it is a basic truth that poverty, mainly through infant malnourishment and mortality, adversely
affects life expectancy. National income has a direct effect on the development of health systems, through insurance coverage and
public spending, for instance. As demonstrated in 1997 by the WHO Commission on Macroeconomics and Health for a panel of 167
countries, while health expenditures are determined mainly by national income, they increase faster than income. Another wellknown relationship is an institutional one. Take the case of tobacco use. Efficient fiscal systems in the OECD have meant that
increases in taxes on tobacco could reinforce other public health policies like rule-based restrictions on smoking in public places.
Some countries have gone very far in this respect, with Ireland actually banning smoking in its famous pubs! Such courageous
initiatives cannot succeed without institutional backing, whether legalistic or otherwise. Another example of how institutional
arrangements can help is through universal provision of insurance coverage, which a larger fiscal base and a small informal sector
help to attain. Globalisation in general, and trade liberalisation in particular, also affect healthcare, via constrained pricing and trade
policies of pharmaceuticals, and the need for enhanced health surveillance across borders and populations. The
effects of
health on development are clear. Countries with weak health and education conditions find it
harder to achieve sustained growth. Indeed, economic evidence confirms that a 10%
improvement in life expectancy at birth is associated with a rise in economic growth of some
0.3-0.4 percentage points a year. Disease hinders institutional performance too. Lower life
expectancy discourages adult training and damages productivity. Similarly, the emergence of
deadly communicable diseases has become an obstacle for the development of sectors like the
tourism industry, on which so many countries rely. Policy choices cannot be taken lightly. Health financing,
through out-of-pocket expenditures, is inequitable and can expose whole populations to huge cost burdens that block development
and simply perpetuate the disease/poverty trap. On the other hand, health
systems need financing and investment to
improve their performance, yet this need cannot in turn impose an unfair burden on national spending or
competitiveness. This is a very delicate balance for policymakers to have to strike. There are other challenges too. For
instance, in high-income countries, the lack of benefit portability associated with employer-provided
health insurance often constrains worker mobility, so impeding the efficiency of labour markets
we all want to see. And there are indirect effects on other spending decisions, both by households and governments. In other
words, if you want to raise investment in health spending, you may need to find cuts elsewhere in the economic system. As
policymakers with public responsibilities, we must never forget that decisions taken in one sphere affect conditions, stakeholders
and policies in another. We all want better health systems, but the
impact of health on the economy should not
be underestimated. Our challenge is to harmonise health and economic policies to improve health outcomes,
of course, but also to minimise any negative impacts while promoting synergies wherever possible .
We cannot do this alone and need the international evidence and shared learning that organisations like the OECD can provide.
Poverty/Structural Violence
Public charge structures unemployment, welfare dependence, and pregnancy
as inherently undesirable and unproductive, causing a “chilling effect” that
locks immigrants into a cycle of poverty and stigmatization
Park 1 (Lisa Sun-Hee Park, Assistant Professor in the Ethnic Studies Department and the Urban Studies and Planning
Program at the University of California, Hein Online, EBSCO Host, 2001, “Perpetuation of Poverty Through ‘Public
Charge,’” Introduction, Denver University Law Review)//jy
INTRODUCTION A number of federal and state policies have had significant impacts on low-income, pregnant immigrant women living in California. This
paper focuses on the issue of "Public Charge," in conjunction with the 1996 Welfare Reform(FN1) and the 1996 Immigration Act.(FN2) I argue that the
social contexts that helped garner support for such anti-immigrant legislative measures created an
environment that essentially criminalized motherhood for low-income, immigrant women -whether they be undocumented or documented. Public charge is a term used by the Immigration and
Naturalization Service and the State Department to refer to immigrants who have or will become
dependent on public benefits.(FN3) Interestingly, this term has been a part of U.S. immigration law for
more than 100 years as grounds for inadmissibility and deportation.(FN4) However, it is with the
passage of recent immigration and welfare reform laws that concerns regarding "public charge"
have resurfaced. In particular, the vagueness of its definition and the standards with which this
measure is applied generated considerable confusion regarding who is eligible for certain
federal, state, or local public benefits and whether non-citizens may face adverse immigration
consequences as a public charge for having received public benefits. This concern prompted
some non-citizens (including residents legally residing in the U.S.) and their families to avoid seeking public
benefits for which they are eligible -- including health care. Such is the case for many lowincome, pregnant immigrant women seeking prenatal care. In April 1998, the National Health Law Program and the
National Immigration Law Center found that "[t]hroughout the country, advocacy groups and healthcare
providers are reporting that immigrants are medically 'on the run,' too afraid to obtain health
care, even when they legally are entitled to it."(FN5) As a result of this chilling effect, low-income,
pregnant immigrant women in California are left with few options. On the whole, they either opt not to
seek prenatal care, choose self-pay, or enroll in Medi-Cal(FN6) and take the risk of public
charge.(FN7) Whichever option they choose, the threat of public charge sends a clear message:
low-income immigrant women -- documented and undocumented -- are not welcome to use
public benefits, including health care for which they are eligible. Immigrants, regardless of their
documentation status, are not viewed as having the same rights and privileges as citizens. The
recent passage of both the Welfare Reform Act and the Immigration Act of 1996, underscore the secondary status of immigrants and the popular
assumption that they have a "natural" tendency for dependency.(FN8) In this way, public
charge is used as a form of
punishment and guarantee against further increases in the number of poor immigrants and their
families. This paper is part of a larger project investigating the impact of the welfare and immigration reforms on prenatal care providers and
immigrant health advocates who serve low-income immigrant communities in California.(FN9) For this paper, I focus on low-income, pregnant
immigrant Latinas' access to Medicaid. In the larger study, we interviewed ninety-nine key informants -- government officials, safety-net prenatal care
providers,(FN10) and immigrant advocates -- who serve low-income, pregnant Asian and Latina immigrants at the national, state, or local levels. We
focused on four regions in California where seventy-seven percent of new immigrants are concentrated: Los Angeles, San Diego, San Francisco Bay
Area, and Central Valley.(FN11) Safety-net
health care providers and advocates who work with low-income immigrant
Latinas repeatedly and consistently reported a "chilling" environment in which women are afraid to
access Medicaid to cover their prenatal care. We found that three factors contributed to this "chilling"
environment: (1) the sharing of information between the California Department of Health
Services and the federal Immigration and Naturalization Service, (2) the slow and confusing
implementation of the reforms, and (3) the intimidating Medicaid eligibility process.(FN12) Drawing on
data from this project, I discuss how these barriers to health care punish Latinas and their children. I argue that this punishment comes in
the form of criminalizing the status of being low-income immigrant, Latina, and of childbearing age. This
was evident in a number of Medicaid fraud detection programs established at the Mexico-U.S.
border, and later at the Los Angeles and San Francisco International Airports. As Nancy Ehrenreich points out, women's reproduction
and the meaning of motherhood are power struggles,(FN13) wherein the state (i.e., courts, or in this case,
federal and state legislatures) determines those who are "good" or "deserving" mothers and those who
are "bad" or "dependent" mothers. I also argue that the consequences of this criminalization are significant, in that lowincome immigrant women are treated as deviants for giving birth to yet another unwanted
"immigrant" and this in turn helps to maintain their subjugated status. In other words, rather than
assistance towards upward mobility, recent retrenchments in welfare benefits and stringent
immigration policies have helped to perpetuate the continued poverty of low-income immigrant
women and their families. Part I critiques the feminization of poverty model and discusses its limitations as an explanatory instrument
for immigrant Latinas. Part II discusses how these legislative policies have worked to perpetuate the poverty among low-income immigrant
communities in California. Part II.A briefly outlines particular provisions in the 1996 Welfare and Immigration policies that are relevant to immigrant
women's health. Then, Part II.B and II.C present a case study of how public charge determinations (long dormant until these recent legislative reforms)
and point of entry detection programs maintain the poverty of low-income Latina immigrants by criminalizing their motherhood. Finally, I conclude
with a discussion of the larger social context of anti-immigrant policies and their implications on women's poverty.
Public charge grounds for inadmissibility exclude the disabled- affidavit of
support excludes the poor
Moore 17 (Andrew F. Moore, Associate Professor of Law at the University of Detroit, 2017,
CARE”, Albany Law Review, LexisNexis)/CWB
B. Public
Charge The ground most closely affiliated with mental disorders is also one of the oldest
grounds for exclusion, and now inadmissibility, and remains a separate ground for deportation after
admission; the "public charge" ground. n246 Like the mental health exclusions of the past, it reflected a belief
that many immigrants coming to this country may become a burden on public resources. n247
The original language and the 1952 INA also used the terms "pauper" as well as "professional beggar" and "vagrant." n248 The
language changed in 1990, to reflect a somewhat greater acceptance of immigrants with disabilities. n249 However, the public
charge inadmissibility ground became more stringent in the 1996 reforms in that an immigrant's sponsor
is required to file a legally-binding document called an affidavit of support. n250 The sponsor of the immigrant n251
attests in the affidavit [*106] that he or she had a sufficient income n252 to support the immigrant
and that he or she will reimburse any public or private entity that ended up giving support to the
immigrant. n253 Looking at the visa ineligibility statistics maintained by the Department of State,
public charge grounds serves as one of the most frequent bases for denying a visa. n254 Unlike the
mental disorder ground, the INA retains a separate ground of deportability for becoming a public charge. n255 It continues the
extended border control concept of the 1952 INA by stating that if an immigrant becomes a public charge within five years of entry,
removal may occur. n256 However, the current provision still has the same limitation as the 1952 version, n257 because it provides
that an immigrant who can affirmatively show that the conditions causing him or her to become a public charge arose after entry,
can avoid deportation. n258 As with the mental disorder ground, it is infrequently invoked today as a reason for deportation. n259
The great decline in its use as a ground of deportation happened in the 1940s. n260 Therefore, it
appears the grounds
historically used to rid the nation of immigrants with mental illness are rarely used today. This
does not lead to the conclusion that we are more permissive toward immigrants with mental
health issues. Rather, it is the theory of this article that these grounds have been to a significant [*107] extent replaced by
removal grounds related to drug use and criminal behavior.
New policy invites government corruption, overt racism, inequality and denial
of health care
Gonzalez and Stahl 18 (Alberto Gonzalez, master’s degree in Public Policy from
Harvard, Senior State Advocacy Manager for the State Consumer Health Advocacy Program at
Community Catalyst, former Statewide Policy Advocate for the California Immigrant Policy
Center, Eva Marie Stahl, Ph.D. in social policy from Brandeis University, Director of Community
Catalyst’s Children's Health Initiative, partner with New England Alliance for Children’s Health,
former employee for Institute of Medicine and for the Agency for Health Care Research and
Quality, 2/9/18, “‘Public Charge’ Would Create a Public Health Crisis for Immigrant Families”,
Health Policy Hub,
“Public Charge” Would Create a Public Health Crisis for Immigrant Families Yesterday, Vox published a
leaked version of a new regulation that seeks to limit legal immigrants’ access to public benefits. In
sum, the rule would empower immigration officials to deny immigrants’ applications for certain
visas or green cards if they are considered likely to utilize available social services. The
regulation essentially gives immigration officials a structural racism roadmap, labeling
immigrants as a “public charge” if they or their dependents (often their U.S.-born children)
utilize needed benefits. The most likely effect of the revised rule is that it will scare immigrants
away from using benefits they are legally eligible for, and undermine the ability of immigrant
families to protect the health and well-being of themselves and their children. So what is considered
a public benefit? According to the Trump administration’s draft rule, the list of what is considered a “public benefit” is far-reaching
and includes: Cash benefits such as Temporary Assistance for Needy Families (TANF) Head Start’s educational and developmental
supports Children’s Health Insurance Program (CHIP) coverage Financial help to purchase health coverage on the marketplace
Supplemental Nutrition Assistance Program (SNAP) assistance Women, Infants, and Children (WIC) assistance to ensure healthy
pregnancies and breastfeeding Some housing support and low-income supports for home heating Transportation vouchers or
support If a person uses any of the aforementioned services to access food, housing, health care or transportation to keep their
families secure and healthy, they could be denied a new visa or green card. The new rule does exempt refugees and people seeking
asylum from the public charge test. Immigrants
have limited options in avoiding the public charge
designation. For example, they can ask another individual to sign an “affidavit of support,” where the signee promises to
support them if they fall below 125 percent of the federal poverty level. However, officials can dismiss the affidavit at their
discretion. A second option
for immigrants is to pay the government a $10,000 bond in exchange for
removal of their public charge designation. The Department of Homeland Security would have discretion
in accepting the bond and if the individual uses any public benefits over the next five years, they forfeit the $10,000 bond to the
government. This
policy invites corruption and discrimination. Why does the public charge test matter? The
quite clear throughout the leaked document: immigrants
are not welcome in this country. The willingness to jeopardize the health and well-being of
families and young children in an effort to set up extensive rules that would codify racism and
deny many individuals needed supports is unconscionable. Speaker Ryan naming Trump’s support as a
Trump administration’s view on immigration is
condition for a Dreamer solution calls into question his own commitment to protect Dreamers and to anti-immigration policies more
broadly. Finally,
in addition to the specific anti-immigrant content of this proposal, we have to
note that the public charge test is part of a larger Trump administration effort to stigmatize and
limit access to benefits for low- and moderate-income people. This administration is taking
aggressive action to accelerate systemic barriers to Medicaid coverage through “work
requirements” and other tests that aim to reduce the use of public benefits and services. They
are messaging these tests as extending dignity to underserved individuals but in reality they are
simply a judgment portfolio, denying those who are struggling day-to-day to meet their health
and wellness needs as unworthy. We are better than this. The Trump administration’s leaked plans
would inflict acute pain on women and children of immigrants and would create a chilling effect
— deterring people from seeking medical care when they need it most. Consumer health and
social justice advocates can play an active role in protecting immigrant families who are being
targeted by the White House and Congress. By exploring ways to collaborate with local groups supporting
immigrant families and elevating how devastating this rule change would be for your constituencies, your organization can help
complement ongoing efforts led by immigrant rights groups. Community Catalyst has worked closely with national partners leading
the fight to protect immigrant families. We recognize that it is important to educate and inform our partners, stakeholders and
community leaders about the important contributions immigrants make, and how the
actions of this administration
and its allies in Congress are not only bad for immigrant families, but for the country as a
Trump’s proposal will dissuade immigrant from using public health care – risks
health problems, and loss of economic self-sufficiency
Jewett, Bailey, and Andalo18 (Christina Jewett and MELISSA BAILEY PAULA ANDALO, Kaiser
Health News is a nonprofit news service that is an editorially independent program of the Kaiser
Family Foundation and not affiliated with Kaiser Permanente, "Under A Trump Proposal, Lawful
Immigrants Might Shun Medical Care," [], 5-10-2018, accessed: 7-11-2018,
The Trump administration is considering a policy change that might discourage immigrants who
are seeking permanent residency from using government-supported health care, a scenario that
is alarming some doctors, hospitals and patient advocates. Under the proposed plan, a lawful
immigrant holding a visa could be passed over for getting permanent residency — getting a
green card — if they use Medicaid, a subsidized Obamacare plan, food stamps, tax credits or a
list of other non-cash government benefits, according to a draft of the plan published by The Washington Post.
Even letting a child who is a U.S. citizen use such benefits could jeopardize a parent's chances of
attaining lawful residency, according to the measure. Health advocates say such a policy could
frighten a far broader group of immigrants into avoiding government-supported health
coverage, creating public health problems that could be dire in the long run — for those
patients and for U.S. hospitals. About 3 million people received green cards from 2014 through 2016, government
records show. Immigrants in the U.S. on a visa or those who have no legal status but plan to seek citizenship based on a close family
relationship would be affected. "We
are very concerned that this rule, if finalized, would have a
significant impact on health in this country," says Erin O'Malley, senior director of policy for America's Essential
Hospitals, who discussed the plan with Trump administration officials in mid-April. O'Malley says she fears that some visa holders
and their families would steer clear of getting routine treatment and resort to going to emergency rooms for medical care. Such
change would "undermine the stability of our hospitals by creating uncompensated care costs
and creating sicker patients," O'Malley says. If enacted, the rule could force a mother to weigh the need for hospital
inpatient care for an ailing newborn against losing her legal immigration status, says Wendy Parmet, director of the Center for
Health Policy and Law at Northeastern University. "The administration, in the draft, talks about self-sufficiency," she says. "But we
don't expect that of [babies]" who are U.S. citizens because they were born in this country. "It's extremely hardhearted." Pushback
has already begun against the leaked draft proposal, even though it is in the earliest stages of the rulemaking process. Washington
state's Gov. Jay Inslee, a Democrat, is sending staff in mid-May to meet with the White House Office of Management and Budget,
which is vetting the proposed rule. Inslee sent a letter on April 24 urging OMB Director Mick Mulvaney to consider the impact on
tax-paying, lawful immigrants. "This will
undoubtedly lead to people across the U.S. going hungry, not
accessing needed medical care, losing economic self-sufficiency, and even becoming
homeless," Inslee's letter says. The leaked draft document said immigration officials would count the
use of one or more non-cash benefits by the applicant within three years as a "heavily weighed
negative factor" in deciding whether to grant permanent residency. On March 29, the Department of
Homeland Security sent a version of the proposal to OMB, which is reviewing it for conflicts with existing law. Next, it will be
published as a proposed rule that the public can comment on before it's finalized. Marilu Cabrera, public affairs officer with the U.S.
Citizenship and Immigration Services, declined to comment on whether the draft published by the Post mirrors what the OMB is
reviewing. Fear in immigrant communities already weighs on physicians. Dr. Julie Linton, a spokeswoman
for the American Academy of Pediatrics, treats many Latino [Latinx] immigrant families at an outpatient clinic in Winston-Salem, N.C.
One woman from Mexico, who had a newborn baby and three other children, told Linton she was afraid to keep her family enrolled
in the nutrition program for Women, Infants, and Children — commonly known as WIC. "Is it safe to use WIC?" the woman asked
Linton. Linton said questions like that put pediatricians in a tough position. On the one hand, Linton says, evidence shows enrolling
in WIC leads to better health outcomes for kids. But what if it also puts the family at risk of being split apart? "It
feels very
frightening to have a family in front of me, and have a child with so much potential ... and be
uncertain how to advise them" on whether to accept public benefits, Linton says. Maria Gomez, president
of Mary's Center, which runs health clinics in Washington, D.C., and Maryland, said she's seeing three to four people a week who are
not applying for WIC and are canceling their appointments to re-enroll in Medicaid. The
proposal homes in on who is
considered a "public charge." The concept emerged in immigration law in 1882, when Congress
sought to bar immigrants deemed "idiots, lunatics" or otherwise likely to become a burden on
the government. The notion of a "public charge" last surfaced in 1999, when the immigration service clarified the concept.
Then and now, an immigrant considered a "public charge" is inadmissible to the U.S. if the person is likely to rely on cash support
from the government for income, or lives in a government-funded long-term institution. Yet the guideline published in 1999 clarified
that legal residents were free to access non-cash benefits like Medicaid, food stamps and assistance for heating bills. "These benefits
are often provided to low-income working families to sustain and improve their ability to remain self-sufficient," the guideline says.
The leaked proposal draft would rewrite those rules. If enacted, Trump's
proposal would label anyone who had
recent or ongoing use of a non-cash government benefit in the previous 36 months a likely
"public charge," and therefore inadmissible to the U.S. The use of such benefits by a spouse,
dependent parent or child would also be taken into account. Applicants who have "expensive
health conditions" such as cancer, heart disease or "mental disorders" and who have used a
subsidized program would also get a heavily weighted negative mark on their application, the
leaked proposal says. Forty-eight-year-old Marnobia Juarez battled cancer successfully and is hoping her husband's green card
application is approved; she also dreams of one day getting her own. Juarez says she never wanted to apply for public benefits until
she was diagnosed with breast cancer in 2014. Since then, she has been treated at no cost under a program run by the state of
Maryland. "I'm alive thanks to this program," says Juarez, who is a community leader at CASA de Maryland, an immigrant advocacy
group. "You don't play with life, and they are playing with life." The proposal says immigrants would have the option of posting a
minimum $10,000 bond to help overcome a determination that they are likely to be a "public charge." The
changes would
affect people sponsored by a U.S. citizen family member, most employment-based immigrants,
diversity visa immigrants and "certain non-immigrants," the leaked proposal says. In 2016, roughly 1.2 million
people got their lawful permanent residence status, or a green card in the U.S. Of the total, 566,000 were immediate relatives or
spouses of U.S. citizens and 238,000 more were family-sponsored, according to data from the Department of Homeland Security.
The change would not affect some immigrants — such as refugees and people granted political
asylum. Nor would it apply to undocumented immigrants. "We're talking about middle-class and
working families," says Madison Hardee, a senior policy analyst and attorney with the Center for Law and Social Policy, which
has organized a coalition to fight the proposal. "This could really put parents in an impossible situation —
between seeking health assistance for their children and obtaining a permanent legal status in
the U.S.," Hardee says. The list of benefits includes, among other programs, the Children's Health Insurance Program; nonemergency Medicaid; the Supplemental Nutrition Assistance Program, or food stamps; WIC and short-term institutionalization at
government expense. The leaked proposal notes that foreign-born and native-born Americans use such programs at similar rates.
The leaked proposal says it is meant to ensure that people seeking to "change their nonimmigrant status are self-sufficient." It notes
"relevant congressional policy statements," including one that says "the availability of public benefits [should] not constitute an
incentive for immigration to the United States."
Public charge restrictions undermine health for immigrant women and children
and destroy education outcomes
Parrott 18, (Sharon Parrott, Trump “Public Charge” Rule Would Prove Particularly Harsh for
Pregnant Women and Children, 5-1-2018, Center on Budget and Policy Priorities,
the Trump Administration is planning[2] a radical change in policy
that would jeopardize the immigration status of substantial numbers of immigrants lawfully in
the United States who work at low-wage jobs and whose families receive any of a sweeping array of benefits or tax credits — even though these immigrants are
In an accompanying paper[1], we explained that
fully eligible to receive them. If implemented, the new policy would set new rules for who could stay in or come to the United States, and it would likely convince large numbers
of immigrants in the country lawfully and their U.S. citizen family members to forgo benefits and tax credits for which they are eligible and that help their families make ends
The new policy could affect a wide range of individuals of all ages,
but its impact could be particularly harsh on pregnant and postpartum women and children.
Their decision to forgo health care and nutrition assistance could have serious negative
consequences for them in both the near and long term. In particular, the children may lose
access to benefits that, in their later years, could mean better health, higher educational
achievement, more work, and greater earnings. Public Charge Rules Would Be Dramatically Changed Under longstanding federal law,
meet and access health care and nutrition assistance.
immigration authorities must determine whether an individual who is seeking lawful admission to the United States and whether an immigrant who is seeking to adjust to
become a lawful permanent resident[3] is or will likely become a “public charge.” For decades under administrations of both parties, immigration authorities considered (among
other factors) whether the individual received (or was likely to receive) cash assistance benefits and the part of Medicaid that pays for nursing homes and other forms of longterm care. Someone could be considered a public charge if she or he was primarily dependent (for more than half of his or her income) on cash assistance benefits or Medicaid
long-term care benefits. (Cash assistance benefits include assistance from the Temporary Assistance for Needy Families program, the Supplemental Security Income program
and state cash aid programs, which are now uncommon.) The draft rule, which was leaked to the media, would dramatically change the benefit-related criteria used to make a
public charge determination. The draft proposal would put someone at risk of being deemed a “public charge” if that person — or anyone in the person’s immediate family,
including citizen children — receive any of a far broader set of benefits. The criteria also would consider any receipt, not whether the individual was primarily dependent, so
working families who receive benefits to supplement their low pay could receive an unfavorable public charge determination. The benefits and tax credits that would be
considered include the Earned Income Tax Credit (EITC), the low-income component of the Child Tax Credit, Medicaid, the Children’s Health Insurance Program (CHIP), subsidies
to help people afford health insurance in the Affordable Care Act’s marketplaces, SNAP (formerly known as food stamps), the Special Supplemental Nutrition Program for
Women, Infants and Children (WIC), and others. Because undocumented immigrants are ineligible for nearly all of these forms of assistance — and because cash assistance is
the rule targets immigrants who are lawfully in the United States
and working along with their citizen children and spouses. This extreme proposal would have two main effects. First,
already considered in public charge determinations —
immigration authorities could use it to prevent some immigrants here lawfully who receive — or whose close family members receive — any of these benefits or tax credits from
becoming permanent residents, and to prevent prospective immigrants who want to reunite with their families from entering the United States, if the authorities rule that they
the proposal almost certainly
would convince large numbers of immigrants here lawfully and their children, many of them U.S.
citizens, to forgo benefits or tax credits for which they’re eligible. Because the rules for determining whether someone is a
or any member of their families have received or would likely receive any of these benefits in the future. Second,
“public charge” are technical and the circumstances under which the authorities make a determination can be hard to understand, the number of low-income immigrant
families that would choose not to receive benefits would likely exceed by a sizable amount the number that would ultimately be subject to a “public charge” determination. This
has happened previously. In the late 1990s, widespread confusion and fear about how public charge rules could impact families’ ability to adjust their status among immigrants
with children eligible for and in need of federal benefits such as SNAP and Medicaid resulted in many being deterred from applying for benefits. Partly as a result, the share of
eligible individuals among these groups who were participating in benefits was low. For example, in 1999, just 40 percent of eligible citizen children living in households with
immigrants participated in SNAP, compared to 70 percent of all eligible children.[4] Concerned that eligible individuals in immigrant households were unable to access federal
benefits, the Clinton and George W. Bush Administrations took actions to clarify public charge rules and to ensure that benefit program applications and outreach were designed
to address the fear and confusion. Participation rates subsequently improved significantly for eligible children in immigrant families.[5] Finally, the draft rule indicates that the
Administration is considering whether to change the rules governing when federal authorities can deport legal immigrants in ways that might make their receipt of benefits a
consideration — though we have no information about what, if any, changes the Administration may propose. If the Administration makes problematic changes in this area, that
would heighten the risk that the rule would have a very large “chilling” effect on lawfully present immigrants receiving benefits for which they are eligible. Especially Acute
The proposed rule could convince immigrants to forgo health coverage or
nutrition assistance for themselves or for their infants, preschoolers, and school-age children
and families to forgo tax credits like the EITC for which they are eligible. The results could
include pregnant women who decline to enroll in Medicaid and thus lose access to pregnancyrelated services, families that choose not to enroll babies and young children in Medicaid or
CHIP, pregnant and postpartum women and young children who choose not to enroll in WIC,
and school-age children who go to school without the health coverage and food assistance they
need to succeed. In these cases, the result could be higher rates of poor birth outcomes —
Impact on Pregnant Women and Children
including higher rates of infant and maternal mortality — as well as poorer health, education,
and financial outcomes for children of all ages. The harm would be particularly acute for
pregnant women and young children — and the young children affected would typically be
citizen children — who may lose access to benefits that would lead to better long-term
outcomes, including better health, greater educational attainment, and brighter future earnings
prospects. The impacts for these children can start before birth, when the lack of prenatal care
and nutrition assistance for their mothers could affect their birth and early health outcomes,
and extend decades into the future, diminishing their opportunity to thrive in tangible and
entirely preventable ways. More specifically, under this rule: Women who qualify for Medicaid that would cover prenatal care and labor and delivery may
feel that they face the impossible choice of (1) risking a public charge determination by signing up
for this coverage, (2) finding a way to pay thousands of dollars for labor and delivery, as well as
prenatal and postpartum care, or (3) going without needed care. A pregnant woman or mother of an infant (generally a
citizen) might avoid enrolling herself and her child in WIC, which provides critical nutrition assistance to pregnant and breastfeeding women, infants, and preschoolers.[6] That’s
not a mere hypothetical possibility. In recent weeks, service providers reported that families said they were afraid to apply for WIC benefits. As The New York Times recently put
it, “Immigrants hoping for permanent residence are dropping out of public nutrition programs even before prominent elements of the Trump administration’s proposed policy
changes are enacted, fearful that participating could threaten their citizenship eligibility or put them at risk for deportation, according to program administrators.”[7] Eligible
children (including citizens) could miss out on Medicaid, which produces near and long-term benefits for children.[8] Children who are eligible for Medicaid do better in school,
on average, and miss fewer school days due to illness or injury. They’re also likelier to finish high school, attend college, and graduate from college.[9] And they earn more as
adults and experience fewer emergency room visits and hospitalizations, research shows. Eligible children could miss out on SNAP, which also produces long-term benefits for
children.[10] Research on the early days of the SNAP program shows that children who received food stamps (as SNAP was previously known) had greater rates of high school
completion and a lower incidence of heart disease, stunted growth, and obesity as adults. In addition, eligible legal immigrant families with one or more adults working hard at
low pay may forgo the Earned Income Tax Credit or Child Tax Credit for which they are otherwise eligible. Children in immigrant families that forgo these credits — including
citizen children — would face more poverty and hardship immediately and weaker prospects in the labor market in the future. Without these tax credits, they would be less
The rule would likely have other adverse effects
as well — for example, on the financial health and viability of many hospitals, due to the
significant increase it would produce in people who lack health insurance and come to
emergency rooms for their medical care.
likely to do well in school, finish high school, and go on to college, research indicates.
Public charge discrimination spills over to other poor people by undercutting
the ACA and education
Hayoun 18 (Massoud Hayoun, writer for the Pacific Standard, 2/14/18, “THE TRUMP
The Trump administration is revising a little-known, century-old rule to penalize immigration
applicants whose American-citizen relatives receive social assistance, reports say. Washington calls
the draft rule a safeguard against the misuse of tax dollars; immigrant rights advocates warn
that it could drive United States citizens into abject poverty. The "public charge" provision of the
U.S. immigration law aims to bar immigrants who would become dependent on state resources,
unable, financially or mentally, to care for themselves. Currently the provision bars the government from
considering non-cash benefits—food or housing assistance, for example—against family-based immigration petitions. The
Department of Homeland Security's new
draft rule, first reported by Reuters late last week, would make those noncash benefits count against applications for immigration status. In effect, low-income families
with non-citizens applying for legal residency status would have to choose between living with
loved ones or much-needed public aid for their citizen relatives. Civil liberties advocates are
concerned not just for immigrants, but for low-income Americans in general. The draft rule
emanates from "a nativist position that says we don't want certain people in our country," says
Kevin Solis, spokesman for immigrant rights group DREAM Team Los Angeles, "combined with the Republicans trying
to undo the social welfare state, it's a twofer. You get all their worst ideologies in one package." The aid that
under the new draft rule could harm applications for immigration status includes subsidies for
health-insurance coverage guaranteed by the Affordable Care Act. The apparent blow to the
ACA is "not incidental," says Claudia Calhoon, director of health policy at the New York Immigration Coalition advocacy
group. "[The administration is] trying to come at it from every angle they can." But the potential
effect on American communities is more far-reaching than Donald Trump's apparent push to
undo Obama-era policy. Among the benefits that would become public charge considerations
are food stamps and other food safety programs. When children go hungry, their schooling
takes a hit, "and that starts a cycle of potential challenges that aren't good for anybody," Calhoon
says. The affected communities include a long list of non-citizens with U.S.-born or naturalized relatives, including people granted
stays of deportation by immigration courts, Temporary Protected Status recipients, and many others who have come under attack
by the Trump administration, Calhoon explains. The draft rule has the stated aim of protecting American taxpayers. "The
administration is committed to enforcing existing immigration law, which is clearly intended to protect the American taxpayers,"
Department of Homeland Security Press Secretary Tyler Houlton tells Pacific Standard. "Any potential changes to the rule would be
in keeping with the letter and spirit of the law—as well as the reasonable expectations of the American people for the government
to be good stewards of taxpayer funds." A copy of the draft rule published in Vox echoes that concern for American dollars. "The
availability of public benefits must not constitute an incentive for immigration to the United States; and Aliens in the United States
must not depend on public resources to meet their needs," the draft reads. But
some fear that the safeguarding of
tax dollars is really just a pretext for the administration's populist brand of politics, and indeed
the provision has been used in the past to enable discriminatory immigration policy, analysts say.
The "obscure" public charge provision was first enacted in 1882, according to analysis from the
left-leaning Center for American Progress, and has historically been used as means for barring
the disabled, Jewish European immigrants escaping the Holocaust, and the Irish escaping
famine, among others. Today, under Trump, the provision would target Americans of Mexican
origin and other people who hail from the communities targeted by Trump's rhetoric on
immigrants. "The plan would significantly restrict family-based legal immigration from Mexico
and other countries that have been the subject of the administration's racist and discriminatory
animus," the CAP report reads.
Removing public charge lowers income requirements- reunites families
NIF 12 (National Immigration Forum, 7/26/12, “Immigration Backlogs are Separating American
Reduce income requirements that close off opportunities for some hardworking, but low-paid
Americans to reunite with family members: In 1996, a new provision was added to the immigration law
requiring all citizens or legal permanent residents wishing to petition for a family member must
earn at least 125% of the federal poverty level and sign a legally enforceable affidavit of
support promising to support the immigrant financially. While this requirement was added to
the law to ensure that immigrants will be provided for by family members and will not become a
“public charge,” for some hardworking but low paid Americans, it shuts off an opportunity to
reunite with close family members. For example, immigrants in certain occupations, if they earn the median income for
that occupation, might earn less than 125% of the federal poverty level for their family size. Though they may be hard working,
these Americans may lose the chance to reunite with close family members because of the new income requirements. The
income requirement should be lowered, so that hardworking but low-paid workers are not
penalized and kept from reuniting with family members simply because they do not earn
enough in their jobs.
War Impact Add-on
Economic inequality creates grievance over differences and ethnonationalismempirically causes war
UK Essays 15 (UK Essays undergraduate student submission, 3/23/15, Ed. 4/25/17, “Does
Poverty Cause War?”,
Awareness by the poor of the disparities between wealth and income acts as a trigger in the
stages leading to war: There was a 30:1 gap in 1960 in the average per capita income between the fifth of the world's
population in rich countries and the fifth of the world's population living in poor countries. This increased to 60:1 in 1990 and
beyond 2000, 74:1. The
figures now stand at $30,000 annual average income per person and less
than $400. These vast disparities lead to tensions, riots and insurgencies. A few developing
countries with a yawning gap between wealth and income have been victims of civil war. For
example, In Sierra Leone and Columbia half the population has about 5 percent of the country's
total income. These inconsistencies increase the probability of armed conflict. The World Development
Report 2000- Attacking Poverty also discusses the condition of poverty, `as perceived by the poor.' [14] The theory of
`relative deprivation' also indicates the occurrence of a similar situation. Relative deprivation is `perceived
discrepancy between value expectations and value capabilities' and adequately encompasses
most pre requisites to revolution. If dissidents feel that their goals can be achieved only by
altering the system, terrorist tactics will be applied to gain support and publicize the
government's incapability. [15] Modern wars do not happen by chance. They stem from the
perceived difference between income and available resources. Conflicts and wars within states
have occurred due to food shortage, water scarcity and land ownership. Riots in Indonesia and Lesotho
were a result of sudden rise in food prices. The Chiapas rebellion in Mexico, guerrilla movement in Columbia and conflicts in Senegal
were an outcome of the opposition movement's claim on large land tracts. [16] Role played by Frances Stewart's Horizontal
Inequalities (HI) in the sequence of events leading to war: The
discussion on plausible causes of war is
incomplete without analysing the role of Stewart's Horizontal inequalities - 'inequalities in economic,
social or political dimensions or cultural status between culturally defined groups'. If driven by
political HI's, higher the socio economic inequalities, higher is the likelihood of conflict. [17] HIs
give rise to grievances, which may cause violent disturbances. The longevity of these grievances
can lead to wars-Yorkshire in Britain, various cities in the US displayed this trend. So did India.
India's war against the colonization rule of the East India Company was finally won over after 200 years. Civil wars are severe
manifestations, such as the Biafra and Eritrean attempts to fight for independence. Burundi and
Rwanda massacres, terrorism in its local and international form- 9/11 attacks are examples of
economic and cultural horizontal inequalities between the US and the world's Muslim
population. [18] In Sierra Leone, unemployment and inability of the youth to access education acted as Horizontal
Inequality and regionally and ethnically defined identity, poverty and insecurity, in the Democratic Republic of Congo.
[19] Horizontal inequalities between ethnic groups and states can promote ethno-nationalist conflict. Tests
with new data on wealth and ethnic groups' boundaries and political access show- the rich and
poor groups with respect to the national average are conflict participants. [20] Exclusion from citizenship
is a form of HI and a considerable cause of inequalities as it can decline people's right to work, join a union or receive government
assistance. For
example, in Nigeria, the settler distinction has been the source of many local level conflicts. [21] Factors like
poor governance, historical developments and International linkages contribute to poverty and
inequalities, which lead to grievances, which may lead to war: UN Secretary-General, Kofi Annan, in a speech
given in October 1999 co relates grievances due to horizontal inequalities and poverty, to violence- `A recent study has shown that
one highly explosive structural factor is "horizontal inequality'' which rises when power and resources are unequally distributed
between groups that are also differentiated by race, religion, or language…Grievances by groups with uneven access to power can
provide a trigger…., The fact that political violence occurs more frequently in poor countries has more to do with failures of
governance….' [22] Inadequate State
policy and institutional capacity lead to poverty which
gradually becomes a grievance. Bad Governance and poverty are closely linked. [23] Underdeveloped
states raise revenue through resources or foreign aid and lack incentives for public goods. Political factors like predatory rule,
authoritarianism and state decay along with economic variables can also cause conflict. Also, specific groups may enjoy a state bias
while others are alienated. The Tamil population in Sri Lanka, for instance, suffered from land colonization and education policies
leaving them feeling alienated. [24] International linkages also play their part in civil wars. `Bad governance (political
underdevelopment) is made, not born and ''we'' (in the North) play a part in creating and maintaining it.' [25] Structural adjustment
and trade deregulation stemming from international policies cause exclusion and grievance. For
instance, liberalization in Sri
Lanka devastated peasant farming and horticulture in the Tamil North East. [26] 'Poor societies are at risk of falling into
no-exit cycles of conflict in which ineffective governance, societal warfare, humanitarian crises, and the lack of development
perpetually chase one another'. [27] The dynamics of historical developments cannot be ignored in causing grievances. Many
today's conflicts date back to the colonial era and marginalisation of poor. For instance, Rwanda crisis
is an outcome of failed development policies of past decades. [28] Poverty, starvation and inequity of the Irish famines affected
Anglo-Irish relations. The ill-treatment, drawing, redrawing of borders of the Middle East by the West during colonial times did not
spark a rebellion in the 19th century but gradually developed an animosity between the two factions. When
grievance interacts with economic and political agendas, it can lead to war. [29]
a long term
AT: Public Charge Good
Public charge exclusion fails to ensure only the best immigrants come- main
cause for denial of immigrant healthcare and basic liberties
Lister 10 (MATTHEW LISTER, PhD in philosophy from the University of Pennsylvania, law
degree from the University of Pennsylvania, professor of business and law at Deakin University,
November 2010, “IMMIGRATION, ASSOCIATION, AND THE FAMILY”, Law and Philosophy, Vol.
29, No. 6, Springer, JSTOR)/CWB
Additionally, other
factors, not directly related to the rights of association held by society as an
association, but rather relating to the need to maintain reciprocity within the state among
members, will further place limits on family-based immigration. In what follows I will first look at how the
need to maintain reciprocity within the state may place some limits on family-based
immigration rights. Secondly, I will attempt to establish how broad the right to family-based immigration ought to be. If, as
argued by Rawls and others, reciprocity among citizens is a condition on (domestic) justice, then
maintaining reciprocity may be reasonable grounds for limiting immigration. That is, if allowing
in immigrants would be expected to make those in the country worse off than they would be
without allowing in the immigrants (after relevant considerations of global justice are accounted
for - here I again assume some form of modest cosmopolitanism), then this might be grounds
for a state to limit immigration. This would be the case if immigrants were expected to use more
resources than they produced, for example. Rules to prevent such cases are wide-spread in
western countries, all of which exclude would-be immigrants who are likely to become public
charges.64 Such rules are, I shall, for now, assume, largely acceptable, especially when placed
within the context of the duty of assistance towards burdened societies and duty to provide
protection for refugees.65 The question that remains is how this requirement for reciprocity affects family-based
immigration. The U.S. addresses this issue by requiring that a citizen (or permanent resident) who wishes to bring in family members
must be able to support his or her family at 125% of the poverty level for a family of the given size.66 This may be done via evidence
of employment, proof of assets, or, if the person seeking to bring in her family does not meet this level on her own, by means of a
third-party guarantor. Furthermore, the
petitioner must promise to maintain this level of support for the
would-be immigrant for at least five years.67 This rule has two practical effects. First, if a
citizen is unable to meet this requirement she cannot successfully petition to bring in her
foreign-born non-citizen family members.68 Secondly, once the foreign family members are in
the US, this rule makes it difficult for the foreign-born family member to qualify for meanstested government assistance, since the assets of the sponsor are deemed to be available to the
immigrant.69 When joined with restrictions on access to public benefits to new immigrants (when
these are needed to ensure reciprocity - this need not always be the case) such measures can help ensure that allowing family-based
immigration does not violate reciprocity among citizens. Measures
such as these cannot, of course, ensure that
family-based immigration will bring the largest possible benefit to the receiving country that
any immigration policy could. This will most likely not be the case. But, to demand that would be to ask
too much. While certain measures may be taken to ensure that no citizens are used as a mere means to the support of another's
choices, there
is no duty of justice to promote the highest amount of aggregate welfare when
this would interfere with the basic liberties.
AT: Trump Rule Won’t Pass
Even if it wasn’t enforced before Trump, public charge language commits to the
abled, white norm- new rule coming now
Perez and Dunkelberg 6/1 (Katherine Perez, Ph.D. in Disability Studies at the University of
Illinois at Chicago, law degree from UCLA, co-founder of the National Coalition for Latinxs with
Disabilities, awarded the University Centers for Excellence in Developmental Disabilities
Diversity (UCEDD) Fellowship, the American Association of People with Disabilities Paul G.
Hearne Leadership Award, member of the California Bar, former Congressional Hispanic Caucus
Institute Fellow, Anne Dunkelberg, Associate Director for the Center for Public Policy Priorities,
founding member of the Texas Children’s Health Coverage Coalition, 6/1/18, “Immigration and
Disability: The "Public Charge" Rule”,
Disability has been used as a justification to exclude historically in U.S. immigration policy. The
1882 Act to Regulate Immigration prohibited any “lunatic, idiot, or any person unable to take
care of himself or herself without becoming a public charge.” In 1907, immigration law denied
entry to the “mental or physically defective…” and to anyone with “any mental abnormality
whatever…” and provided power to inspectors who could justify the exclusion of “defective
races.” (Baynton, 2005). This exclusion at the border was part of the national project of eugenics, an
effort to create a “superior national race”. (Hirschmann & Linker, 2015). Immigration law today
explicitly maintains the “public charge” language. Though in practice it has not been strictly
enforced, it has demonstrated the latent commitment in the U.S. to a historical and cultural
value of an abled, white norm. Under Section 212(a)(4) of the Immigration and Nationality Act
(INA), an individual seeking admission to the United States or seeking to adjust status to that of
an individual lawfully admitted for permanent residence (green card) is inadmissible if the
individual, "at the time of application for admission or adjustment of status, is likely at any time
to become a public charge." (“Public Charge” Department of Homeland Security). The law also explicitly
prohibits individuals with “physical and mental disorders” who have “harmful behaviors” that pose
a threat to oneself or others. (Immigration and Nationality Act 8 U.S.C. 1182 § 212(a)(2)(A)(iii).) It was leaked early this
year that new DHS rules will be enacted (after public comment) that will penalize documented
immigrants (immigrants applying for citizenship or adjustment of status) who use non-cash
benefit social welfare programs (i.e. Medicaid, SNAP) by making them a priority for
deportation. (Department of Homeland Security, 8 CFR Parts 103, 212, 213, 214, [237], and 248 [CIS No. 2499-10; DHS Docket
No. USCIS-2010-0012]). Immigrants with disabilities’ and their families' lives are at stake. Panelists will explain "public charge" and
address the advocacy efforts that are being put into place (namely a concerted effort to flood DHS with comments on the proposed
rule in order to slow or shut the process down).
Trump’s rule will be published for notice-and-comment within a month
Hesson, 18, (Ted Hesson, ‘Educator spring’ spawns candidate wave, 7-5-2018, POLITICO,
Public charge rule: The
Trump administration’s so-called “public charge” proposed rule is expected to
be published this month, according to the spring regulatory agenda. The rule would make it easier to deny
green card applications filed by immigrants who avail themselves of welfare or public benefits, according to draft copies obtained by
the Washington Post and Reuters. Advocates for low-income families oppose the regulation, but it could find backers among
immigration hawks and welfare opponents.
That’ll finish in 30 days
Us Legal, Inc. No Date, (Us Legal, Inc., Length of Comment Period – Administrative Laws, No
According to Federal Administrative Procedure Act, an agency can state in the notice that the comments must be received by a
specified date. Some cutoff margin is required to receive comments. An abbreviated comment period, such as ten days, can be
deemed as proper if necessitated by deadlines for agency action. An
agency can compensate for an abbreviated
comment period by stating that comments received after the effective date of the rule will be
considered later. An agency can re-promulgate the rule after those comments are received. Parties can challenge an agency
rule even if they fail to do so during the notice and comment period.[ii] In Fund for Animals v. Frizzell, 402 F. Supp. 35 (D.D.C. 1975),
the court observed that the abbreviated comment procedures do not contravene the public participation provisions of the
Administrative Procedure Act. The Administrative Procedure Act generally obliges an agency to publish for comment the technical
studies and data on which it relies. However, to avoid perpetual cycles of new notice and comment periods, a final rule does not
require an additional round of notice and comment even if the final rule relies on data submitted during the comment period.[iii]
Although the Administrative Procedures Act does not establish a minimum time period for third
parties to submit comments, it was observed in Fleming Cos. v. USDA, 322 F. Supp. 2d 744 (E.D.
Tex. 2004), that a thirty day notice and comment period is sufficient.
Yes passage – Trump explicitly wants it
Boyer 6-21 (Dave, White House correspondent for The Washington Times. Washington Times,
6-21-2018. “Trump proposes new immigration rules”) NREM/Lil’ GBN
At a raucous campaign rally Wednesday night in Iowa, President Trump proposed new immigration rules that
would bar newcomers to the U.S. from receiving welfare benefits for five years. At an event in Cedar Rapids
that was partly a victory celebration of Republican wins in several special House elections, Mr. Trump got the crowd on its feet
with tough talk on immigration, saying other countries don’t treat the U.S. fairly on cross-border issues. “I believe
the time has come for new immigration rules which say that those seeking admission into our
country must be able to support themselves financially and should not use welfare for a period
of at least five years,” Mr. Trump said to cheers and applause. “We’ll be putting in legislation to that effect
very shortly,” he said. Both of those plans Mr. Trump talked about are already enshrined to some extent in current
law. The 1996 welfare reform law approved by a Republican Congress and signed into law by President Clinton included a five-year
bar on immigrants accessing most welfare programs. And a
prohibition on immigrants becoming public charges
has been law for more than a century. But experts say enforcement of both provisions — and
particularly the public charge requirement — has been lacking.
Trump doesn’t need congress and empirically has passed anti-immigrant
Ewing 6-28 (Walter, Ph.D., is an Editor and Writer at the American Immigration Council.
American Immigration Council, 6-28-2018, “Re-Definition of ‘Public Charge’ Could Drastically
Slash Family Immigration”) NREM/Lil’ GBN
The Trump administration is quietly attempting to revamp the U.S. immigration system by
circumventing Congress and changing the nation’s immigration policies through new federal
regulations. The administration has always favored a significant reduction in legal immigration
and has pursued that goal through multiple avenues: admitting fewer refugees, cutting
Temporary Protected Status for several countries, and asking Congress to reduce the number of
available family visas. In August 2017, the administration supported the RAISE Act—which sought, among other goals, to
drastically cut family immigration and eliminate the Diversity Visa. Now, the administration could significantly
restrict family-based admissions by adding to the circumstances under which a non-U.S. citizen
is deemed a “public charge”—meaning someone who depends on government means-tested
benefits or is likely to depend upon these benefits in the future. Being a public charge is grounds
for inadmissibility into the country, and—depending on how far the administration wants to
take this—might even become grounds for deportation as well.
AT: Rulemaking
Rulemaking insufficient
Fix and Capps 17 (Michael and Randy, reporters for Migration Policy Institute. Migration
Policy Institute, February 2017. “Leaked Draft of Possible Trump Executive Order on Public
Benefits Would Spell Chilling Effects for Legal Immigrants”) NREM/Lil’ GBN
Redefining “public charge” and “means-tested public benefits” to span a much wider variety of
federal programs. The draft order refers to all “public benefits for which eligibility or amount is determined in any way on the
basis of income, resources or financial aid.” Though rulemaking might narrow its scope, this definition could
include a wide variety of federal programs such as school lunches, college financial aid, home
heating assistance, and public health services that are not included in the welfare law’s meanstested definition.
AT: Case By Case
Public charge grounds give inspectors discretion to exclude immigrants
Hirota 17 (Hidetaka Hirota, June 2017, “Exclusion on the Ground: Racism, Official Discretion,
and the Quotidian Enforcement of General Immigration Law in the Pacific Northwest
Borderland”, American Quarterly, Volume 69, Number 2, Johns Hopkins University Press, Project
Inspectors’ discretion affected immigration control more directly during the examination of arriving
newcomers. The Immigration Act of 1893 provided that unless immigrants appeared to the officer “clearly and beyond doubt
entitled to admission” during the preliminary examination on arrival, they would be detained for additional interrogation by a Board
of Special Inquiry, which consisted of four inspectors. The immigrants in question were not allowed to land without a favorable
decision made by at least three members of the board.26 The interview by the board often set an inescapable
trap against
foreigners deemed undesirable by the officials, such as Japanese and Mexican laborers. Under the Treasury
Department’s 1893 guidelines for immigration regulation, in order to avoid exclusion as paupers or people
likely to become public charges, immigrants had to show thirty dollars in cash and prove their financial self-sufficiency in
the United States. At the same time, however, immigrants who had already secured employment prior to departure would be
denied landing for violating the contract labor law.27 While the combination of the public
charge and contract labor clauses
generally allowed American officers to find flexible ways to prevent the landing of undesirable
foreigners, the Board of Special Inquiry in the Puget Sound district also exercised discretion in a different way. In a five-hour
examination session in late May 1900, the board interviewed seventy-one Japanese passengers who arrived in Tacoma from
Yokohama on the Glenogle, deciding to send back fifty of them. One of these passengers, twenty-four-year-old E. Ogawa, possessed
thirty dollars in cash. Nevertheless, from the information provided by a Japanese missionary acting as an interpreter and a board
member, the board established the fact that “no more Japanese were needed on the railroads” at that time and that there were
hundreds of unemployed Japanese in Seattle and Tacoma. In light of this situation, the board decided
to exclude Ogawa as a
person likely to become a public charge. Likewise, G. Tsuchiya, a laborer bound for San Francisco, carried with him
thirty dollars and demonstrated no sign of a labor contract, but the board refused to land him because of his likelihood of becoming
a public charge, based on the anticipation that “the great portion of his thirty dollars will be necessary to carry him to San
Francisco.”28 During Board of Special Inquiry sessions, which were not open to the public, officials could rely on informal evidence
such as unfounded hearsay and subjective presumptions of the immigrant’s financial circumstances to determine the person as
excludable. Puget Sound officials
interpreted the situation of Japanese passengers who could otherwise
pass the inspection in manipulative ways to apply the public charge clause to them. To exclude all
suspicious Japanese with minimum procedures, one inspector even suggested to the collector of customs that their simple
reluctance to answer questions during the interview should be taken
as “prima facie cause for rejection.”29
Adv – Ableism
Top Level
The “likely to become a public charge” clause is a form of poverty-based
immigration control that works to exclude those deemed unproductive to the
Green 17 (Emma Green, The Atlantic, 2/2/17, “First, They Excluded the Irish,”
Immigration restriction
in the United States was rooted in poverty. The British colonists introduced a law which regulated
the movement of the poor, including the expulsion of poor people from their territory. That
model developed into passenger laws for prohibiting the landing of poor people. The critical turning point
Emma Green: What’s the historical connection between poverty and immigration restrictions in the United States? Hidetaka Hirota:
came in the 1840s and ’50s, when a large number of impoverished Irish immigrants arrived in the United States. New York and Massachusetts were two major receiving states.
They responded by enhancing and strengthening their laws to more effectively restrict the immigration of poor Irish people. This really laid a framework for immigration control
in the United States. In the 1870s, when the U.S. Supreme Court declared some of the state passenger laws unconstitutional, these two states started a campaign to transform
their state laws into federal laws. The result was America’s first national immigration laws. Green: How do you tease apart Americans’ economic reasons for wanting to keep
These laws were targeted against poor immigrants, rather than against all Irish
immigrants. In that sense, the poverty of immigrants was at the core of state-level immigration policy.
immigrants out versus cultural or religious prejudice? Hirota:
But at the same time, such policy would not have developed if there was no strong cultural and religious prejudice, especially against Irish Catholics. Ethnic prejudice really
facilitated the formation of state policies that targeted the destitute. Green: What was the distinction in early American immigration laws between those who were poor and
: If you had skills or resources, there was no obstacle for landing. But if
you were poor and didn’t have financial resources, you wouldn’t be allowed to enter the United
States unless the shipmaster paid a bond to the government—money that could be spent if
people became paupers and required public assistance. According to The Washington Post, the Trump
administration will seek to deny any alien who is “likely to become a public charge.” This clause has a
notorious history, precisely because of the vagueness and subjective nature of the adjective “ likely.” The term comes from state-level
passenger laws. Massachusetts used the term in the 18th century, and New York did, too. The tricky thing about this clause is that officers could
reject immigrants even if they were not actually paupers—officers could interpret the adjective
“likely” in any way they liked. The clause was a convenient tool to inject religious, ethnic, and
racial prejudice into technically neutral immigration law. Green: One thing that’s been clear in the last week or so, since President
those who had skills or were wealthy? Hirota
Trump released his first executive order on immigration and refugees, is that low-level bureaucrats and officers have a lot of power to interpret and enforce the law as they like.
From the moment of the introduction of
the clause, it was abused by officers who already had personal prejudices against particular
immigrants. In the mid-19th century, the target was the Irish. Even if an immigrant had a sufficient amount of money at
the time of arrival, immigration officers excluded some people on the ground that there was no
demand for their employment. So officers regarded them as “likely to become a public charge.”
One immigration scholar in the early 20th century noted that this clause was used as the “miscellaneous” reason to exclude
immigrants when officials didn’t like them but couldn’t find appropriate grounds for their
rejection. The vagueness of “likely” gave flexible ground for exclusion, to the extent that anyone
could be denied landing. Green: It seems like a large portion of the people who have made arduous journeys over sea and land to come to the United States
What power have those kinds of people had historically in shaping American immigration? Hirota:
were doing so in hopes of finding a better economic life. Was there ever a time when immigrants were not largely poor? Hirota: The vast majority of immigrants were poor,
that’s for sure. The distinction nativists and immigration officers hoped to make was whether an immigrant could work or not. As long as a person appeared to be employable,
the criteria for self-sufficiency remained vague so that officers could determine certain
groups of immigrants as non-self-sufficient. Even though many of the immigrants were poor, some were more likely to be labeled as paupers
than others. Law enforcement was never equal. It was always shaped by the enforcing officers’
personal prejudices and racism. Green: How does this compare to immigration policy today? What’s similar and different? Hirota: I see more parallels
than differences, honestly. Trump’s potential executive order is targeted against immigrants who will
allegedly consume public taxpayer funds. In the 19th century, anti-Irish nativists called immigrants “leeches” on American taxpayers, saying
that’s fine. But
The people “threatening” the United States have changed. Earlier, it
was the Irish, and then later, it was the Chinese and Asians. Now it’s Muslims and undocumented immigrants from Latin America. But I think the fundamental
language—such as “national security” and “national peace”—remain the same. Immigration
control is always justified as a matter of the community’s right to protect its citizens from
external threats. This language has remained the same from the 19th century to today. Green: People
they should be deported back to Ireland as soon as possible.
sometimes portray the U.S. as a land that welcomes strangers and immigrants with open arms, pointing to Emma Lazarus and the Statue of Liberty as evidence. Those who
protested against Trump’s execute order at airports this past weekend certainly relied on that narrative. But that’s a fiction, right? The United States has always had strong
policies of exclusion accompanying its welcoming spirit. Hirota: The United States has been a nation of immigrants and a major receptor of those seeking freedom—no doubt. It
the unfortunate historical fact is that nativism
has been integral to the American experience. We want to be welcoming. But the fact is that some forms of restriction
have always existed in the U.S. Green: What’s the long-term legacy of America’s immigration restrictions? Hirota: One of the most important long-term
is a U.S. tradition to accept people who need to come to this country. But at the same time,
legacies is what immigration scholars call the plenary-power doctrine. It’s basically a doctrine that assumes that congressional immigration policy is beyond judicial review for
constitutionality. Within that framework, immigration officers could do anything with undesirable foreigners or aliens. The doctrine is now weaker than it was, but still, it’s at
Law enforcers have massive power over the fate of newcomers. And the roots of
that doctrine and a harsh mental attitude toward immigrants really came from the state-level
treatment of destitute Irish immigrants. The “likely to become a public charge” clause—povertybased immigration control—can be really dangerous, precisely because it seems racially and
ethnically neutral. Historically, the clause allowed racial and religious bigotry to flourish by giving
too much power to law enforcers.
play in immigration policy.
The public charge standard is rooted in racism and ableism inherent in the
evaluation of an immigrant’s “dependency”
Galusca 9 (Roxana Galusca of University of Michigan, Michigan U-M with expertise in Cultural
Anthropology, Performing Arts, Visual Arts, “From Fictive Ability to National Identity: Disability,
Medical Inspection, and Public Health Regulations on Ellis Island,” Cultural Critique, Spring 2009,
Pages 137-163)//SLiang
Goddard’s successful attempt to collapse race and “cognitive impairment” was not without
precedent. However, the results of his studies reinforced both the inspectors’ and the public’s
attitudes toward certain ethnicities. “Feeblemindedness” became the favorite label on Ellis
Island, and its direct corollary, according to inspectors’ judgments, was an immigrant’s liability
to become a public charge. Like the label of dependency, feeblemindedness was the easiest
“impairment” to be pinned to an immigrant’s identity, especially when racial considerations
came into play. Under the threat of racist stereotypes, immigrants had to be alert and control
any bout of happiness, fatigue, or sadness that could lead to their being labeled “mental
instable” or “feebleminded.” Sometimes, in spite of their efforts to avoid suspicions, they would
fall victim to their own racial identities. At a time when racial taxonomies formed an integral
part of the scientific truth, the inspectors were well educated about each racial group’s
peculiarities. Consequently, their final evaluation of an immigrant’s condition took into
account any deviation from the inherent characteristics associated with a given race. As a
doctor on the island explained, “if an Englishman reacts to questions in the manner of an
Irishman, his lack of mental balance could be suspected. . . . If an Italian responded to questions
as the Russian Finn responds, the former would in all probability be suffering with a depressive
psychosis” (Shapiro, 138). Under the rubric of “mental illness,” categories of race and disease
grew blurry, leading to further classifications and hierarchical systems. Goddard’s Ellis Island
study sustained a racial-ableist hierarchy, according to which feeblemindedness ranked highest
among Russian immigrants (87 percent), seconded by Jews (over 83 percent), and closely
followed by Hungarians and Italians (Smith, 119). As cognitive impairments and mental illnesses
became the main preoccupations of the inspectors, especially because of Goddard’s studies,
more nuanced diagnosis supplemented the physicians’ charts. The immigrant’s terror of being
found “diseased” or “impaired” conjoined with the inspectors’ urgency to trace cognitive and
physical impairments in their most extreme details. The interaction between the immigrant
and the medical inspector reconfigured citizenship as ability and translated loyalty to the
nation as ablebodiedness. To belong to the American nation-state, the incomer had first of all
to prove physical and cognitive ability, a tiresome task given the racial and gender stereotypes
that framed medical inspections. The medical treatises and studies, both originating in and
supporting the ableist practices on Ellis Island, worked to re-imagine the healthy and unitary
space of the nation-state through what Aimee Carrillo Rowe calls the process of negation.
According to Carrillo Rowe, space becomes meaningful only when represented as demarcated
and limited by boundaries. The legitimacy of a state, then, is created by the negation of
everything that falls outside its borders. The border becomes “a highly contested site wherein
the contradictory needs of the capital-driven U.S. nationstate clash: the need for cheap labor
clashes with its fear of the racialized, classed, non-citizen subjects” (119). The bordered space of
the nation-state empowers some and disempowers others, so that “only some people can walk
some of the time” (119). An intersectional analysis at the confluence of immigration and
disability studies unmasks the nation-state’s dependency on a coherent narrative of fictive
ability. Throughout U.S. history, immigration debates have run parallel with public health
warnings of contagions, germs, and disabilities. Through studies and research, public health
institutions have frequently inculcated into the public imaginary the distinction between the
diseased/illegal other and the population within borders, whose legitimacy and ability are given
by those very boundaries. The ableist immigration bills that signed Ellis Island into existence
were a symptom of the national need for borders and authorized spaces. Such immigration
policies transformed the immigrants into negated identities and bound the immigrant’s body to
the marginalized space of the island. The pathologized immigrant identity arose as a
destabilizing force that upset the homogeneous national identity and played havoc with
national values of normativity and ablebodiedness. At the same time, the diseased other
emerged as an excessive and paradoxical abnormality that affirmed the nation-state in its
negation of everything that the national body appeared to be. In this sense, the Ellis Island
individual, by falling outside the bordered space, became the site of conflicts and crises,
negating and affirming at the same time the nation-state. This process of denial left the
excluded individual a mere prop in the national narrative of ablebodiedness and racial purity.
That standard of “fictive ability” reinforces ableism and the otherization of the
Galusca 9 (Roxana Galusca of University of Michigan, Michigan U-M with expertise in Cultural
Anthropology, Performing Arts, Visual Arts, “From Fictive Ability to National Identity: Disability,
Medical Inspection, and Public Health Regulations on Ellis Island,” Cultural Critique, Spring 2009,
Pages 137-163)//SLiang
Under the continuous gaze of the inspectors and the public, the immigrant was interpreted as
l’homme extraordinaire, the freak body, defined and constructed in contrast with l’homme
moyen, the decent and physically “normal” individual (Garland-Thomson, Extraordinary Bodies,
63–66). According to Garland-Thomson, “the meanings attributed to extraordinary bodies reside
not in inherent physical flaws, but in social relationships in which one group is legitimated by
possessing valued physical characteristics and maintains its ascendancy and its self-identity by
systematically imposing the role of cultural or corporeal inferiority on others” (7). Constructed
as different because of their foreignness and supposed disease and defined in relation to the
American tourists at ease on the site, the immigrants stood for “the extraordinary,” to be
displayed and stared at. As Ellis Island inspector Philip Cowen commented, Ellis Island became a
circus and a zoo, where visitors came “to see the animals” (Pegler-Gordon, 193). The immigrant
was “formed by differentiation,” pitted against the decent and healthy American visitor, in a
process of counteridentification by which visitors defined themselves as ablebodied.
Concurrently, this type of live tourism offered the government the opportunity to deliver
publicly the message of a nation threatened by outsiders and to advertise its representatives as
national saviors. The wretched masses of immigrants, tired and dirty, created an image that
encouraged anti-immigration attitudes. They were certainly a stark contrast to the well-dressed
and purportedly educated bourgeoisie strolling on the island. Ellis Island, as a diseased site,
represented both fear and attraction for tourists. The sight of the expelled immigrants alleviated
citizens’ anxiety about “strangeness” and underpinned an appropriate discourse on national
values of ability and racial purity in the face of invaders from the other side of the globe. The
amateurish gaze of the visitor supplemented that of the physicians, and both collaborated to
support a system of classifications based on normativity. Thus, national narratives of ability took
shape both through touristic gazes of counteridentification and through the inspectors’
redundant transcription of ideal citizenship against the alien others. In this way, fictive ability
was staged publicly as the prerogative of a few white, ablebodied, male, and heterosexual
citizens. As the first and largest immigration station in the United States, Ellis Island translated
ideals of nation and citizenship into a medical discourse based on fictive ability. The medical
inspections on the island represented not only a prerequisite for citizenship but also a
prerequisite for redefining the nation in objective scientific terms. Medical science served to
blur the demarcations between human difference and pathology, leading to a rendition of
foreignness as always already contagious. Fictive ability, then, functioned as the imaginary
standard against which immigrants were judged and which informed national attitudes toward
race, gender, and class. Moreover, ability and health were made to appear as inherited traits to
be defended at any cost, betraying the fantasy that an ideal state always attracts and produces
healthy citizens—citizens who maintain in turn the moral, physical, and intellectual vigor of their
home nation. Thus, the United States emerged as a privileged space, scientifically designed to
protect the chosen few from the crowds of diseased incomers amassing at its borders. The
nation-state has always been haunted by the specter of its others. At first glance, it may seem
that merely acknowledging those marginal to the state will suffice to offer a potent critique of
its construction. A critical account of nationality, however, must rely on a vision of many others,
both those within and without, and approach otherness on the model of intersectional theory,
situating disability studies among theories of race, gender, and class. Only an intersectional
approach that makes visible the central role of disability in national narratives will shed light
upon the ubiquity of ability and its medical enforcement in the makeup of the nation-state.
When interrogated at multiple intersections with disability, the nation-state shows itself for
what it truly is—an ideology that depends for its cohesiveness on other no less significant
Ableism is ingrained in public charge law
Fernando and Rinaldi 17 (Shanti Fernando, professor of undergraduate political science at
the University of Ontario Institute of Technology, PhD degree in Political Science from Queen's
University, former professor at York University, Mount Allison University, Jen Rinaldi, professor
of social sciences and humanities at the University of Ontario Institute of Technology, researcher
for the Women’s College Hospital, PhD in philosophy, 2017, “Seeking Equity: Disrupting a
History of Exclusionary Immigration Frameworks”, Canadian Ethnic Studies, Volume 49, Number
3, Project Muse)/CWB
This ableism was formalized when prohibited classes were introduced into immigration law at the
beginning of the 20th century. In 1902, legislation was amended in An Act to Amend the Immigration Act to prohibit the entry of
immigrants “suffering from any loathsome, dangerous, or infectious disease or malady”. When debating the amendment in the
House of Commons, Minister of the Interior Mr. Frank Oliver held that “the first consideration—in immigration standards—should
be the intellectual as well as the physical quality of those immigrants” (House of Commons Debates 1902, 3740). In the 1906
iteration of the statute, under sections 26-28, the
following persons constituted classes prohibited from
entering Canada: physically and mentally disabled persons, or anyone “who is feeble-minded, an
idiot, or an epileptic, or who is insane, or has had an attack of insanity within five years; [who is]
deaf, or dumb, blind or infirm;” persons with diseases, “loathsome…contagious or infectious and
which may become dangerous to the public health or widely disseminated;” and impoverished
persons, or anyone “who is a pauper, or destitute, a professional beggar, or vagrant, or who is
likely to become a public charge…or has become a charge upon the public funds.” An exception that
was originally made under section 26, for disabled persons who were admissible as long as they had families willing and able to
provide permanent support, was left out of the 1910 amendments for cases of mental defect. As a state responsibility (rather than
Medical Superintendents’), government officials were granted discretionary powers to determine in/admissibility under sections 2123 of the 1906 Immigration Act. Judith Mosoff (1999) observes that through this long restrictionist era, “from 1906 to 1976, labels of
diagnoses were absolutely determinative of admissibility” (151) regardless of family support or capability to contribute to the
Canadian economy or live independently. A
CRT analysis show both the social and political construction of
those with diagnoses or with limited funds as undesirable, and the convergence of economic
interests that justified excluding undesirable immigrants. The calculus of these interests showed
that even some of those who were not going to be economically undesirable immigrants were
still labelled as undesirable as their disability rendered them so.
Public charge determination is ableist, determining admission off capital
Flores 13 (Verónica Bayetti Flores, Assistant Director of the Civil Liberties and Public Policy
program at Hampshire College, 4/18/13, “THE DRAFT IMMIGRATION REFORM BILL IS A MIXED
During the long path from RPI status to citizenship, low-income immigrants aren’t eligible for public
assistance, like Medicaid or food stamps. And it’s not yet completely clear whether folks with RPI status
will benefit from the provisions of the ACA, though it’s not looking good. In
very real terms, this may mean 15 years
of almost complete lack of access to basic health care – pap smears, birth control, hormones,
basic physicals. What’s more, the RPI status must be renewed after 6 years, at which time people will have
to go through what’s called a public charge determination – i.e. they will try to determine if the
person renewing is likely to become a “public charge” or a drain on society. Getting older?
Developed a chronic illness? You may be out of luck! Because in this ableist society, we only
deem people worthy in terms of how much capital they are able to produce.
The origins of public charge are rooted in eugenics and ableism that perpetuate
the medical model and damn people of disabilities to a status undeserving of
rights accessed by abled-bodies
Baynton 5 (Douglas C. Baynton, professor of American Cultural History, History of Disability, and American Sign
Language, “Defectives in the Land: Disability and American Immigration Policy, 1882-1924,” Journal of American
Ethnic History, Vol. 24, No.3, pg. 32-35, 2005, jstor)jy
William Williams, the Commissioner of Immigration at Ellis Island, had built a reputation as a strict enforcer of the immigration laws, particularly those related to physical and mental defects. He urged the
Secretary to dismiss Fuko's appeal, because "her child will always be physically defective, and it would be improper to admit merely because of the relatives here." The Commissioner General of the Bureau of
Immigration agreed, saying that "the Bureau does not think the mere presence here of two sons affords any good ground for admitting these physically defective aliens." The Secretary, deferring as he usually did
to the Commissioner of the station and the Commissioner General when they were in agre ment, dismissed the appeal. Sophie Fuko and her son were put aboard the USS Pennsylvania on December 21 and
One of the driving forces behind early federal immigration law, beginning with the first major
Immigration Act in 1882, was the exclusion of people with mental and physical defects (as well as those considered criminal or immoral,
returned to an unknown fate in Hungary.1
problems seen at the time as closely related to mental defect). Congressional legislation throughout this period repeatedly, and with ever increasing urgency, identified defective immigrants as a threat to the
The desire to keep out immigrants deemed defective was not a isolated development, but
rather was one aspect of a trend toward the increasing segregation of disabled people into
institutions and the sterilization of the "unfit" and "degenerate" under state eugenic laws. While antination.
immigrant sentiment in the United States has long been a significant area of scholarly research, disability has held a marginal place in that scholarship. John Higham's Strangers in the Land identified three main
by 1917 the immigration
policy of the United States had been restricted in seven major ways," with admission being
denied to "Asians . . .; criminals; persons who failed to meet certain moral standards; persons
with various diseases; paupers; assorted radicals; and illiterates." Alan Kraut's Silent Travelers and Amy Fairchild's recent book, 33
Science at the Borders, brought a welcome focus to medical inspection, but did not examine
communicable disease and disability as distinct issues, nor explore the cultural stigmatization of
disability that formed the background to these laws.2 Sophie Fuko does not fit into any of the categories that historians of im migration policy have
currents of anti-immigrant sentiment: anti-Catholicism, fear of foreign radicals, and racial nativism. Roger Daniels stated in Coming to America that "
described as fundamental to anti-immigrant sentiment or the enactment of exclusionary immigration policies in the United States. Though she had little money at hand, she was by no definition a pauper. Neither
she nor her son was a carrier of disease. The only charge against Fuko, and many other similar immigrants, was that they were defective. Countless other immigrants passed through Ellis Island with fewer financial
Disability was a crucial factor in deciding
whether an immigrant would be allowed to enter the United States. The first major immigration law, the Act of
1882, prohibited entry to any "lunatic, idiot, or any person unable to take care of himself or
herself without becoming a public charge." Those placed in the categories "lunatic" or "idiot" were automatically excluded. The "public
charge" provision was intended to encompass individuals with disabilities more generally, and
was left to the examining officer's discretion.3 The criteria for excluding disabled persons were
steadily tightened as the eugenics movement and popular fears about the decline of the
national stock gathered strength. The Act of 1891 replaced the phrase "unable to take care of
himself or herself without becoming a public charge," with "likely to become a public charge."
The 1907 law then required a medical certificate for anyone judged "mentally or physically
defective, such mental or physical defect being of a nature which may affect the ability of such
alien to earn a living." While nondisabled immigrants continued to be admitted unless found to be "likely to become a public charge," disabled people were subject to this more rigorous
standard.4 Exclusions for mental defect were steadily expanded. In 1903 people with epilepsy were
resources, no family in the United States to turn to in case of difficulty, and certainly less poignant personal circumstances.
added, as well as "persons who have been insane within five years previous [or] who have had
two or more attacks of in sanity at any time previously." In 1907 "imbeciles" and "feeble-minded
persons" had been barred, in addition to "idiots." In 1917 the classification of "constitutional
psychopathic inferiority" was added, which inspection regulations described as including
"various unstable individuals on the border line between sanity and insanity, such as . . . persons
with abnormal sex instincts." Officials were instructed to exclude persons with "any mental
abnormality whatever . . . which justifies the statement that the alien is mentally defective." This provision, the regulations explain, was intended "as a
means of excluding aliens of a mentally inferior type, not comprehended in the other provisions of the law, without being under the necessity, as
formerly, of showing that they have a defect which may affect their ability to earn a living ."5 The rules governing
exclusion for physical disabilities were equally vague and expansive. Regulations instructed inspectors that "each individual should be
seen first at rest and then in motion," in order to detect "irregularities in movement" and
"abnormalities of any description." It listed defects that could be cause for exclusion, a few
examples of which were arthritis, asthma, bunions, deafness, deformities, flat feet, heart
disease, hernia, hysteria, poor eyesight, poor physical development, spinal curvature, vascular
disease of the heart, and varicose veins.6 An Ellis Island medical inspector later wrote that his task was "to detect poorly built, defective or broken down human
beings."7 In short, the exclusion of disabled people was central to the laws governing immigration . As the
Commissioner General of Immigration reported in 1907, "The exclusion from this country of the morally, mentally, and physically deficient is the principal object to be accomplished by the immigration laws."8
These laws were usually presented as simply a matter of economics. The issue, however, was rarely so straightforward. Many
rejected immigrants had been self-supporting in their home countries. Others received job offers while awaiting their hearing, but still were deported as likely to become public charges. More
importantly, to the extent that some people with disabilities might indeed encounter
difficulties in finding employment, the public charge law also assumes that the unemployment
or underemployment of disabled people is a problem centered in bodies rather than in the
relationship between particular bodies and the constructed physical and social environments
in which they live. This may have been the only practical assumption for immigration officials, but historians should put immigration restriction into context as one element in a larger system
of dis crimination that made it difficult for disabled people to live and move about independently. Leaving aside, however, complex questions of what factors made (and still make) it difficult for disabled people to
, the economic explanation for exclusion remains an incomplete one. Two examples of the mixed motives and
these exclusions were the diagnoses "poor physique" and "lack of sexual
development." In his Annual Report of 1904, the Commissioner of Ellis Island, William Williams, suggested that the country was "receiving too many immigrants
find work
reasoning that went into
whose physical condition is poor." The only disabled persons specifically excluded under law at that time were idiots, insane persons, and epileptics (the category of "physical and mental defects" came in 1907). As
Williams explained, to exclude immigrants certified with physical impairments required finding that they were likely to become public charges, "yet it is obviously impossible to exclude on this ground all persons
urged that the exclusion of immigrants certified as having "poor physique" be
made mandatory in all cases.9 Soon thereafter, Robert DeCourcey Ward of the Immigration Restriction League wrote to the Commissioner General of Immigration, Frank Sargent,
whose physical condition is poor." He
urging him to take up Williams's cause before Congress.10 The specific diagnostic category was never embodied in law, but within a year "poor physique" was being widely used as a diagnosis by immigration
The immigration service defined poor physique as
covering individuals "who have frail frame, flat chest, and are generally deficient in muscular
development," or who are "undersized--markedly of short stature--dwarf."11 As one medical officer explained, the
"immigrant of poor physique is not able to perform rough labor, and even if he were able,
employers of labor would not hire him."12 That is, the belief that an immigrant was unfit to work
justified exclusion, but so did the belief that an immigrant was likely to encounter discrimination
because of a disability. Eugenic considerations also played an important role in both the creation and the application of immigration law. In a letter to the Commissioner General, the Ellis
Island Commissioner wrote that the Bureau had "no more important work to perform than that of picking out all
mentally defective immigrants, for these are not only likely to join the criminal classes and
become public charges, but by leaving feebleminded descendents they start vicious strains
which lead to misery and loss in future generations and influence unfavorably the character and
lives of hundreds of persons."13 This inter-generational "contagion" of defect worried the Commissioner General about immigrants with "poor physiques." In a 1905
memorandum, he explained that "a certificate of this nature implies that the alien concerned is afflicted with a body but illy adapted ... to the work necessary to earn his bread," and further that the
immigrant is "undersized, poorly developed [and] physically degenerate, and as such, not only
officials to exclude immigrants on grounds of being "likely to become a public charge."
unlikely to become a desirable citizen, but also very likely to transmit his undesirable qualities to
his offspring, should he unfortunately for the country in which he is domiciled, have any."14
Ableism is rooted in immigration law
Schweik 11 (Susan, Associate Dean of Arts and Humanities. In 2018 she was awarded the
Jeanette K. Watson Distinguished Visiting Professorship at the Humanities Center, Syracuse
University. A recipient of Berkeley's Chancellor's Award for Advancing Institutional Excellence
and U.C.'s Presidential Chair in Undergraduate Education , she has been involved with the
development of disability studies at Berkeley for over 17 years. Social Research, Vol. 78, No. 2,
The Body and the State: How the State Controls and Protects the Body, Part I (SUMMER 2011),
pp. 417-442, “Disability and the Normal Body of the (Native) Citizen,” Johns Hopkins University
As historians Douglas Baynton, Penny Richards, and Alison Carey have shown, while categorical racial and gender
exclusion from citizen ship has been thoroughly questioned and denaturalized, only recently have we begun to
interrogate and challenge the denial of the rights of citizens to people with disabilities (Baynton
2001; Richards 2004; Carey 2009: 2). "One of the fundamental imperatives in the initial formation of
American immigration policy," Baynton wrote in an essay foun dational to disability studies, "was the exclusion of
disabled people" social research Vol. 78 : No. 2 : Summer 2011 417 This content downloaded from on Tue, 10 Jul
2018 18:40:57 UTC All use subject to (2001: 45). I saw this clearly in my research for my book on the socalled American "ugly laws," municipal laws
common in U.S. cities that banned "diseased, maimed, deformed . .
. unsightly and disgusting" people, particularly "unsightly beggars," from exposing themselves to
public view (Schweik 2009). U.S. immigration law in the late nineteenth and early twentieth century was ugly law writ
large, and unsightly begging was often labeled as a "European exposure method," antitheti cal to
American modernity (Schweik 2009: 167). "One of the fundamental imperatives in the initial formation of
American immigration policy," Baynton wrote in an essay foundational to disability studies, "was the exclusion of
disabled people. Beyond the targeting of disabled people, the concept of disability was
instrumen tal in crafting the image of the undesirable immigrant" per se; that is, entire groups
could be excluded from citizenship on what were essen tially disability grounds, on the grounds
that they were feeble-minded or weak or irrational or spreaders of disease (Baynton 2001:45). Baynton
shows that what Kamal Sadiq has called the "distinguishability assump tion"—the "putative wall separating citizens from
immigrants"—has always been underlain, in the United States, by an ability assumption, a putative wall
separating those
likely to be a public charge from those likely to be in charge of them. The "infrastructure of
citizenship, a citizenship from above" (Sadiq 2008: 6) that draws the line around the community of citizens,
decides who will be eligible for inclusion in that community, and polices the boundary of the territory
has depended, implicitly and explicitly, on disability as a factor in exerting its normative force. We know
what the normal body of the citizen is by knowing what it is not: not confusing or
misrecognizable (Campbell 2009: 11), not too hostage to its "recalcitrant corporeal matter" (Mitchell and
Snyder 2000: 49; Campbell 2009: 11). In relation to what Allison Carey calls the "storybook citizen," intellectually fine,
physically upstanding, morally both of the above, exuding "intelligence, independence, and the
ability to contribute to the national well-being through hard work, political participation, and
bravery," people with disabilities have 418 social research historically appeared "unworthy, at best, and a
threat to the nation . . . at worst" (Carey 2009: 2). Particularly in the case of people with intellec tual, developmental, and
psychosocial disabilities, deprivation of many rights that we might call "rights of the body" (the right to be
sexual, to marry, to choose where to live or when to eat or be in public space or bathe), a denial of rights that are automatically
accorded to others, is still "widely accepted and viewed as legally justified and even morally imperative" (Carey 2009: 2). For exactly
this reason, as
disability theorists have pointed out, a focus on disability is particularly useful for
allowing us to explore our most basic definitional assumptions—in this case, our definition of the
"citizen" and our foundational understanding of the citizen's body. As Carey puts it: "Should rights be
conferred based on ability, membership in a community, or other considerations? Does the state have an obli gation to provide
assistance or social rights to enhance citizens' well being? What should happen to individuals who are denied rights? Does the state
have any obligation to non-rights-bearing citizens?" (Carey 2009: 2). In this article I will explore some cases in which these ques tions
have come to the fore. I will focus primarily on a moment in the early twentieth century, where dynamics of exclusion are shockingly
visible. Then, exploring what Aihwa Ong calls "the problem-space of American citizenship" (Ong 2006: 3), I will move to related but
less visi ble moments in our present. In all these cases, I will show that the
body politic of American democratic
citizenry binds itself together through an internal logic that, even as it attempts to manage the
incorporation of disabled subjects, drives disability down or assumes it away. But it never does so decisively
and never without contradiction, and that is a lucky thing. For as Michael Berube has eloquently put it,
Trump Policy
Trump’s attempt to exclude certain bodies from the concept of a “normal
citizen” necessitates discussion on disability’s relationship with the state
Raphael ‘17 (Raphael Raphael, RDS Associate Editor for Multimedia & Creative Works, Review of Disability Studies:
An International Journal, “Thinking About Immigration and Disability,” v. 13, n. 2,
The state and the body are always connected. In times of crisis (political and economic), there is often
increasing concern with borders, both of the nation and of the body. It becomes “urgent” to
protect the state from contagions and threats, real or imagined. With increasing urgency,
leaders often attempt to unify their base by clearly articulating what it means to be a "normal
citizen,” identifying which bodies are included and which are not. We can see this connection between body and
state both in the present and in the past. History is replete with examples, and the lessons are not subtle. As the
Third Reich consolidated power in 1933, among their first actions was to identify people with disabilities as enemies of the state. Just six months after
assuming power, they passed the Law for the Prevention of Progeny with Hereditary Diseases. On one hand, the physically strong and independent
Übermensch (superman) served as powerful symbol of a strong independent German state. On the other hand, there
was perhaps no
more inconvenient sign than people with disabilities: inconvenient truths of the vulnerability of
bodies, of their needs and undeniable interdependence. Eliminating these inconvenient bodies
became an important early step in nation-building, and the muted national response to their
elimination became a tragic rehearsal for much larger atrocities. (See Liz Crow’s short film Resistance (2009) and
David Mitchell and Susan Snyder’s upcoming Disposable Humanity.) Our present moment reflects a great deal of border
anxiety. There’s rhetoric of literal wall building to protect and reify imaginary and geographic
borders and a troubling rise of isolationist/anti-immigrant rhetoric in the United States and
Europe. The rising chorus of voices saying which bodies should be citizens and which should not
marks a shift that has taken many in the world by surprise: there was near global shock to the
assumption of power by the current POTUS in the US and to the passage of Brexit in Great Britain, as well as to the recent
near-miss in closely watched elections in France. At least in the United States, this rise in border anxiety appears to
coincide with increasing government disdain (or at least apparent disinterest) in the needs of those with
disabilities. The current POTUS, who as a candidate famously mocked a reporter with
disabilities, has a pattern of choosing appointees with apparent disinterest in the needs of
people with disabilities. It was widely reported that now Secretary of Education Betsy DeVos appeared confused about basic legal
protections afforded to all students with disabilities. As recently as May 24th, Ms. Devos refused to say she would refuse federal funds to schools that
discriminated against students with special needs. The confirmation hearing of Supreme Court nominee Neil Gorsuch, revealed a seemingly similar lack
of concern: a case showed him unnecessarily ruling against a student with autism, a questionable ruling the Supreme Court subsequently rebuked
(during his actual confirmation hearings).
Some rhetoric in current efforts at immigration reform has also
evoked the danger posed by immigrants drawing on public services in ways that could easily
target those with disabilities for exclusion. While this particularly anxious moment has taken many by surprise, immigration
and disability have long been tied in the history of the United States. Two centuries ago, with the Immigration Act of 1882, the country
identified people with disabilities as potential “threat to the nation” and has since had a long history of using disability as
criteria for immigration exclusion (See Daniel J. Wilson’s “‘No Defectives Need Apply’: Disability and Immigration.” OAH Magazine of
History 23 [July 2009]: 35-40.) Today, the ‘ideal’ citizen has been more explicitly tied to religion and ethnicity than to issues of ability, with Islamic
people the immediate subject of particularly intense suspicion. At the same time, history suggests it’s
wise for us to keep mindful of
possible slippages of otherness, slippages that frequently allow these fears to bleed to the body
and to disability. With a view shared by many, embattled former National Security Advisor Michael Flynn famously described Islam in
biological terms, as a “cancer” threatening national security and as a “sick” ideology that, per his tweet, “needs to B [sic] healed.” The US
administration’s recent attempt at a Muslim ban attempted to “cure” this “sickness.” As the effects of early exclusion policies still echo and debates
rage over who belongs, who does not belong, who is worthy of entrance, who is not, a great deal of attention is rightly paid to the ethnic and religious
dimensions of the debate. Perhaps we
should give more attention to also considering the ways in which
disability may intertwine with these. In a time when nations are actually increasingly
interdependent, with a variety of bodies—with a variety of needs—often living in flow between
nations, perhaps the greatest threat is pretending this isn’t so. And in this chain of bodies that need one another
and have the power to speak out for one another, now more than ever, as Martin Niemöller reminded us, it doesn’t matter who they come for first
Immigrant health care stops ableist deportations
Moore 17 (Andrew F. Moore, Associate Professor of Law at the University of Detroit, 2017,
CARE”, Albany Law Review, LexisNexis)/CWB
In recent years, disturbing
stories of mentally ill people facing deportation have found their way into
mainstream media, and have brought to light problems they face in our immigration system. n1
In detention, without medication, support or professional help, these individuals reveal just how
helpless someone can become. The stories tell of being trapped in a series of holding facilities,
unable to understand the legal proceedings that face them, with their mental health
deteriorating so that they are unable to communicate without representation. n2 The stories
also reveal a legal system that is not prepared to cope with mental illness. A whole host of issues
arise when it comes to the treatment of the mentally ill in our immigration system including
exclusion from admission, n3 due process issues when it comes to removal, n4 and [*78] access
to treatment while in detention. n5 Upon looking into each of these issues, it becomes clear that the stigma
attached to mental illness is alive and well in our immigration system. n6 As the news stories above reveal,
procedural issues - such as the overuse of detention, assessing competency, and the right to representation - moved to the forefront
of concern for those advocating for fairness in our immigration system. n7 There is good reason for this focus given the
widespread human rights violations that are transpiring in our system. n8 This situation raises other
compelling and overlooked issues: to what extent has mental illness placed a person into the removal system in the first place? Can
better access to mental health care help immigrants avoid conduct that leads to removal? This
article will explore these issues, looking at developments in mental health care in the United States generally, the particular needs of
immigrants to mental health care, and the barriers they face. A review of the literature on the mental health treatment of
immigrants reveals an interesting phenomenon: immigrants
arrive in the United States with better mental
health overall when compared to the general population of the United States. n9 This phenomenon has been dubbed by
psychologists and scholars studying the issue as the "immigrant paradox," and runs contrary to perceptions,
both historical and contemporary, that immigrants are [*79] more likely to be impaired and a
burden. n10 Studies show, however, that over time many immigrants' mental health deteriorates, generating behavior - such as
drug use or low-level criminal activity - that might place them into the immigration removal system. n11 If this is the case, then
improved mental health care can prevent behavior leading to deportation. Part II of this article provides an overview of mental
health care in the United States. The story is one of de-institutionalization and an increasing overlap between those in need of
mental health care and negative behaviors leading to involvement in the criminal justice system. n12 Part III will focus on the
particular mental health
challenges of immigrants in the United States. The article details the barriers to
receiving mental health care, such as social and cultural barriers, economic barriers such as
poverty and a lack of access to insurance, that account for the result that immigrants are
underserved and underutilize mental health services. n13 Part IV connects how immigrants' mental
health issues can lead to removal from the United States. It starts with the history of excluding those
deemed to be mentally or physically deficient or likely to become a public burden. Reflected in
these exclusive grounds is a deeply rooted belief that other countries would send those who are
feeble, incompetent or criminal to the United States. n14 While there are strains of that thinking still
present in our public debate, n15 the evolution of the mental health system and [*80] the immigration
removal system toward a criminal enforcement approach suggests that today many immigrants
who do not receive adequate mental health treatment face removal for a wide variety of actions
and offenses that grow out of the untreated mental issues. n16 In fact, what has happened is that the
modern removal grounds for drug use and criminal behavior have replaced the traditional
grounds as means of deporting those deemed deficient. n17
mental health exclusion
Spillover – Gender, Race, Income
Public charge rules justify excluding women who don’t meet Western gender
Moloney 6 (Deirdre M. Moloney, director of fellowships advising at Princeton University,
author of National Insecurities: Immigrants and U.S. Deportation Policy Since 1882, American
Catholic Lay Groups and Transatlantic Social Reform in the Progressive Era, Summer 2006,
“Women, Sexual Morality, and Economic Dependency in Early U.S. Deportation Policy”, Journal
of Women's History, Volume 18, Number 2, Published by Johns Hopkins University Press, Project
This article examines how U.S.
federal immigration policy in the late nineteenth century and early twentieth century
regulated female immigrants who bore children outside of marriage, had sexual relations
outside of marriage, or were suspected of prostitution. The author examines the ways in which immigration
officials racialized the application of the moral turpitude clause in immigration law, and how this
racialization reflected deeper social concerns about women’s shifting economic and political roles and the definitions and
expectations of marriage. Although few women were
actually deported on moral turpitude grounds,
patrolling women’s sexuality and economic status at the borders reduced migration
opportunities for women in general, subjected them to intense scrutiny by the state, constricted
the contours of their personal relationships, and in some cases permanently separated them
from their infant children. In 1909, Caterina Bressi was deported to Naples, Italy with her young, American-born child,
having been charged with prostitution. She spent some months sleeping on the streets of Naples, until a group of wealthy women
there provided her with funds to return to the United States, where she supported herself by obtaining a low-wage job at an Illinois
candy factory. Bressi claimed she was raped by a coworker at gunpoint and became pregnant. In 1910, the twenty-three-year-old
was ordered deported by Chicago immigration authorities on
grounds that she was likely to become a public
charge. Her deportation order was overturned by Illinois Federal District Court Judge Kenesaw Landis on a writ of habeas corpus.
Judge Landis concluded that there was insufficient evidence to suggest that because Bressi had once practiced
prostitution and would soon become the sole support of two children that she would necessarily
become a public charge. An immigration official defended the federal government’s decision to
deport her a second time, stating, “[T]here can be no doubt that a woman of loose morals who, while
attempting to maintain an appearance of respectability, consents to occasional acts of illicit
sexual intercourse is by that defect of character rendered likely to become a public charge.” The
official added that Bressi was unlikely to earn enough to support her family, especially since she was soon to enter a period of
confinement.1 Bressi’s case neatly captures the relationship between sexual morality issues and women’s economic roles that
emerged in the context of the United States’s rapidly industrializing society. By the early twentieth century, growing
concerns over non-marital pregnancy and prostitution (commonly referred to as “white slavery”) helped to shape
immigration policies concerning the exclusion and deportation of female immigrants arriving in
the United States. That scrutiny of female immigrants occurred in an era in which American citizenship itself was being
contested on several levels. Native-born women had renewed their mobilization for federal voting rights and had challenged many
assumptions about their social roles. Women’s rates of employment and educational attainment increased in this period, leading to
concerns of “women adrift” in urban settings as well as the rise of organizations such as the YWCA. It was also a time in which
African Americans formed the NAACP and other organizations to fight Jim Crow segregation policies, and in which the United States
expanded its political territory to include the Philippines, Panama, Puerto Rico, and elsewhere. The legal status that these countries’
inhabitants had in relation to the United States was widely debated. A major impetus for federal regulation of immigration arose
from labor leaders, who sought to limit the number of alien laborers arriving in the country on the grounds that they depressed
American wages. Other early proponents of restriction included those opposed to Asian immigrants on the West Coast, eugenicists
who feared the effects of large-scale immigration, and officials in states such as New York, who sought to reduce the costs
associated with the growing number of immigrants requiring public institutional care and charity. Thus, concerns about immigrant
women reflected larger social debates about who was fit for American citizenship and how the large influx of immigrants would
shape American society and its institutions. Moreover, settlement house workers and other Progressive reformers widely perceived
immigrant women, in their roles as mothers or potential mothers, to be the primary transmitters of critical cultural and moral values
to the next generation. Their
maternalist perspective, which emphasized the special place of mothers
and children in society, was evident in settlement programs and in reforms such as the SheppardTowner Act, which provided medical care to mothers and infants. The regulation of women’s non-marital sexuality at the borders,
including prostitution, non-marital births, and common law marriage, was a means to ensure that admitted immigrant women
would become both moral citizens themselves and the mothers of moral future citizens.2 The 1875 Page Law first addressed
concerns about immigrant women’s morality by placing major constraints on the immigration of
unmarried women from China, casting them as likely to engage in prostitution. The Chinese Exclusion Act and the
Immigration Act of 1882 constituted the first major federal laws regulating immigration to the United States. The Immigration Act,
revised in 1891, allowed for the exclusion or deportation of immigrants deemed “likely to become public charges, persons suffering
from a loathsome or contagious disease, persons who have been convicted of a felony or other infamous crime or misdemeanor,
involving moral turpitude, polygamists, and also any person whose ticket or passage has been paid for with the money of another.”
Prior to the 1882 Immigration Act, there were some efforts by the states to regulate immigration at incoming ports, using boards or
commissions, but there was no systematic effort to limit immigration and no federal government agency authorized or granted a
budget to regulate the flow of immigrants. Over the next few decades additional laws were passed to regulate immigration, to
strengthen and broaden the scope of deportation policies, and to deepen the mechanism for enforcement of those laws and policies
to the major ports of immigration, the Canadian and Mexican border, and many cities across the United States that became
immigrant destinations. Between 1900 and 1909, over 8.2 million immigrants arrived in the United States, primarily from Europe. In
fact, the percentage of immigrants arriving in the United States totaled just below 11 percent of the U.S. population, a ratio that was
its second highest in history until the 1990s. The influx of immigrants from Europe began to slow by World War I and in the 1920s a
series of immigration restriction acts greatly reduced the flow of immigrants. The national quota system did not place numerical
restrictions on immigrants from Canada or Mexico, though they were subject to other forms of regulation, based on public health
restrictions, for example. By the Great Depression of the 1930s, large numbers of immigrants, especially Mexicans, were deported or
pressured to repatriate to their countries of origin.3 Some of the earlier state-level policies carried over to federal
including precedents about “paupers” and pregnant women. The Likely to Become a Public Charge
(LPC) provision was a modern incarnation of traditional Anglo-American poor laws, which
reinforced prevalent views about women’s economic vulnerability and dependency on male
wage earners. Therefore, female immigrants became especially vulnerable to the Likely to Become a Public
Charge (LPC) provision, but also to increasing social concerns about women’s morality.4 These two issues
were intertwined, given that women who immigrated outside family structures were viewed as far more economically vulnerable
than men. If they were unable to earn a living in industry or domestic service, they might turn to prostitution, as had women such as
Caterina Bressi. Indeed, for many women in industrializing capital economies, prostitution served as one of the few profitable
alternatives to domestic service or low-paid factory jobs. 98 Journal of Women’s History Summer As with domestic service or factory
jobs, there was a clear demand for such work in the United States. My research suggests that because
it was easier to
prove, women who were suspected of prostitution or who lived with their partners or children
outside of a formal marriage were often excluded on the basis of the LPC provision rather than
on grounds of prostitution or moral turpitude. Indeed, LPC and other provisions related to economic dependency were the
most common reason for exclusion, in large part because they were easier charges to substantiate. In 1916, for example, 10,263
people were excluded at the ports of entry and returned to their countries of origin on the basis of the LPC
provision. That number equaled 55 percent of those excluded that year. Additionally, 1,431 immigrants were deported
after having resided in the United States because they were or were deemed likely to become dependent on
public funds or to become inmates of public institutions.5 In the first two decades of the twentieth century,
women of all nationalities constituted about a third of all immigrants arriving in the United States, but they were
proportionately more likely than men to face LPC charges, especially if they were unmarried and
traveling outside a family structure. In contrast, from 1892 to 1920, the numbers of immigrant women excluded from
the United States on the basis of prostitution went from 80 in 1892 to a high of 510 in 1917. In six of those years, no immigrants
were excluded for prostitution. The mean number of immigrant women excluded annually for prostitution in the years from 1892 to
1920 was 131. The number of immigrant women deported on grounds of prostitution (after having resided in the United States) also
remained low, generally under 200 per year prior to 1920. Thus, from 1892 to 1920, immigration officials used provisions of the LPC
clause more often than those specifically related to prostitution to exclude or deport immigrant women from the United States.6 By
1910, female immigrants traveling alone from Europe, Mexico, the Caribbean, Asia, and the Middle East were routinely scrutinized
to determine their moral, familial, and economic status. Issues of female sexual behavior had previously surfaced in state-level
immigration policies. In Pennsylvania, for example, state officials developed a policy of deporting single, pregnant immigrant women
in the 1880s. In 1884 the State of Pennsylvania noted in “The Second Immigration Report of the Board of Commissioners of Public
Charities for the Year Ending June 30, 1884” that seventeen persons were returned to Europe that year. The report writer noted
with typical Victorian delicacy that “Twelve (12) of those were incapacitated for labor on account of illness, or inability, and five (5)
were enciente [sic].”7 A similar situation was reported by Frederick Busch, keeper of the Erie County Almshouse, who noted that his
agency had assisted a German woman of 24 who had been sent alone to the United States by the father of her child, 2006 Deirdre
M. Moloney 99 and was later returned to Germany by the State Board of Charities. When immigration was regulated by the states,
there were relatively few legal mechanisms and virtually no resources expended to address immigration law. Therefore, there was
little enforcement regulating immigrants from Europe until the close of the nineteenth century.8 Yet, some of the earlier principles
determining the
grounds for deportation did influence the development of federal policy. For example, the policy
of excluding or deporting women who were pregnant on the grounds of their likelihood to
become public charges carried over to federal policy following the passage of the Immigration Act of 1882, which
transferred the enforcement of immigration policy to the federal government. Even when written as gender neutral,
immigration laws and policies concerning sexual morality, economic independence, and public
health had significantly divergent effects on men and women. Ultimately, the policies that sought to ban
immigrant women who had sexual relations outside of marriage, defined by evidence of prostitution, non-marital pregnancy, or
adultery, greatly restricted all women’s ability to immigrate to the United States unaccompanied by husbands or fathers. By the
early twentieth century the Bureau of Immigration used its gate-keeping authority to promote marriage between partners who were
not legally married. The richly detailed case files and administrative records of the Bureau of Immigration, housed in the National
female immigrants who immigrated independently
from their families and how those who faced exclusion or deportation proceedings were treated.9
Archives, offer crucial insights into attitudes toward those
The origins of public charge exclusion prove its massive discretion to executive
discrimination based of ability, income and gender roles
Baynton 5 (Douglas C. Baynton, professor of American cultural history and history of disability
at the University of Iowa, PhD from the University of Iowa, serves on the Editorial Board of Sign
Language Studies, Disability Studies Quarterly, and Deaf Studies Digital Journal, Spring 2005,
“Defectives in the Land: Disability and American Immigration Policy, 1882-1924”, Journal of
American Ethnic History, Vol. 24, No. 3, Published by: University of Illinois Press on behalf of the
Immigration & Ethnic History Society, JSTOR)/CWB
Congressional legislation throughout this period repeatedly, and with ever increasing urgency,
identified defective immigrants as a threat to the nation. The desire to keep out immigrants
deemed defective was not a isolated development, but rather was one aspect of a trend toward
the increasing segregation of disabled people into institutions and the sterilization of the "unfit"
and "degenerate" under state eugenic laws. While anti-immigrant sentiment in the United
States has long been a significant area of scholarly research, disability has held a marginal place
in that scholarship. John Higham's Strangers in the Land identified three main currents of anti-immigrant sentiment: antiCatholicism, fear of foreign radicals, and racial nativism. Roger Daniels stated in Coming to America that "by 1917 the
immigration policy of the United States had been restricted in seven major ways," with admission
being denied to "Asians . . .; criminals; persons who failed to meet certain moral standards; persons
with various diseases; paupers; assorted radicals; and illiterates." Alan Kraut's Silent Travelers and Amy
Fairchild's recent book, Science at the Borders, brought a welcome focus to medical inspection, but did not examine
communicable disease and disability as distinct issues, nor explore the cultural stigmatization of
disability that formed the background to these laws.2 Sophie Fuko does not fit into any of the categories that
historians of immigration policy have described as fundamental to anti-immigrant sentiment or the enactment of
exclusionary immigration policies in the United States. Though she had little money at hand, she was by no
definition a pauper. Neither she nor her son was a carrier of disease. The only charge against Fuko, and many other similar
immigrants, was that they were defective. Countless other immigrants passed through Ellis Island with fewer financial resources, no
family in the United States to turn to in case of difficulty, and certainly less poignant personal circumstances. Disability was a crucial
factor in deciding whether an immigrant would be allowed to enter the United States. The
first major immigration law,
the Act of 1882, prohibited entry to any "lunatic, idiot, or any person unable to take care of
himself or herself without becoming a public charge." Those placed in the categories "lunatic" or "idiot" were
automatically excluded. The "public charge" provision was intended to encompass individuals with
disabilities more generally, and was left to the examining officer's discretion.3 The criteria for
excluding disabled persons were steadily tightened as the eugenics movement and popular fears
about the decline of the national stock gathered strength. The Act of 1891 replaced the phrase
"unable to take care of himself or herself without becoming a public charge," with "likely to
become a public charge." The 1907 law then required a medical certificate for anyone judged "mentally or physically
defective, such mental or physical defect being of a nature which may affect the ability of such alien to earn a living." While
nondisabled immigrants continued to be admitted unless found to be "likely to become a public charge," disabled people were
subject to this more rigorous standard.4 Exclusions for mental defect were steadily expanded. In 1903 people
with epilepsy were added, as well as "persons who have been insane within five years previous [or] who have had two or more
attacks of in sanity at any time previously." In 1907 "imbeciles" and "feeble-minded persons" had been barred, in addition to
"idiots." In 1917 the classification of "constitutional psychopathic inferiority" was added, which inspection regulations described as
including "various unstable individuals on the border line between sanity and insanity, such as . . . persons with abnormal sex
instincts." Officials were instructed to exclude persons with "any mental abnormality whatever . . . which justifies the statement that
the alien is mentally defective." This
provision, the regulations explain, was intended "as a means of
excluding aliens of a mentally inferior type, not comprehended in the other provisions of the
law, without being under the necessity, as formerly, of showing that they have a defect which
may affect their ability to earn a living."5 The rules governing exclusion for physical disabilities
were equally vague and expansive. Regulations instructed inspectors that "each individual should be seen first at rest
and then in motion," in order to detect "irregularities in movement" and "abnormalities of any description." It listed defects that
could be cause for exclusion, a few examples of which were arthritis, asthma, bunions, deafness, deformities, flat feet, heart dis
ease, hernia, hysteria, poor eyesight, poor physical development, spinal curvature, vascular disease of the heart, and varicose
veins.6 An Ellis Island medical inspector later wrote that his task was "to detect poorly built, defective or broken down human
beings."7 In
short, the exclusion of disabled people was central to the laws governing immigration.
As the Commissioner General of Immigration reported in 1907, "The exclusion from this country
of the morally, mentally, and physically deficient is the principal object to be accomplished by
the immigration laws."8 These laws were usually presented as simply a matter of economics.
The issue, however, was rarely so straightforward. Many rejected immigrants had been selfsupporting in their home countries. Others received job offers while awaiting their hearing, but still were deported as
likely to become public charges. More importantly, to the extent that some people with disabilities might
indeed encounter difficulties in finding employment, the public charge law also assumes that
the unemployment or underemployment of disabled people is a problem centered in bodies
rather than in the relationship between particular bodies and the constructed physical and
social environments in which they live. This may have been the only practical assumption for
immigration officials, but historians should put immigration restriction into context as one
element in a larger system of discrimination that made it difficult for disabled people to live and
move about independently. Leaving aside, however, complex questions of what factors made (and still make) it difficult
for disabled people to find work, the economic explanation for exclusion remains an incomplete one. Two examples of the mixed
motives and reasoning that went into these exclusions were the diagnoses "poor physique" and "lack of sexual development."
Public charge used to exclude immigrants officials deemed undesirable based
off ethnicity, sexuality and ability
Baynton 13 (Douglas C. Baynton, professor of history of disability at the University of Iowa,
author of Defectives in the Land: Disability and Immigration in the Age of Eugenics, Forbidden
Signs: American Culture and the Campaign against Sign Language, Through Deaf Eyes: A
Photographic History, serves on the Editorial Board of Sign Language Studies, Disability Studies
Quarterly, and Deaf Studies Digital Journal, Ed. Lennard J. Davis, Professor of Disability and
Human Development at the University of Illinois at Chicago, 2013, “Disability and the
Justification of Inequality in American History”, The Fourth Edition of the Disability Studies
Reader, Routledge,
Ethnicity also has been defined by disability. One of the fundamental imperatives in the initial
formation of American immigration policy at the end of the nineteenth century was the exclusion of disabled
people. Beyond the targeting of disabled people, the concept of disability was instrumental in
crafting the image of the undesirable immigrant. The first major federal immigration law, the Act of 1882,
prohibited entry to any “lunatic, idiot, or any person unable to take care of himself or herself without becoming a public
charge.” Those placed in the categories “lunatic” and “idiot” were automatically excluded. The “public charge”
provision was intended to encompass people with disabilities more generally and was left to the
examining officer’s discretion. The criteria for excluding disabled people were steadily tightened
as the eugenics movement and popular fears about the decline of the national stock gathered strength. The Act of 1891 replaced the
phrase “unable to take care of himself or herself without becoming a public charge,” with “likely to become a public
The 1907 law then denied
entry to anyone judged “mentally or physically defective, such mental or physical defect being of a
ability of such alien to earn a living.” These changes considerably lowered
the threshold for exclusion and expanded the latitude of immigration officials to deny entry.28
The category of persons automatically excluded was also steadily expanded. In 1903, people with
nature which may affect the
epilepsy were added and, in addition to those judged insane, “persons who have been insane within five years previous [or] who
have had two or more attacks of insanity at any time previously.” This was reduced to one “attack” in the 1917 law; the classification
of “constitutional psychopathic inferiority” was also added, which inspection regulations described as including “various unstable
individuals on the border line between sanity and insanity . . . and persons with abnormal sex instincts.”29 This
was the
regulation under which, until recently, gays and lesbians were excluded. One of the significant factors in
lifting this ban, along with other forms of discrimination against gays and lesbians, was the decision by the American Psychiatric
Association in 1973 to remove homosexuality from its list of mental illnesses. That is, once gays
and lesbians were
declared not to be disabled, discrimination became less justifiable.
Public charge is inherently racist—the provision justifies exclusion based on
racial inferiority and subjects immigrants to dehumanizing medical profiling
Sibara 14 (Jennifer Barager Sibara, “Disease, Disability, and the Alien Body in the Literature of Sui Sin Far,” MultiEthnic Literature of the US, Project Muse, Volume 39, Number 1, 2014, pg. 57)//jy
The Advent of Medicalized Nativism Operating in confluence with North American trade unionists’ arguments against Chinese laborers in
1870s, two health-related discourses—biological racism and public health—influenced popular
opinion against the Chinese in North America and fostered public support for immigration
exclusion. 4 While the “science” of biological racism characterized Chinese and other racialized peoples as innately inferior in intelligence, ability,
and appearance, 5 Nayan Shah explains that the emerging field of public health characterized them as prone to
contagious diseases ( Contagious 1) because of their non-Western lifestyles and medical prac- tices (11) and their
nonnormative gender and sexual formations (79), including bachelor societies and extended kinship networks (12), which
arose in response to the disproportionate exclusion of Chinese women. 6 In addition to facilitating the passage of the Chinese and other race-based
exclusion laws, biological
racism and public health discourses inspired several immigration restrictions
and exclusions explicitly directed at the disabled and diseased, yet implicitly directed at nonwhite foreigners.
California’s 1872 immi- gration law established a one-thousand-dollar bond for any “lunatic, idiot, deaf, dumb, blind, cripple or
infirm person not members of families, or who are likely to become permanently a public charge” (qtd. in Chan 98). This law, passed amid great antiChinese fervor in California, provided
an opportunity for state officials to turn away Chinese and other
Asian immigrants on the pretext of any number of imprecise diagnoses ranging from insanity to
suspicion of prostitution. In August 1882, just three months after the Chinese Exclusion Act (US Cong. Act to Execute) was
passed, the US Congress approved An Act to Regulate Immigration, which echoed California’s 1872 immigration law by
prohibiting entry to any “lunatic, idiot, or any person unable to take care of himself or herself
without becoming a public charge.” This second federal exclusion law extended and strengthened the new gatekeeping
apparatus established under the Chinese Exclusion Act and provided a flexible mechanism for excluding immigrants
believed to be racially inferior and predisposed toward disease. This law author- ized
immigration officials to profile and physically examine newcomers, an inva- sive and dehumanizing
process Shah refers to as crossing the medical border ( Contagious 179). Thus, the second 1882 immigration law provided US
officials with an extra means of excluding Chinese immigrants; those who could prove their merchant-class exempt status under the Chinese Exclusion
Act might still find themselves rejected at the port on medical grounds
The public charge provision is entrenched in ableist origins that have worked to
exclude immigrants on the basis of ethnicity, race, and sexual orientation
Baynton 13 (Douglas C. Baynton, “Disability and the Justification of Inequality in American History,” The Disability
Studies Reader, Ch.2, pg. 45-48, 2013,
One of the fundamental imperatives in the initial formation of American
immigration policy at the end of the nineteenth century was the exclusion of disabled people. Beyond the targeting of disabled
people, the concept of disability was instrumental in crafting the image of the undesirable
immigrant. The first major federal immigration law, the Act of 1882, prohibited entry to any “lunatic, idiot, or any
person unable to take care of himself or herself without becoming a public charge.” Those placed in the
categories “lunatic” and “idiot” were automatically excluded. The “public charge” provision was intended to encompass
people with disabilities more generally and was left to the examining officer’s discretion. The
criteria for excluding disabled people were steadily tightened as the eugenics movement and
popular fears about the decline of the national stock gathered strength. The Act of 1891 replaced the phrase “unable
Ethnicity also has been defined by disability.
to take care of himself or herself without becoming a public charge,” with “likely to become a public charge.” The 1907 law then denied entry to anyone judged “mentally or
physically defective, such mental or physical defect being of a nature which may affect the ability of such alien to earn a living.” These changes considerably lowered the
1903, people with epilepsy were added and, in addition to those judged insane, “persons who
have been insane within five years previous [or] who have had two or more attacks of insanity
at any time previously.” This was reduced to one “attack” in the 1917 law; the classification of “constitutional
psychopathic inferiority” was also added, which inspection regulations described as including
“various unstable individuals on the border line between sanity and insanity . . . and persons with abnormal sex instincts.”29 This was the
threshold for exclusion and expanded the latitude of immigration officials to deny entry.28 The category of persons automatically excluded was also steadily expanded.
One of the significant factors in lifting this ban, along with other
forms of discrimination against gays and lesbians, was the decision by the American Psychiatric Association in 1973 to remove homosexuality
from its list of mental illnesses. That is, once gays and lesbians were declared not to be disabled,
discrimination became less justifiable. Legislation in 1907 added “imbeciles” and “feeble-minded persons” to the list, in addition to “idiots,” and
regulation under which, until recently, gays and lesbians were excluded.
regulations for inspectors directed them to exclude persons with “any mental abnormality whatever . . . which justifies the statement that the alien is mentally defective.” These
changes encompassed a much larger number of people and again granted officials considerably more discretion to judge the fitness of immigrants for American life. Fiorello H.
over fifty percent of the deportations for
alleged mental disease were unjustified,” based as they often were on “ignorance on the part of the immigrants or the doctors and the inability
LaGuardia, who worked his way through law school as an interpreter at Ellis Island, later wrote that “
of the doctors to understand the particular immigrant’s norm, or standard.”30 The detection of physical disabilities was a major aspect of the immigration inspector’s work.
The Regulations for the medical inspection of immigrants in 1917 included a long list of diseases and disabilities
that could be cause for exclusion, among them arthritis, asthma, bunions, deafness, deformities, flat feet, heart
disease, hernia, hysteria, poor eyesight, poor physical development, spinal curvature, vascular disease of the heart, and varicose veins. A visiting
physician in 1893, when admission standards were still relatively liberal, described the initial inspection: “If a man has a hand done up, or any physical injury in any way . . . , or if
a person has but one leg or one arm, or one eye, or there is any physical or mental defect, if the person seems unsteady and in any way physically incapacitated to earn his
a young Italian couple who would have been
deported (the man had a “game leg” that required use of a crutch) had not a wealthy philanthropist visiting Ellis Island taken an interest in the
couple and intervened, guaranteeing that they would not become a public charge.32 In short , the exclusion of disabled people was
central to the laws and the work of the immigration service. As the Commissioner General of Immigration reported in 1907,
“The exclusion from this country of the morally, mentally, and physically deficient is the principal object to be accomplished by the immigration laws.” Once the laws
and procedures limiting the entry of disabled people were firmly established and functioning well,
attention turned to limiting the entry of undesirable ethnic groups. Discussion on this topic often began by pointing to the
livelihood, he is passed to one side to be examined later.”31 An immigration official later recalled
general public agreement that the laws excluding disabled people had been a positive, if insufficient, step. In 1896, for example, Francis Walker noted in the Atlantic Monthly
that the necessity of “straining out” immigrants who were “deaf, dumb, blind, idiotic, insane, pauper, or criminal” was “now conceded by men of all shades of opinion”; indeed
there was a widespread “resentment at the attempt of such persons to impose themselves upon us.” As one restrictionist wrote, the need to exclude the disabled was “self
restrictionists found the concept of
disability to be a powerful tool. That is, while people with disabilities constituted a distinct category
of persons unwelcome in the United States, the charge that certain ethnic groups were mentally
and physically deficient was instrumental in arguing for their exclusion. The belief that discriminating
on the basis of disability was justifiable in turn helped justify the creation of immigration quotas based on
ethnic origin. The 1924 Immigration Act instituted a national quota system that severely limited the numbers of immigrants from southern and eastern Europe, but
evident.”33 For the more controversial business of defining and excluding undesirable ethnic groups, however,
long before that, disabilities stood in for nationality. Superintendents of institutions, philanthropists, immigration reformers, and politicians had been warning for decades
before 1924 that immigrants were disproportionately prone to be mentally defective—up to half the immigrants from southern and eastern Europe were feebleminded,
Rhetoric about “the slow-witted Slav,” the “neurotic condition of our Jewish
immigrants,” and, in general, the “degenerate and psychopathic types, which are so
conspicuous and numerous among the immigrants,” was pervasive in the debate over
restriction.35 The laws forbidding entry to the feebleminded were motivated in part by the desire to limit immigration from inferior nations, and conversely, it was
assumed that the 1924 act would reduce the number of feebleminded immigrants. The issues of ethnicity and disability were so
intertwined in the immigration debate as to be inseparable.
according to expert opinion. 34
Public charge restrictions continue US immigration’s historical admission based
off ability, race, gender and sexuality
Parker 15 (Alison M. Parker, professor of history at the College at Brockport, PhD in history
from John Hopkins University, Andrew W. Mellon Foundation Visiting Fellow, James Weldon
Johnson Institute for the Study of Race and Difference at Emory University, Spring 2015,
“Intersecting Histories of Gender, Race, and Disability”, Journal of Women's History, Volume 27,
Number 1, Johns Hopkins University Press, Project Muse)/CWB
From the moment colonists introduced slavery into North America, they justified it by claiming that “Africans brought to North
America were by definition disabled” and unable to care for themselves (42). Captured and enslaved Africans faced the excruciating
and perilous middle passage; if they survived, they encountered many potentially disabling situations, from severe punishment to
work-related injuries. Although whites viewed all slaves as disabled by virtue of their race and condition of servitude, only those
whom they deemed unfit for labor were considered “damaged goods” (46). Just
as ideas about race and disability
helped to justify slavery, so too did they inform debates about immigration. The U.S. Congress
passed the Immigration Act of 1882, for instance, mandating that immigrants be screened and excluded if
they appeared to be “unable to take care of [themselves] without becoming a public charge”
(103). Nielsen rightly notes that increased immigration from Southern and Eastern European countries made many
native-born white Americans nervous about maintaining racial purity, yet she misses an opportunity to
highlight the links between white society’s fears of the physically and mentally disabled (a concept that
included “sexual perversion,” or homosexuality), and its fears of racial others. Although she mentions
the 1875 Page Law, Nielsen does not identify it as the first immigration law to single out Asian female immigrants as probable
prostitutes who should not be allowed into the country. Nielsen also neglects to note that just a few months before Congress
passed the 1882 Immigration Act, which screened out people with identifiable disabilities, it had passed the
Chinese Exclusion Act. Asians appeared the most racially and culturally different of all immigrants to the United States, who mostly
came from Europe, and thus Asians seemed the most threatening to white Americans. The rise of Social Darwinism and eugenics at
the turn of the century provided a rationale for severe restrictions on immigration and prohibitions against first-generation Asian
immigrants gaining U.S. citizenship. 180 Journal of Women’s History Spring As the example of early restrictions
on Asian
into the United States suggests, gender and disability have also intersected at key
moments throughout American history. Beginning her book in the colonial era, Nielsen points out that Puritan
women’s entry
ministers charged dissident women such as Anne Hutchinson and Mary Dyer with producing stillborn “monstrous births,” ostensible
proof of God’s displeasure with these women’s disruption of the patriarchal order. During the American Revolution, the language of
ability and disability became a means for those fomenting revolution to describe and create the boundaries of a new self-governing
nation. Civic fitness was gendered and raced in ways that privileged white, able-bodied, property-owning men. Drawing on the
historian Barbara Welke’s work, Nielsen explains that for much of U.S. history, citizenship was defined as much by who could not be
a citizen as by who could be. Ability,
race, and gender all contributed to one’s perceived suitability for
legal personhood; thus, able-bodied white men had the clearest claims to legal personhood and
full citizenship. Men’s legal independence and privilege were based on English common law,
including the law of coverture for married women, and rested on the subordinate status of blacks, all
women, and those deemed physically or mentally disabled. In the nineteenth century, white men benefitted
most from the privileges of full citizenship since only those who owned themselves could own land. Military service imposed
burdens and dangers on men who served, but it also provided them many benefits. The U.S. government often paid veterans of the
American Revolution, the War of 1812, and the Mexican War with land seized or claimed from Native Americans and Mexicans.2 For
medical and scientific male “experts,” women’s sexuality and bodies served as a rationale to deny them full citizenship rights,
including voting, higher education, and property ownership. As the common school movement spread after the Civil War, medical
experts such as Edward Clarke issued warnings that if respectable white women began to acquire higher education, the mental
strain could damage “a good reproductive system that could [otherwise] serve the race” (94). In the twentieth century, state
legislatures passed sterilization laws that forcibly
restricted who could and could not contribute new
citizens to the nation. Condoned by the U.S. Supreme Court, with Justice Oliver Wendell Holmes’s memorable assertion that
“three generations of imbeciles are enough” (Buck v. Bell, 1927), these laws tragically resulted in over 65,000 forced sterilizations by
disability history, making
consistent links to race, gender, and sexuality throughout. Students in any U.S. history survey course, or a more
the 1960s. Nielsen does an excellent job overall at highlighting the most innovative work in American
specialized course in race, gender, or disability in American history, would benefit from reading Nielsen’s book.
AT: Trump Thumps
Even if the plan isn’t a silver bullet, it’s necessary to check back against the
harms of Trump’s “chilling effect” – In order to combat Trump’s violence, small
legal fixes must check back against his policies
Avina 18, Marisol - Program Manager, Prevention, The California Endowment 23 April 2018 California Endowment
You may have heard something in the news about the federal government’s plans to expand the
definition of which immigrants are considered a “public charge” and the fear this is causing. In
order to put the threat in perspective, and better understand how we can respond, it’s important to clarify what is meant by a
“public charge,” how it’s used, and the limits on how the federal administration can use it. Public charge is a concept that’s been
around for over a century, and is used to determine whether someone applying for admission to the U.S. or for a green card will
become a burden on U.S. taxpayers. Those who
are deemed to be a burden, or a public charge, are
typically denied entry or a green card, and in very rare circumstances, can face deportation.
Currently, someone who accepts cash benefits, such as Temporary Assistance for Needy Families (or CalWorks in California), or longterm institutional care, could be considered a public charge. Note that accepting one of these benefits does not automatically define
someone as a public charge, because under the law, federal authorities also have to take other factors into account, such as any
special skills the person has, whether the person has a sponsor, and their health and age. It’s also important to note that public
charge determinations are not used to decide who becomes a U.S. citizen, and are not applied to refugees or survivors of trafficking,
domestic violence, or other serious crimes. The
federal administration can’t change any of this, as it requires
an act of Congress, and the odds of Congress being able to muster the votes to pass a law to change these criteria are
practically zero. So what can the federal administration do on its own? It can change regulations, but
not laws. Since regulations are the rules agencies follow to implement laws, changing
regulations can make a significant difference, but it has its limits, and can be undone by the next
president’s administration. Leaked memos reveal that the current administration plans to use
the rule-making process to expand the types of qualifications that the Department of Homeland
Security can use to make a determination whether someone is deemed a public charge. In
particular, the federal administration is planning to propose that DHS consider expanding the list
of public benefits that trigger a public charge determination. Such benefits could include: Medicaid, the
Children’s Health Insurance Program (CHIP), food stamps, WIC nutrition benefits, Obamacare tax credits that help pay for health
insurance, housing assistance, energy assistance, transportation services, and the Earned Income Tax Credit. Many of these
programs provide assistance and support to families that sometimes fall under difficult times and help meet basic needs to keep
families healthy and stable. The rules would also count benefits received by dependents, including U.S. citizen children, toward the
public charge determination of someone applying for a green card. It
is estimated that this could affect 20 million
children in the U.S. For example, an immigration official may determine that a mom whose citizen child is receiving health
care under Medi-Cal or the CHIP program might become a public charge, and deny her application for a green card. Immigrant
families have the same dreams as all of us and they work hard to take care of their children. This
all sounds awful, and it
is, but it’s not reality yet. Nothing has changed. The federal administration has to propose a new rule,
which is open for public comment for 60 days, then take all of the comments into account and
develop a final rule. There are strict laws governing this process, so any attempts to take
shortcuts will likely be met with vigorous legal challenges. Sadly, the fear created by talk about
new public charge rules has led many people to withdraw themselves and their children from
important programs that keep them and their families healthy and able to meet their basic
needs. At this point, no one should be withdrawing from programs or benefits that currently
aren’t used to determine public charge. If or when the regulations change, they cannot apply retroactively.
Families should continue to participate in Medi-Cal, CHIP, WIC and other housing, energy and
transportation programs. This latest attempt to attack immigrants is a reminder to not let fear
drive our decisions, especially when those decisions could be detrimental to our health and the
health of our families. Remember that we are not alone. Nor are we weak. We have power in our voices, our communities,
on our streets, in our state’s institutions, among advocacy organizations that are taking action, and in the hundreds of lawyers
fighting on our behalf in the courts. We’ve
seen these forces slow down the Muslim ban, block the
federal government’s actions against sanctuary cities, and reopen the DACA renewal process.
Let’s speak up and continue to rise up as one.
AT: Climate Change Turns Case
The negative’s climate rhetoric fosters a culture of neglect that justifies an
“adaptation apartheid” – discourses on climate are inaccessible for many
disabled people and justify ableist logic
Wolbring 09, Gregor - tenured Associate Professor at the University of Calgary's Cumming School of Medicine “A Culture of
Neglect: Climate Discourse and Disabled People” Vol. 12 No. 4 M/C Journal//mr
Although climate change will disproportionately impact disabled people, despite the less than stellar record of disaster adaptation
and mitigation efforts towards disabled people, and despite the fact that other social grou ps (such as women, children, „the poor‟,
indigenous people, farmers and displaced people) are mentioned in climate - related reports
such as the IPCC reports
and the Human Development Report 2007/2008, the same reports do not mention disabled people. Even
worse, the majority of the material generated by, and physically set up for, discourses on
climate, is inaccessible for many disabled people (Australian Human Rights Commission). For instance, the IPCC
report, Climate Change 2007: Impacts, Adaptation and Vulnerability , contains Box 8.2: Gender and natural disasters , makes the
following points: (a) “men and women are affected differently in all phases of a disaster, from exposure to risk and risk perception;
to preparedness behaviour, warning communication an d response; physical, psychological, social and economic impacts; emergency
response; and ultimately to recovery and reconstruction”; (b) “natural disasters have been shown to result in increased domestic
violence against, and post - traumatic stress disord ers in, women”; and (c) “women make an important contribution to disaster
reduction, often informally through participating in disaster management and acting as agents of social change. Their resilience and
their networks are critical in household and comm unity recovery.” The content of Box 8.2 acknowledges the existence of different
perspectives and contributions to the climate discourse, and that it is beneficial to explore these differences. It seems reasonable to
assume that differences in perspectives, contributions and impact may well also exist between people with and without disabilities,
and that it may be likewise beneficial to explore these differences.
Disabled people are differently affected in all
phases of a disaster, from exposure to risk and risk perception; to preparedness behaviour,
warning communication and response; physical, psychological, social and economic impacts;
emergency response; and ultimately to recovery and reconstruction. Disabled people could also make an important contribution to
disaster reduction, often informally through participating in disaster management and acting as agents of social change. Their
resilience and their networks are critical in household and community recovery, important as distributors of relief effort s and in
reconstruction design. The Bonn Declaration from the 2007 international conference, Disasters are always Inclusive: Persons with
Disabilities in Humanitarian Emergency Situations , highlighted many problems disabled people are facing and gives rec
ommendations for inclusive disaster preparedness planning, for inclusive response in acute emergency situations and immediate
rehabilitation measures, and for inclusive post - disaster reconstruction and development measures. Many workshops were initiated
by disabled people groups, such as Rehabilitation International. However, the
disabled people disaster adaptation
and mitigation discourse is not mainstreamed. Advocacy by people with disability for accessible transport and
universal or “life - cycle” housing (among other things) shows how they can contribute significantly to more effective social systems
and public facilities. These benefit everyone and help to shift public expectations towards accessible and flexible amenities and
services — for example, emergency response and evacuation procedures are much easier for all if such facilities are universally
accessible. Most suggestions by disabled people for a more integrative, accessible physical environment and societal attitude benefit
everyone, and gain special importance with the ever - increasing proportion of elderly people in society. The IPCC Fourth Assessment
Report is intended to be a balanced assessment of current knowledge on climate change mitigation. However, none
of the
2007 IPCC reports mention disabled people. Does that mean that disabled people are not
impacted by, or impact, climate change? Does no knowledge of adaptation, mitigation and
adaptation capacity from a disabled people lens exist, or does the knowledge not reach the
IPCC, or does the IPCC judge this knowledge as irrelevant? This culture of neglect and
unbalanced assessment of knowledge evident in the IPCC reports was recognised before for rise of a global
climate discourse. For instance, a 2001 Canadian government document asked that research agendas be developed with the
involvement of, among others, disabled people (Health Canada). The 2009 Nairobi Declaration on Africa‟s response to climate
change (paragraph 36) also asks for the involvement of disabled people (African Ministerial Conference on the Environment).
However, so far nothing has trickled up to the international bodies, like the IPCC, or leading conferences such as the United Nations
Climate Change Conference Copenhagen 2009. Where Will It End? In his essay, “We
do not need climate change
apartheid in adaptation”, in the Human Development Report 2007/2008 , Archbishop Desmond Tutu suggests that we are
drifting into a situation of global adaptation apartheid — that adaptation becomes a euphemism for social injustice on a glob al scale
(United Nations Development Programme). He uses the term “adaptation apartheid” to highlight the inequality of support for
adaptation capacity between high and low income countries: “Inequality in capacity to adapt to climate change is emerging as a
potential driver of wider disparities in wealth, security and opportunities for human development”. I submit that “adaptation
apartheid” also exists in regard to disabled people, with the invisibility of disabled people in the
climate discourse being just one facet. The unwillingness to accommodate, to help the “other,” is nothing new for
disabled people. The ableism that favours species - typical bodily functioning (Wolbring, “Is there an end to out - able?”; Wolbring,
“Why MBIC?”) and disablism (Miller, Parker, and Gillinson) — the
lack of accommodation enthusiasm for the
needs of people with “below” species - typical body abilities and the unwillingness to adapt to
the needs of “others” — is a form of “adaptation apartheid,” of accommodation apartheid, of
adaptation disablism that has been battled by disabled people for a long time. In a 2009 online
survey of 2000 British people, 38 per cent believed that most people in British society see disabled people as a “drain on resources”
(Scope). A majority of human geneticist concluded in a survey in 1999 that disabled people will never be given the support they need
(Nippert and Wolff). Adaptation
disablism is visible in the literature and studies around other
disasters. The 1988 British Medical Association discussi on document, Selection of casualties for treatment after
nuclear attack , stated “casualties whose injuries were likely to lead to a permanent disability
would receive lower priority than those expected to fully recover” (Sunday Morning Herald). Famine is
seen to lead to increased infanticide, increased competitiveness and decreased collaboration (Participants of the Nuclear Winter:
The Anthropology of Human Survival Session). Ableism
and disablism notions experienced by disabled people
can now be extended to include those challenges expected to arise from the need to adapt to
climate change. It is reasonable to expect that ableism will prevail, expecting people to cope with certain
forms of climate change, and that disablism will be extended, with the ones less affected being
unwilling to accommodate the ones more affected beyond a certain point. This
ableism/disablism will not only play itself out between high and low income countries, as Desmond
Tutu described, but also within high income countries, as not every need will be accommodated. The disaster
experience of disabled people is just one example. And there might be climate change consequences that one can only mitigate
through high tech bodily adaptations that will not be available to many of the ones who are so far accommodated in high income
countries. Desmond Tutu submits that adaptation apartheid might work for the fortunate ones in the short term, but will be
destructive for them in the long term (United Nations Development Programme). Disability studies scholar Erik Leipoldt proposed
that the
disability perspective of interdependence is a practical guide from the margins for
making new choices that may lead to a just and sustainable world — a concept that reduces the distance
between each other and our environment (Leipoldt). This perspective rejects ableism and disablism as it plays itself out today,
including adaptation apartheid. Planned adaptation involves four basic steps: information development and awareness - raising;
planning and design; imple mentation; and monitoring and evaluation (Smit et al). Disabled people have important knowledge to
contribute to these four basic steps that goes far beyond their community. Their understanding and acceptance of, for example, the
concept of interdependence , is just one major contribution. Including the concept of interdependence within the set of tools that
inform the four basic steps of adaptation and other facets of climate discourse has the potential to lead to a decrease of adaptation
apartheid, and to increase the utility of the climate discourse for the global community as a whole.
AT: Terror/War Impacts
The neg’s threat construction of disabled immigrants as potential terrorists
replicates the same logic of eugenicist, ableist exclusion which we have
critiqued—the confluence of disability and criminality justifies violence and
relegates those with disabilities to the moral margins
Hughes 17 (Bill Hughes, professor at Glasgow Caledonian University who specializes in Disability Studies, Taylor &
Francis Online, “Impairment on the move: the disabled incomer and other invalidating intersections,” Eugenics:
contamination of the stock by disabled migrants, pg. 472-475, 3/13/17)//jy
Immigration Act of the same year. The act was designed to exclude the following categories of people from entering the USA: insane
and contagiously ill people, idiots, convicted felons, polygamists, paupers and any person who
might become a ‘public charge on society’; ‘Senility (old age), varicose veins, hernias, poor vision, and deformities of the limbs or spine were
among the primary causes of exclusion’ (Bateman-House and Fairchild 2008, 238). Concerned about the calibre and stock of people
passing through Ellis Island, the State of New York had, prior to the federal take-over of immigration control, raised a statute to
‘prevent the landing of mendicants, cripples, criminals, idiots &c’ (Schweik 2009, 165). The most striking
feature of Ellis Island was the role it played in the protection of public health. This was based on
eugenic fears of ‘aliens’ conceived as a contaminating threat to the physical and moral
integrity of the nation. Ellis Island was primarily a site of medical inspection dedicated to the exclusion of ‘degenerate’ bodies, including people with impaired
labour power (Fairchild 2003) who were thought to be unable to contribute to industrialisation and the prosperity of the nation (Dolmage 2011). These
immigration priorities were supported – particularly after the introduction in the 1924
Immigration Act of national quotas – by ethnic discrimination based on ‘scientific racism’ in
which preferences for northern over eastern and southern Europeans were evident (Bateman-House and
Fairchild 2008, 239). As Molina (2006) argues, US immigration policy has a long tradition of applying racialised
representations to disabled immigrants and medicalised ‘scripts’ (Molina 2014) to non-white incomers.
Ellis Island, today a museum in New York Bay, was an immigration-processing station opened by the US Federal Government in 1891 in the wake of
The same lexicon, highlighting the potential threat embodied by both groups, is used to spell out and reiterate a dangerous intersection of corrupted flesh which the nation
The growing concern, in a land of immigrants,
about the ‘fitness’ of incomers was a clear indication of the importance that eugenic
conceptions of population – ableist and racist – acquired in nineteenth century America. Eugenics
would do well to exclude from its shores. As we have seen, the policy is ‘heaven-sent’.
comes from DISABILITY & SOCIETY 473 the Greek word eugenes which means ‘well born’. Eugenic policies are designed – as Plato recommended – to eliminate weakness and/or
A restrictive immigration policy in late nineteenth-century America was part
of a wider strategy of bio-politics (Foucault 1979) that included eugenic approaches to health, hygiene
and reproduction (Rose 2001). These policies were designed to manage the population and to contain
and exclude ‘undesirables’. They were designed to ensure, therefore, the vigour of the labour
power of people and the sustainability of the nation. Blocking access to disabled people through
the major points of entry into the USA was an important weapon of the state in the battle against
‘degeneracy’. ‘Degeneracy’ was central to the rhetoric of late nineteenth/early twentieth-century ‘ideology of ablebodiedness’ (Siebers 2008); a deeply embedded
to help the ‘well-born’ to flourish.
post-Darwinian fear which suggested that the moral decline of civilisation was evident in the mass of botched and broken bodies that drained prosperity from modern urban,
Both the Immigration Act of 1891 and the New York statute are infused with
semiotic potency. They combine representations of identities in ways that suggest nefarious
intersections between, on the one hand, impairment categories (cripples and idiots) and, on the other, criminals and mendicants. They condense
crooked bodies and crooked behaviour into a singular physiognomic frame of reference. The ‘folk
devil’ is all the more efficacious in the production of social anxiety when it is made from combinations of moral dubiety. By constructing a point of
confluence at which migrant and disabled identities mix with the moral contaminants of
miscreant and vagrant identities, the immigration regulations – much like the Ugly Laws that operated contemporaneously
industrialised, spaces (Pick 1989).
aroused strong emotions of fear and disgust amongst the normate community (Schweik 2009). In
successfully representing identities seeking to enter a body politic as constituting a potentially
significant threat to the ‘moral economy’, it was relatively easy for legislators to point to the
growing bands of unsightly, mutilated, urban mendicants, in order to legitimate a policy of deportation for
those of similar embodied qualifications who presented themselves at the nation’s borders as candidates for citizenship. The connection between
criminality and disability was a central proposition of the ableist imaginary of the day. It was
evident in the populist ‘pseudo-sciences’, including eugenics, physiognomy and the new ‘scientific’ criminology
promulgated by Lombroso (1835–1909). These views suggested a causal connection between deformity and
criminality and between racial type and crooked character. The practice of medical examiners and Public Health Service officials
with them –
at Ellis Island was strongly influenced by these contemporary ideas and they used them to identify and ‘isolate’ potentially degenerate and undesirable immigrants who would
then be recommended for deportation (Dolmage 2014). Writing in 1905, Dr Allan McLaughlin of the US Public Health and Marine Hospital Service notes that he and his fellow
officials at Ellis Island are practiced in the ‘arts’ of physiognomy: ‘The gait and general appearance suggest health or disease to the practiced eye, and aliens who do not appear
normal are turned aside’. They were wise also to the 474 B. HUGHES legendry deceitfulness of disability: ‘The nonchalant individual with an overcoat on his arm is probably
concealing an artificial arm; the child strapped to its mothers back, and who appears old enough to walk alone, may be unable to walk because of infantile paralysis’ (McLaughlin
The gaze is organised by pseudo-science to identify embodied signs of
undesirability and to unmask its many disguises. Those not fit to contribute to the American dream are singled out and returned to their
place of origin. As Ato Quayson (2007, 176) has argued, representations of undesirability are fickle and eclectic, making
brethren from a number of, more or less, nefarious moral characteristics including ‘illness, deformity,
insanity and criminality’. Ethnicity is another marker of identity that is used to map an unstable ‘interface with otherness’ (2007, 52) that helps the racialised
1905, no page number).
and ableist framework to add virtue to the reputation of dominant cultural groups. At ports of entry to the USA, the deeply held eugenic sensibilities of the day were drummed
into the Public Health Service officials (Bateman-House and Fairchild 2008). This helped them to identify ‘degenerate identities’ and the intersecting scripts of abject subjects.
Public health discourse was alive to the threat of culturally strange ne’er-do-wells and the
melting pot of undesirability that included not just criminals and disabled migrants but also
people of colour (Dolmage 2014; Snyder and Mitchell 2006). The cast of degeneracy conflated ‘feeblemindedness’ – a term invented in Ellis Island – with
stereotypes of minority ethnic retardation. Eugenics massaged the myth of an intersectional threat to the health
and purity of the population: ‘nonwhite races were routinely connected to people with disabilities, both of whom were depicted as evolutionary laggards
or throwbacks’ (Baynton 2001, 36). These groups – conflated beyond recognition into an undifferentiated
identity of degeneracy – were consigned to the moral margins, helping simultaneously to sketch out both the vice of
peripheral lives and the virtues of the normate core of citizenship and nationhood (Galusca 2009). Although often associated singularly with the irrationality of Nazism, eugenics
was not only attractive to ‘racists and extremists’ but was ‘an implicit part of Western cultural assumptions’ (Marks 1999, 35). The movement attracted a widespread
constituency and was deeply embedded in the scientific orthodoxy of the major Atlantic rim countries, where it became a ‘transnational ideology’ (Snyder and Mitchell 2006,
112–121) and a legitimate means of pointing the finger at the legions of ‘social detritus’ that impaired the route to a ‘better’ society and undermined the promise of progress.
Cleansed of the sources of moral degeneracy, society would be able to migrate towards a better
tomorrow. Controlling ‘disability on the move’ was a central part of this transnational agenda of
which Ellis Island was a part. A similar logic of ableism and exclusion was applied to migrations internal to the USA – to, for example, the mass movement of people from the
countryside to the growing industrial cities. Section 36034 of the Chicago Municipal Code – still in place until after the Second World War – read: DISABILITY & SOCIETY 475 Any
person who is diseased, maimed, mutilated or in any way deformed so as to be an unsightly or disgusting objects, or an improper person to be allowed in or on the streets,
highways, thoroughfares or public spaces in this city, shall not therein or thereon expose himself to public view under the penalty of a fine of $1 for each offense. (Quoted in
Schweik 2009, 1–2) Disability segregation was central to the ‘Ugly Laws’: laws that single out the same kind of ‘improper’ persons that were returned from Ellis Island to their
homelands. They were ‘improper’ by virtue of being maimed, diseased or mutilated, ‘down-atheal’ beggars or putative criminals. It was assumed that they would constitute an
economic cost. As Ellis Island officials put it, when invoking one of their categories for excluding candidates from entry they were ‘likely to become a public charge’ (BatemanHouse and Fairchild 2008, 236). The same category was invoked in the twentieth century at the Mexican border to refuse entry to Latino migrants (Molina 2014, 91, 92).
Both disability and ethnicity were assumed to be potentially idle and burdensome and,
therefore, not fit to contribute to American society. The idea that disabled people constituted a potential contaminant to the body
politic is a theme that declined in importance when the Nazis gave eugenics a bad name in the middle of the twentieth century. Yet the importance of the
racist/ ableist doctrine of eugenics in the formation of ideals of US citizenship is central to the
story of the policing of American immigration as well as its urban public spaces. The American dream is a
dream of success and social mobility, but it is also based on an ‘imaginary nation’ of white, able-bodied citizens. The story of the policing and expulsion of disability at Ellis Island
provides a case study of citizenship shaped by the intersection of discriminatory fantasies (Galusca 2009).
AT: Util Good
Utilitarian calculations are reductionist and rely on the medical model of
disability to justify equitable distribution – this creates and justifies the ableist
institutions that create and maintain the aff’s harms
Bickenbach 08, Jerome - Emeritus Professor and Queen's Research Chair. B.A. (San Jose), M.A., Ph.D. (Alberta), LLB
(Toronto). Specialization: Bio-Ethics, Philosophy of Law, Disability Studies “Mark S. Stein, Distributive Justice and Disability:
Utilitarianism against Egalitarianism Social Theory and Practice vol. 34 no. 2 2008 p.300+ Expanded Academic //mr
At the end of the day, I want to suggest, Stein has made his life much easier by systematically
mischaracterizing the domain he focuses on, namely, disability. He begins and ends with a conceptually
anemic understanding of the concept of disability that distorts both the logic of the notion and the lived
experience of people with disabilities. In effect, he is guilty of submerging the individual into disability,
assuming that all questions of welfare can be answered once we have a good grasp of the person's
health-resources requirements. He is hardly alone in this, but in his case the misconceptions make the enterprise
of a head-to-head contrast between utilitarianism and (resource and welfare) egalitarianism far less certain of a positive
outcome for utilitarianism. 2. Stein defines disabilities as "health-related conditions that might be expected to reduce
welfare" (22). The fact that defining disability in terms of welfare reduction threatens to make resource egalitarianism
implausible ab initio is an obvious but relatively minor problem. More importantly, "disability" is a far more complex
notion, and at best Stein is capturing one component of it, which goes by the name of
"impairment." As Stein's other work shows, he is perfectly aware that disability is more accurately conceptualized as a
multidimensional concept representing the outcome of interactions between impairments and
health conditions, on the one hand, and a person's physical, attitudinal, and social environment on the
other. By far the clearest, not to mention empirically tested, description of this model of disability can be found in the World
Health Organization's International Classification of Functioning, Disability and Health, or ICF. (1) (From now on I will depart from
Stein's usage and call the functional or health component "impairment" and the overall, interactive outcome "disability.") On this
more robust, and considerably more plausible, understanding of disability, the phenomenon is linked with a wide
range of disadvantages, only some of which have anything to do with the underlying impairment. As advocates for persons
with disabilities have insisted for decades, the bulk of what makes disability disadvantageous is produced by
social attitudes that stigmatize and exclude, the built environment that restricts access to public
places, schools, and worksites, and social policies that ignore the real need for social inclusion and
genuine participation in all aspects of society. These disadvantages undoubtedly reduce a person's subjective
well-being or welfare, but medical resources are not going to improve things much. People with
disabilities are a diverse group, especially if, as is done in the ICF, impairment is understood continuously rather than
dichotomously. If we understand impairment as a functional decrement in some part of the body, and
one that ranges from mild to severe, then, epidemiologically speaking, everyone has impairments (or will have). Some
impairments certainly incur excessive medical, or more broadly, health, expenses. These are usually associated
with acute rather than chronic health states. Other impairments incur no special health costs whatsoever. A person who is
congenitally blind will likely have no more need of health resources than anyone else. Although small-scale studies for specific
impairments have suggested higher usage of the health care system, we simply have no evidence that this is true, across the full
range of impairments. Assuming that this is true is convenient for Stein, but it still lacks any empirical substantiation. But the
significant point here is that the lived experience of having an impairment--the state of being disabled--is
primarily burdened by a wide range of disadvantages that are caused by the physical and social
environment, not the impairment. So, the first problem with Stein's characterization of disability is that it
focuses entirely on the distribution of health resources, when such a redistribution, although beneficial to people with
impairments (as it would be for everyone) would not deal with the true injustice of disability, namely, social
exclusion and discrimination. Ever on the ball, Stein recognizes and concedes this point (37), but in the end thinks it does
not matter. "The key point is that welfare has been reduced, whether by disability or by social treatment, and that welfare can
accordingly be increased by various forms of assistance." But throughout his book, Stein only speaks of the provision of health
resources, relying on the intuitive plausibility of the claim that as a class, people with impairments will benefit more from the
allocation of health care resources than the class of people without impairments. But would not people with disabilities
benefit more from the allocation of resources that address the disadvantages of disability than those
without disabilities? More specifically, would people in wheelchairs benefit more from ramps than those not in wheelchairs;
would people who are deaf benefit more from sign-language interpreters than those who are not deaf; and would fully
qualified disabled people denied employment because of irrational stigma benefit from
antidiscrimination law more than those who are not in that situation? Well, obviously. 3. Prima facie,
then, there is a glaring problem in Stein's case for utilitarianism. He fundamentally misconstrues the sources of the
welfare deficit that people with disabilities, as a class, experience. Which, then, is greater: the welfare deficit from lack
of medical resources to deal with impairments, or that from the lack of other social resources to deal
with disabilities? We can speculate, but again we have no hard evidence. Whatever the answer, though, there is little
doubt that a plausible utilitarian account needs to go far beyond health-resource redistribution if it
plans to take disability seriously for distributive justice.
Utilitarian logics justifies the logic of eugenics – those who are deemed disabled
aren’t taken into account by utilitarian authors
Stonestreet 17, John - President of The Chuck Colson Center for Christian Worldview and BreakPoint co-host. “The High
Price of Utilitarian Thinking: Bad Ideas Have Victims” 19th April 2017 CNS News
We say it often: ideas
have consequences; bad ideas have victims. And a certain, consistent Princeton bioethicist
continues to show just how true that is. How do we know what’s right? Great minds have wrestled with that question for
much of history. Is it doing our duty regardless of the consequences? Is it doing whatever a virtuous person
would do? Is it doing what brings the most happiness to the most people? That last option—the
greatest good for the greatest number—is the basic premise behind an ethical theory called
“utilitarianism,” whose main champion today is Princeton Professor Peter Singer. In his book, “Practical Ethics,”
he presses this logic to chilling, yet consistent, conclusions, arguing, for example, that killing babies who are born
disabled is not only acceptable, but may be morally necessary. Why? Singer believes the
happiness of able-bodied persons trumps the rights of those with disabilities. Such beliefs are
horrifying enough in the classroom, but they rarely stay there. Enter Rutgers ethicist Anna Stubblefield, who, in 2015, was
convicted of aggravated sexual assault and sentenced to twelve years in prison. Her victim, a thirty-year-old man with cerebral palsy,
identified as “D.J.,” has never spoken a word in his life, and is dependent on caregivers for his basic needs. Using a controversial
technique known as “facilitated communication,” Stubblefield claims she helped D.J. break his lifelong silence by supporting his
hands as he typed on a keyboard. Eventually, D.J.’s family came to believe he had the mental capacity of an adult, and even enrolled
him in college courses. Then Stubblefield made an announcement to D.J.’s family that changed everything: “We’re in love.” Believing
she had received D.J.’s consent via facilitated communication, the married Stubblefield consummated a romantic relationship with
this disabled man. A New Jersey jury decided that the act constituted sexual assault. In response, in a recent op-ed at the New York
Times, Peter Singer and Jeff McMahan argue that Stubblefield’s 12-year sentence is too harsh and that D.J. was capable of more
communication than the judge or jury give him credit for. But their next argument is truly horrifying. “If
we assume,” they
write, “that he is profoundly cognitively impaired, we should concede that he cannot
understand the normal significance of sexual relations between persons or the meaning and significance of
sexual violation. In that case, he is incapable of giving or withholding informed consent … .” They go on to claim that D.J. probably
enjoyed the experience, so it wasn’t that monstrous of a crime. In
other words, because those with profound
disabilities can’t fully comprehend what’s happening, assaulting them isn’t the same as
assaulting a person in possession of full mental faculties. Now, let me be clear: This reasoning is fully
consistent with Singer’s utilitarian ethics, which teaches that net happiness—not objective
concepts like human rights, dignity, or duty—is the standard of right and wrong. And this story
shows why ideas like this are so much more than academic debates. Utilitarian reasoning
justifies all numbers of atrocities, from experimenting on prisoners in order to advance
medicine, to harvesting vulnerable people’s organs to help others. In fact, this logic has been used
to justify eugenics and forced sterilization, and is used today to defend abortion and
Util justifies valuing the disabled beneath others by equating them to animals
and using abstract calculations of how to accord citizenship
Lewiecki-Wilson 11 (Cynthia Lewiecki-Wilson, PhD in English from the University of New
Mexico, professor of English at Miami University, 2011, “Ableist Rhetorics, Nevertheless:
Disability and Animal Rights in the Work of Peter Singer and Martha Nussbaum”, JAC, Vol. 31,
No. 1/2, JSTOR)/CWB
Why read philosophy rhetorically? Not only because it can be read that way, since all texts are
rhetorically situated arguments, but because texts of political philosophy are fundamentally rhetorical in
the classical sense of the term: they are arguments about how we ought to organize social life, accord
citizenship, and make public decisions, based on probabilities.2 In an age of rationed health
care and bioethics committees, we cannot allow decisions about who is considered fully
human or who has a right to live or die or who gets a needed transplant, home health care, a
ventilator, or attendants to be formulated only by technical experts. All citizens need to reflect on and
then speak publicly about these issues. As is apparent from these examples, my interest in Singer's and Nussbaum's work
is not primarily with their theories of animal rights, but in each philosopher's theory of disability rights and secondarily in the way
they connect arguments about humans to animal rights. While the two treat the species boundary line differently and accord rights
to the disabled and animals differently, both presume that there is some connection, in that they apply
their systematic
ethical frameworks. Singer calls his preference utilitarianism and Nussbaum names hers the capabilities
approach to humans with disabilities as well as to animals. "Happy Nevertheless" Peter Singer is
infamous in disability activist circles for advocating that it is ethical to kill babies born with
disabilities (even up to a few months old) and severely mentally incapacitated elders (even
without their consent); that some animals have more sentient capacity and thereby more rights
than infants; for debating disability activist and lawyer Harriet McBryde Johnson on these issues; and for writing her obituary
when she died in 2008. Singer argues that it is a common, universal human response to value living
with disability negatively, an attitude conveyed by the "nevertheless" in the title of his obituary
for Johnson, quoted above and cited in my title. He goes further, arguing that those with
disabilities have fewer claims to rights than those without them. "I do not accept the view that
all human life is equally to be protected" ("Ethics and Disability" 131). Singer's preference utilitarianism is a
philosophy that defines the good as that which satisfies preferences and avoids pain. Determining a
single individual's preference or pain is not the sole way to make an ethical decision, however.
A wider level of calculation and universal abstraction is involved: a person imagines the
consequences of a possible action "from the point of view of the universe" an abstract move
away from self interest to include other humans and animals (How Are 228-29); and then sumranks the results.3 An ethical choice could produce the most satisfaction and least pain for the
greatest number, while inflicting harm on a minor number. In this way, individual humans are
"fungible" swapping individual fates for the greater good can be justified. Singer met Johnson in 2001
in Charleston, South Carolina, where she lived and practiced law. He was giving a lecture on his theory of the justifications for ending
human life, and she was protesting his views, representing Not Dead Yet, a disability activist group opposed to legal suicide and the
killing of the disabled.4 The two were introduced and briefly debated. A few months later, Singer invited her to Princeton to meet
with his classes and continue their debate in a large public forum. A seasoned contender and skilled writer, Johnson
published an account of their 2002 Princeton debate, entitled "Unspeakable Conversations,"5 in The New York Times
Magazine, opening with these lines: He insists he doesn't want to kill me. He simply thinks it would have
been better, all things considered, to have given my parents the option of killing the baby I once
was, and to let other parents kill similar babies as they come along, and thereby avoid the
suffering that comes with lives like mine and satisfy the reasonable preferences of parents for a
different kind of child. (Too Late 201) In her lively account of their debate, Johnson presents many of the key positions of
disability advocates: that when actual disabled people are polled, they report the same levels of
satisfaction with their lives as non disabled people do with theirs; that lack of social supports
and accommodations, or their provision, go a long way toward making life with disability
miserable or enabling; that even if non-disability is a preference, humans are not fungible; and
furthermore, that preferences aren't free and rational choices anyway. "Choices are structured
by oppression," as Johnson writes and coerced by cultural biases. Currently, the disabled suffer
under such biases (220).
Lewiecki-Wilson is correct- debates consistently undervalue disabled rights
Johnson 12 (Jenell Johnson, professor of communication arts and Disability Studies Initiative
director at the University of Wisconsin-Madison, PhD from Pennsylvania State University,
Mellon-Morgridge Professor of the Humanities, 2012, “Disability, Animals, and the Rhetorical
Boundaries of Personhood”, JAC, Vol. 32, No. 1/2, JSTOR)/CWB
Humanity is neither an essence nor an end, but a continuous and precarious process of
becoming human, a process that entails the inescapable recognition that our humanity is on
loan from others, to precisely the extent that we acknowledge it in them. - Tony Davies Cynthia
Lewiecki-Wilson's essay "Ableist Rhetorics, Nevertheless" examines the rhetorical mobilization
of the animal/human boundary in arguments for disability and animal rights in the work of Peter
Singer and Martha Nussbaum. Singer, a utilitarian bioethicist, is revered by many in animal rights circles for his
efforts on behalf of sentient animals; he is equally reviled by many in the disability community for his position
that it is ethical to end the lives of humans with certain impairments. Although Singer has often claimed
that he is misquoted on this latter point, passages like the following from Singer's Rethinking Life and Death speak for themselves:
Both for the sake of 'our children', then, and for our own sake, we may not want a child to start on life's uncertain voyage if the
prospects are clouded. When this can be known at a very early stage of the voyage we may still have a chance to make a fresh start.
This means detaching ourselves from the infant who has been born, cutting ourselves free before the ties that have already begun to
bind us to our child have become irresistible. (213) Disability also takes center stage in Martha Nussbaum's Frontiers of
Justice: Disability, Nationality, and Species Membership, which expands theories of justice to account for "three unresolved
problems": people with disabilities, animals, and poor nations (1-2). Although she considers Nussbaum' s position on disability to be
more "compassionate" than Singer's, Lewiecki-Wilson argues that because Nussbaum is committed to a rational,
tradition, she and Singer share a strikingly similar perspective: both philosophers "center ability (as
judged by 'normal' humans) as the basis of qualifying for rights" (88, 94). In place of this ability
paradigm, Lewiecki-Wilson wonders if rights discourse might begin from "the perspective and
paradigm of a complex ecology of situated, interconnected embodiment," which would shift our
thinking about rights for people with disabilities and also redirect "public, civic debates and
decisions on health care, the environment, and responsibilities to other countries and people"
(94). I have no quarrel with Lewiecki-Wilson's analysis nor do I have anything but enthusiasm for
her recommendations, which I hope will inspire future work on the topic of interdependence
and its implications for rhetoric and composition studies.1 In what follows, I seek to extend Lewiecki-
Wilson's argument by exploring the concept of personhood, a vital term in this debate that remains at the
periphery of her essay.
Util and consequentialism exclude the disabled from the social contract and
disregard need for welfare- reciprocity key
Becker 5 (Lawrence C. Becker, former professor of philosophy at Hollins University
and the College of William & Mary, former president of Post-Polio Health International, former
associate editor of the journal Ethics, October 2005, “Reciprocity, Justice, and Disability”, Ethics,
Vol. 116, No. 1, Symposium on Disability, The University of Chicago Press, JSTOR)/CWB
The adequacy of a theory of distributive justice is now measured partly by its success in dealing
with justice for the disabled. It was not always so. Up to and including Rawls, no major theory of justice in the Western
philosophical tradition made disability a prominent issue.1 No doubt that was partly due to the fact that until the last half of the
twentieth century, the number of severely disabled people who had any reasonable hope of long-term survival was small, and until
recent medical advances, the medical treatment and social arrangements that could help them were limited and relatively cheap.
Thus, until
recently it was probably plausible to think that a proper distribution of wealth could
handle such matters without special philosophical attention to the extent and nature of people’s
disabilities.2 Circumstances have changed. In affluent, developed, stable nations with good
medical systems, many people with major physical and cognitive disabilities have life
expectancies after onset that are 85 percent to 95 percent of that of the population as a whole.3
That is, the disabled have such life expectancies if substantial social resources are committed to them and if the necessary caregivers
can be found. Under such circumstances, the
number of people who live with major disabilities has
increased dramatically, and, in the space of a few decades, it has become implausible to construct a
theory of distributive justice that does not take this into account.4 Doing so however can be
incendiary, at least if the effort is simply to extend standard utilitarian or contractarian theories
of justice to cover disability.5 The current philosophical landscape does not make the issue easy.
On the one hand, there is the well-established commitment to making justice a matter of fairness and
equality for all human beings, plus the well-established lines of argument that urge us to extend theories of
justice to nonhuman animals and to the inanimate environment as well. On the other hand, we continue to build
theories of justice out of notions of mutual advantage, aggregate welfare, moral agency, human
flourishing, membership in the moral community, and participation in social conventions and social
institutions. Those theory-building notions inevitably limit or at any rate focus attention on
arrangements made by and for capable moral agents who have much to gain and lose from the cooperative
arrangements they make or fail to make with eachother.6 Any theory of justice founded on the notions of
impartiality and individual well-being (whether consequentialist or perfectionist) threatens to
discount the welfare of the disabled. Any theory of justice founded on the notions of selfinterest and mutual advantage (whether consequentialist or contractarian) threatens to exclude
some disabled people from social conventions or contracts altogether.7 To many disabled
people or their advocates, what seems to be wrong with standard theories of justice, at least in the case of
profound cognitive disabilities, is that they do not adequately or securely locate entitlements in the
interests, claims, or persons of the disabled individuals themselves. Rather, in social contract theory for
example, it seems that rational agents get together and make contracts among themselves which may or may not deal with the
disabled in a derivative way, by proxy or through trustee arrangements. Moreover, in theories designed to maximize aggregate
welfare, it seems that the interests of humans with profound cognitive disabilities are so heavily discounted that they are effectively
uncounted in the aggregation procedure. For that reason, advocates
for the disabled may initially be more
comfortable with a vaguely Kantian or theological theory of justice founded on the infinite moral worth or dignity of
every human being, which concept of dignity is then often translated into a doctrine of inalienable human rights— rights not only to
life, liberty, and property but also to health and habilitation. Even granting that such rights can be given a convincing philosophical
foundation (a large grant to make), this leaves us with seemingly interminable arguments about positive versus negative rights, claim
rights versus liberties, and conflicts of rights in situations of scarcity. In what follows I will take a different course. I will argue that
an adequate conception of reciprocity goes a long way toward answering the challenge that
disability poses to theories of justice.
Utilitarianism cost-benefit analysis justifies the dehumanization of disabled
Jarman 14 (Michelle Jarman is Associate Professor of Disability Studies at the Wyoming
Institute for Disabilities. She is also adjunct faculty in Gender and Women’s Studies. “Disability
Studies Ethics: Theoretical Approaches for the Undergraduate Classroom,” Review of Disability
Studies: An International Journal, Volume 4, No. 4, 2014,
Utilitarianism takes as its guiding principle that everyone should act according to the greatest
good for all concerned. In other words, moral action is determined by evaluating potential
ramifications, and moral agents are obligated to choose the optimal act, or the one determined
to provide the best consequences (Thiroux, 1998; Kagan, 1998). In practice, however, it is
extremely difficult to predict the outcomes an action will have upon everyone involved. More
important to disability studies, the ideal of the greatest good for greatest number often
devolves into cost-benefit debates where majority interests are pursued at minority groups’
expense. The legacies of utilitarianism are evident in resource allocation debates in modern
industrialized societies, in which providing civic access, medical support, and other resources
to people with disabilities center around cost-benefit analyses. Such models inevitably position
those most in need of supports as least beneficial to the social fabric—assumptions built upon
medical authority, which correlates increased impairment levels with decreased quality of
life—a euphemism for lesser human worth. These arbitrary judgments portray people with
disabilities as tragic sufferers who should be pitied, not as potential contributors to cultural
life—or the bottom line. As Wendell (1996) has argued, this limiting mindset continues to make
it very difficult to allocate disability resources, “because most people still think of disability as a
personal or family responsibility, and…because public aid to people with disabilities has long
been characterized as pure charity, rather than as a social investment in ability and productivity”
(p. 51). In effect, utilitarian and medical model assumptions inhere within social thought and
political structures and function invisibly as natural practices.
Rational, duty based ethics deny the disabled body agency and exclude them
Jarman 14 (Michelle Jarman is Associate Professor of Disability Studies at the Wyoming
Institute for Disabilities. She is also adjunct faculty in Gender and Women’s Studies. “Disability
Studies Ethics: Theoretical Approaches for the Undergraduate Classroom,” Review of Disability
Studies: An International Journal, Volume 4, No. 4, 2014,
In contrast, Kant’s duty ethics assumes that as people act from a sense of innate, rational duty,
they will come to agree upon universal moral rules that will guide their actions—which,
following such reasoning, will tend toward the good of everyone concerned. In this construct,
moral decisions are determined through reason, and are assumed to be logically consistent
(Furrow, 2006). In critique of Kant’s enduring influence, Kittay (2002) has pointed out that his
model connects human value and human dignity to pure rationality and moral duty: “The
capacity that elevates humans to the status of moral agents, [Kant] thought, is the rationality by
which we judge if we can universalize maxims we choose for our own actions. Rational agency,
he maintained, not our mere species membership, gives us the dignity of moral beings” (p. 262).
This privileging of rational agency, which implies an individual subjectivity based upon
independence and autonomy, inevitably excludes people with a variety of intellectual or
communicative impairments. As we explore more modern theories of humanitarian ethics and
social justice, students are encouraged to ask how definitions of personhood, citizenship, and
moral agency continue to reflect such ableist assumptions. In order to trace the enduring nature
of how the human is conceived through reason and competence, we consider the work of Rawls
(1971), arguably one of the most influential modern social philosophers. Moving outside the
boundaries of consequences and internal morality, Rawls (1971) focused upon developing a
comprehensive theory of social justice by outlining the principles that should govern political
structures. His goal was to determine what kind of social contract everyone could agree upon,
taking into account the vast differences people hold about how to live. After looking at the
basics of his theory of social justice, we consider some of the problems his philosophical
framework presents to disabled people. In his theory, Rawls (1971) defined the negotiating or
acting parties as competent adults, thereby constructing a boundary that could be used to expel
many people with cognitive, communicative, or other impairments. I borrow Nussbaum’s (2002)
critique of Rawls (1980), to extend the discussion of philosophical exclusions. The following
quote from Rawls (as cited in Nussbaum, 2002) illustrates to students the rational methods still
used to justify exclusions of people with disabilities from social discourse, and by extension,
society: “So let’s add that all citizens are fully cooperating members of society over the course of
a complete life. This means that everyone has sufficient intellectual powers to play a normal
part in society, and no one suffers from unusual needs that are especially difficult to fulfill, for
example, unusual and costly medical requirements. Of course, care for those with such
requirements is a pressing practical question. But at this initial stage, the fundamental problem
of social justice arises between those who are full and active and morally conscientious
participants in society…Therefore, it is sensible to lay aside certain difficult complications. If we
can work out a theory that covers the fundamental case, we can try to extend it to other cases
later” (as cited in Nussbaum, 2002, p. 190). As we consider this setting aside of so-called
complications, we must ask how a theory of social justice can be built around the deliberate
exclusion of people with dependencies. Also if such people are conceived of from the
beginning as difficult and complicated, won’t their integration back into the social fabric be
fraught with problems as well? As students consider these questions in conjunction with
disability studies values and ethical frameworks, they begin to see how the social structures we
have inherited are very much a product of these philosophical constructs.
Yes util greater-beneift criterion favors the disabled resource distribution, but it
prioritizes the abled in life
Stein 1 (Mark S. Stein, law degree from the University of Michigan, PhD in political science
from Yale, former fellow at Harvard’s Petre-Flom Center, October 2001, “Utilitarianism and the
Disabled: Distribution of Life”, Social Theory and Practice, Vol. 27, No. 4, Special Issue: Embodied
Values: Philosophy and Disabilities, Florida State University Department of Philosophy,
The Utilitarian Greater-Benefit Criterion The first-order distributive principle of utilitarianism is
to distribute resources to the people" who will most benefit from those resources, "benefit"
being understood here as an increase in utility or welfare. Absent secondary considerations, the
distribution of resources to the people who will most benefit from those resources will
maximize welfare. I will refer to the principle that resources should be distributed to the people who would most benefit from
them as the greater-benefit criterion. Harsanyi and Singer, among others, have stressed the centrality to
utilitarianism of the greater-benefit criterion.12 If the utilitarian greater-benefit criterion is applied under the
assumption of lower disabled welfare, it has implications for the distribution of non-life-saving resources that are actually rather
favorable to the disabled. Often resources can be used to cure or ameliorate disability. The assumption of lower disabled welfare
suggests that disabled people would derive considerable benefit from resources used to cure or ameliorate disability. For example, if
paraplegia substantially reduces a per son's welfare, then curing that person's paraplegia will substantially increase his welfare. Even
ameliorative measures that fall far short of a cure can substantially increase the welfare of the disabled. If one reason paraplegia
reduces welfare is that it makes it difficult for people to get around, the provision of wheelchairs to paraplegics can substantially
increase their welfare, as can modification of the environment. Accordingly,
the disabled have a relatively strong
claim on resources under utilitarianism—or so I have elsewhere argued.13 Of course, the distribution or redistribution
of resources to the dis abled would not be unlimited under utilitarianism. In some cases, non disabled claimants for resources,
such as the nondisabled poor, might benefit more from additional resources than disabled claimants. In such cases, the
nondisabled claimants would have a stronger claim on resources than would disabled claimants.
But this aspect of the greater benefit criterion, while perhaps difficult to apply, is not at all offensive. Just as it would seem
unfair if society devoted no extra resources to the disabled, so it would also seem unfair if
society embarked on a campaign of unlimited redistribution to the disabled. The utilitarian greaterbenefit criterion seems to strike the correct balance in the distribution of re sources between disabled people and nondisabled
people.14 Distribution of Life Unfortunately, the
same sensitivity to relative benefit that makes
utilitarianism an appealing approach to the distribution of resources appears to make
utilitarianism a counterintuitive and unappealing approach to the distribution of life. If the
disabled have on average less welfare than nondisabled people, it seems to follow that the
disabled benefit less from continued life than do nondisabled people. Utilitarianism would
therefore place a lower value on disabled life than on nondisabled life, and if a choice had to be
made between saving the lives of disabled people and saving the lives of nondisabled people,
utilitarianism would counsel us to give less preference to the disabled. So, for example, disabled people
would receive less preference, in the distribution of life-saving organ transplants, than nondisabled people. Moreover, the utilitarian
preference against disabled people in the distribution of life would appear to be exactly proportional to the utili tarian preference in
favor of disabled people in the distribution of re sources. However morally
urgent it might be to cure a given
disabled person, increasing her welfare, it would seem that the same moral urgency must attach
to a decision to preserve the life of a nondisabled person in preference to that disabled person,
assuming that only one of them could survive. This problematic seesaw also moves in the other direction. Suppose
we say that the view of disabled people as miserable is based on a superficial and discredited psychology.
Many psychologists believe that people have a great capability for hedonic adaptation to adverse situations, including disability.15
Therefore, it
would arguably be a mistake to think, for example, that much welfare could be gained by
preserving the life of an able-bodied person in preference to the life of a paraplegic. All well and
good, but the apparent implication of such an argument is also that a paraplegic would not achieve much of an increase in welfare if
she were cured of paralysis—and that she would achieve an even smaller increase in welfare from ameliorative aid that benefited
her less than would a complete cure. In their recent book The Allocation of Health Care Resources,16 utilitarian bioethicists John
McKie, Jeff Richardson, Peter Singer, and Helga Kuhse embrace the view that utilitarianism
requires health care
allocators to discriminate against the disabled in the distribution of life. McKie et al. defend such
discrimination as a proper result of the health care allocation theory that seeks to maximize
quality-adjusted life years (QALYs), and they support the QALY-maximization theory as an
application of utilitarianism to the field of health care allocation. Somewhat surprisingly, discrimination
against the disabled in the distribution of life was also endorsed, if gingerly, by the "Panel on Cost
Effectiveness in Health and Medicine," convened by the U.S. Public Health Service. The Panel on Cost-Effectiveness did
not endorse dis crimination against the disabled in the allocation of scarce life-saving medical treatment, such as organ transplants.
However, it did gingerly endorse discrimination against the disabled in the allocation of funds to large-scale projects.17
Discrimination against the disabled in the distribution of life has been termed "double
Framing – Social Model
The public charge provision dovetails with the medical model and politics of
eugenics that shape ableism in society
Weber 04 (Mark C. - main professional interests are disability rights and complex tort litigation. He is the author of Disability
Harassment (NYU Press), Understanding Disability Law, Special Education Law Cases and Material “Opening the golden door:
Disability and the law of immigration.” The Journal of Gender, Race, and Justice, 8(1), 153-175)mr
At one time, the borders of the United States stood open to all immigrants. States and localities exercised
sporadic inspection and control,6 but the federal government did not generally restrict immigration.7 When the federal
government asserted its power over immigration in the late nineteenth century, it enacted a system
of exclusion and inspection that rejected many immigrants on the basis of traits associated with
disability. The exclusions had their origin in, on the one hand, fear of disability itself and the effect that hereditary disability would
have on the native stock. On the other hand, labor policy also determined exclusionary choices.8 The country needed workers for
industrial expansion; the government excluded individuals who appeared unable to contribute to that
effort and who seemed likely to become dependent on the state. A. Legal Standards and Administrative
Operation of Disability-Based Exclusions At the beginning of the twentieth century, federal law explicitly excluded
"pauper[s]" as well as any "lunatic, idiot, or any person unable to take care of himself or herself without
becoming a public charge."9 Of course, nearly everyone traveling steerage was impoverished, but the courts generally ruled
that poverty alone did not justify exclusion, at least if the immigrant was capable of work.10 Disability, however, did. In United
States ex rel. Barlin v. Rodgers,11 the court sustained the exclusion of three impoverished immigrants, the first because he had a
"rudimentary right hand," the second because of "poor appearance" and stammering, and the third because he was "undersized."12
United States ex rel. Canfora v. Williams13 ruled that an amputated leg was sufficient to justify the exclusion of a sixty-year-old,
though the man had grown children able and willing to support him.14 Immigration officers excluded a person at the
point of arrival in the United States if the immigrant appeared to them to have disabilities.15 Inspectors
looked for any of a long list of diseases and abnormalities, including arthritis, asthma, deafness, the loss of an eye or a limb,
deformities, poor vision, underdevelopment, and dementia.16 Moreover, steamship lines were responsible for paying the cost of
the return passage for those immigrants rejected upon arrival in the United States by the official inspectors, so they instituted their
own screening systems;17 some foreign governments also made inspections of immigrants from other countries who crossed their
borders to use their ports.18 A study of thirteen months of these systems estimated that they barred 50,000 individuals during that
time, in comparison to about 14,000 barred by United States inspectors upon arrival at American ports.19 B. Relation to Eugenic
Ideology The eagerness to exclude immigrants with disabilities dovetailed with the contemporary
ideology of eugenics, a pseudo-science that promoted the breeding of an optimal human race.20 Early
in the twentieth century, eugenics was used to justify the exclusion of people with disabilities from social life. Courts influenced by
this ideology ordered the involuntary sterilization of individuals on the unproven charge that they would pass their disabilities on to
their children.21 Before the turn of the twentieth century, public officials established policies to keep people with disabilities apart
from others, promoting their placement in institutions.22 Even more extreme measures were imposed in some other countries.
During the 1930s, Germany initiated a program of killing individuals with disabilities and continued the program through World War
II.23 In the United States, infants with disabilities were denied medical care and left to die.24 Even into the 1940s, some American
doctors defended killing people with disabling conditions.25 Justice Marshall discussed the legacy of eugenics in his partial dissent in
City of Cleburne v. Cleburne Living Center.26 He began by noting that the disability of mental retardation was not always viewed in a
negative light: [T]he mentally retarded have
been subject to a 'lengthy and tragic history' of segregation
and discrimination that can only be called grotesque. During much of the 19th century, mental retardation was
viewed as neither curable nor dangerous and the retarded were largely left to their own devices.27 But eugenics led to a public
policy of segregating people who have disabling conditions: By the latter part of the century and during the first decades of the new
one, however, social views of the retarded underwent a radical transformation. Fueled by the rising tide of Social Darwinism, the
'science' of eugenics, and the extreme xenophobia of those years, leading medical authorities and others began to portray the
'feeble-minded' as a 'menace to society and civilization . . . responsible in a large degree for many, if not all, of our social
problems.'28 This ideology played out into general public policy and promoted the legal exclusion of
people with disabilities from society, even from public view: A regime of state-mandated segregation and degradation
soon emerged that in its virulence and bigotry rivaled, and indeed paralleled, the worst excesses of Jim Crow. Massive custodial
institutions were built to warehouse the retarded for life; the aim was to halt reproduction of the retarded and 'nearly extinguish
their race.' Retarded children were categorically excluded from public schools, based on the false stereotype that all were
ineducable and on the purported need to protect nonretarded children from them. State laws deemed those with
disabilities 'unfit for citizenship.'29 Eugenics had a profound influence on immigration law at the turn
of the century, as lawmakers gradually made the language of the public charge exclusion stricter and
tied it more closely to mental and physical disability. The exclusion that began as that of any person "unable to
take care of himself or herself without becoming a public charge," became that of those "likely to become a public
charge" in 1891, and then in 1907, transmuted into the elimination of anyone "mentally or physically defective, such mental or
physical defect being of a nature which may affect the ability of such alien to earn a living."30 Language aimed at excluding those
with mental illness became more inclusive over the same period.31 Policymakers were frightened of degeneracy, as the
Commissioner of Ellis Island declared in 1912: The fact that mentally defective immigrants may become a burden on the taxpayer is
a relatively unimportant consideration. What is vitally important is that such persons contribute largely to the criminal classes and
that they may leave feeble minded descendants and so start vicious strains leading to misery and loss in future generations and
influencing unfavorably the character and lives of hundreds of persons.32 John Higham summarizes: From the eugenicists'
point of view, the immigration question was at heart a biological one, and to them admitting
"degenerate breeding stock" seemed one of the worst sins the nation could commit against itself. It
was axiomatic to these naive Mendelians that environment could never modify an immigrant's germ plasm and that only a rigid
selection of the best immigrant stock could improve rather than pollute endless generations to come.33 Eugenics' impact on
immigration policy as a whole was limited only because the eugenicists could not persuasively tie degeneracy to specific ethnic
groups until racism gained widespread respectability (outside the South) in the 1910s and 1920s.34 Prior to that time, the impact of
the movement was felt specifically by the persons with disabilities rather than generally by whole ethnic classes of supposedly
inferior human beings.
The medical model of disability is justification for societal oppression – even if
the social model’s premise isn’t 100% correct, it is necessary to transform
government policy
Crane 15, Sarah Elizabeth Rachel - LEWIS & CLARK Graduate School of Education and Counseling; dissertation submitted in
partial fulfillment of the requirements for the degree of Doctor of Education in Leadership “Foucault, Disability Studies, and Mental
Health Diagnosis in Children: An Analysis of Discourse and the Social Construction of Disability” 2015//mr
In our society, we use a medical, deficit model of disability, which leads us to believe that
disability is wrong and should be fixed (Hughes, 2005). This is precisely where Disability Studies steps in. Disabilities
Studies researchers believe we have a history of discriminating against people with difference. Limiting one’s options
because one has a disability is no different than limiting one’s options because one is black,
female, gay, or queer. People with disabilities have been oppressed, separated, and even used,
but their plight received less attention than other marginalized groups until Disability Studies came into
the picture (Baglieri, Valle, Connor, & Gallagher, 2011). It is important to note our history of using disability as a way
to further discriminate against people in marginalized groups. Labels of disability found through
testing, have, at different times in our history, been used to suggest a generalized disability and lack of
worth of people of color, women, and people of Jewish decent (Baynton, 2001). Understanding societies’
discomfort and fear of disability leads to great self-reflection. Do we believe people with disabilities are worth
less? While most people would answer “no,” our traditions, agencies, and societal treatment
would suggest people with disabilities have to fight to show their worth (Hughes, 2005). Research
continually suggests there is a preference toward people who are normal (Adler & Wahl, 1998; Snyder-Grant, 2001; Thomas, 2000).
A person with a difference in mental well-being is particularly stigmatized and seen as abnormal (Charlton, 1998; Tringo, 1970).
Regardless of whether a difference is real or perceived, normative culture does not tolerate such
diversity, but instead seeks conformity (Hinshaw & Cicchetti, 2000). Social Construction To socially construct
something is to create reality through social interactions and discourse. According to Disability Studies scholars, the social
construction of disability leads to the social reproduction of a belief that something is wrong and needs to be fixed within the
individual. In contrast, Disability Studies locates the problem of difference within society and the environment (Siebers, 2008).
Changes in the environment are necessary for children with mental health diagnoses. Disability Studies scholars suggest our
society should accept and expect difference; policies which point out differences through
naming them are actually the problem, not the solution (Campbell, 2005). Instead, policies and laws should
require inclusive, accessible environments across our society.
Despite its failure to acknowledge the biological and cultural constitution of the
body, the social model is net better than the medical model—confining
impairment to nature internalizes the corresponding apolitical, medical agenda
which perpetuates ableist segregation from the public domain
Hughes 2000 (Bill Hughes, Taylor & Francis Online, Medicine and the Aesthetic Invalidation of Disabled People,”
Disability & Society, Vol. 15, No. 4, pg. 555-557, 2000)//jy
the medical model. This model is far from
socially benign, since for disabled people, it is based on the disabling extrapolation that bio-physical
‘maladaptation’—to use the ubiquitous evolutionary terminology— leads to social maladaptation. The premise
contained in the extrapolation, namely, that the biological determines the social is both far from fact and
politically conservative: ‘To define abnormality in terms of social maladaptation is’ wrote Georges
Canguilhem (1991, p. 283) ‘more or less to accept the idea that the individual must subscribe to the fact of such a
society, hence must accommodate himself to it as a reality which is at the same time a good.’ This
Throughout modernity, until very recently, the dominant framework for understanding disability has been
philosophical rebuttal of the view that the wisdom of the body lies in its acquiescence to the social status quo (thts e rather wet dream of sociobiologists, functionalists and
While the medical model
demands that disabled people adapt to society, the social model demands changes in social
structure that will reflect the needs of disabled people. The social model emphasises the
collective, structural, and social—as opposed to the individual, personal and medical—origins of
disability (Oliver, 1990). As disabled people began—in the wake of the radicalism of the 1960s—to develop autonomous organisations and an emancipatory political
positivists of a conservative persuasion) contains the critical seed which led to the germination the social model of disability.
agenda, the medical management of disability came under fire from disabled people who had experienced medical patronage as unhelpful or demeaning. Cure—despite medical
while care and rehabilitation did much for the reputation of the
medical profession, for disabled people, such practices served, primarily, to sustain the myth
that they were sick and dependent (Oliver et al., 1988). Even medical sociology which embraced a social model of health participated in the
discourse which reduced disability to invalidism: ‘ medical sociology has tended to investigate all impairments … from
an illness perspective’ (Barnes & Mercer, 1996, p. 5). Disabled people were both defined and confined by medical jurisdiction. The identities of
disabled people were reduced to medical categories and their scope for social participation was
limited either by segregation in medically managed spaces or by problems of access to the
public domain, most notably, mainstream education, transport and the labour market (Barnes, 1991). By mapping out the social origins
of disability, disability activists had produced a radical model which set an agenda for social
change as opposed to medical intervention (Finkelstein, 1980; Oliver, 1990). This position entailed a sharp distinction between disability and
impairment which became the theoretical bedrock of the social model. It focused its attention upon socially produced
disablement and its elimination to the neglect of a sociological account of impairment. The latter was
regarded as a facet of the domain of nature, as a pre-social bodily disposition (Hughes & Paterson, 1997). Whilst this had huge political
advantages for the youthful disability movement, it has become much clearer in recent years that in a
‘somatic society’ (Turner, 1996) the body is at the heart of social life, and that its constitution is both biological
and cultural. The contemporary intellectual and political climate is no longer convinced by the
dualisms of modernity or the binary oppositions of structuralism. Recognition of the social nature of impairment within
disability studies began to register (Abberley, 1987; Shakespeare and Watson, 1995 a,b), but it sat uneasily alongside the concern that it
implied a return to the much maligned medical model and the reactionary politics of disability
that its hegemony had fostered. Strong and understandable reservations have been expressed about the need for a ‘sociology’ or ‘social model’ of
impairment (Oliver, 1996). Nevertheless, it can be argued that confining impairment to the domain of nature
(which medical discourse claims as its object) is to accept, without question, medical jurisdiction over matters of the
rhetoric to the contrary—was not on offer, and
body and to concede to an apolitical, medical agenda with respect to it (Hughes & Paterson, 1997). My contention is
that a sociology or social model of impairment can deepen—rather than damage—the critique of the medical
model of disability, partly because it is better placed—than an unreconstructed social model of disability—to attend to a
critique of medicine as culture. Elsewhere, I have argued that the oppression and alterity of disabled people is closely connected to the negative
perceptual constitution of impairment in the visual culture of post-modernity and that the medical gaze has been a key player in
invalidating bodies that do not conform to its ideal discursive constructs (Hughes, 1999). What I wish to propose in
this paper is, that a challenge to the aesthetic of oppression is also a challenge to medicine and the medical model of disability. In drawing out the links between the
aestheticisation and medicalisation (speciŽ cally the ‘geneticisation’) 1 of contemporary life, I want to suggest that these partner processes—particularly in the ways in which
they interact in the new genetics—play an important role in reinforcing the alterity and exclusion of people with impairments.
The social model enables political organization, collective identity, and
promotes individual self-worth
Goering 15 (Sara Goering, “Rethinking disability: the social model of disability and chronic disease,” Vol. 8, Issue 2,
Current Reviews in Musculoskeletal Medicine, pg. 134-135, 4/11/15)//jy
One result of the common medical understanding of disability is that people with disabilities often
report feeling excluded, undervalued, pressured to fit a questionable norm, and/or treated as if
they were globally incapacitated. People with disabilities often express frustration when they are met with pitying attitudes or incredulity if they
speak about anything positive related to living with their conditions. Many memoirs and books now attest to this common experience (e.g., Encounters with Strangers [3], Waist-
For many people with disabilities, the main disadvantage
they experience does not stem directly from their bodies, but rather from their unwelcome
reception in the world, in terms of how physical structures, institutional norms, and social
attitudes exclude and/or denigrate them. As Lois Keith remarks, Doing disability all day long can be an exhausting process. I don’t mean having
High in the World [4], Moving Violations [5], The Rejected Body [6]).
an impairment, in my own case not being able to walk. Like most disabled people I can deal with this. I mean having to spend a significant part of each day dealing with a
physical world which is historically designed to exclude me and, even more tiring, dealing with other people’s preconceptions and misconceptions about me.^ [7] The social
In response to the traditional medical model of disability, disability activists and
scholars have offered a social model of disability [8], which relies on a relatively sharp distinction
between impairment and disability. Within the social model, impairment is understood as a
state of the body that is nonstandard, defined as lacking part of or all of a limb, or having a defective limb, organ or mechanism of the body^ ([8],
p. 22). As such, impairment may or may not be met with a negative evaluation by its possessor [ 9].
model of disability
People who are blind from birth, for instance, often understand their blindness as a neutral way of being, rather than as a deficit or a problem. Consider Deborah Kent, who
reports that B…from my point of view, I wasn’t like a normal child – I was normal. From the beginning I learned to deal with the world as a blind person. I didn’t long for sight any
more than I yearned for a pair of wings…I premised my life on the conviction that blindness was a neutral characteristic^ ([10], p. 57–58). Similarly, and even in regard to
impairment is, in fact, nothing less than a description of the physical body.^
([8], p. 35) Disability, by contrast, is the disadvantage or restriction of activity caused by a
contemporary social organization which takes no or little account of people who have physical
impairments and thus excludes them from participation in the mainstream of social activities^ ([8],
p. 22). The point of making and emphasizing this distinction is to show how much and sometimes all of what is
disabling for individuals who have impaired bodies has to do with physical and/or social
arrangements and institutional norms that are themselves alterable (e.g., stairs vs. ramps; presentation of data using
acquired impairment, Oliver notes that
only auditory means vs. universal design for communication, restrictive definitions of job requirements vs. expansive accommodations for different modes of performing work,
People with impairments of a particular kind may be in a minority [11], but they are typically not thereby rendered incapable of work and social
need a more inclusive framework in which to participate. In addition to pointing to the tangible environmental
and structural changes that could be made to be more inclusive for people of differing body types, the social model of disability focuses
attention on the attitudinal obstacles faced by people with non-standard bodies. Other people’s
expectations about quality of life, ability to work, etc. for a person with a disability not only affect the ways in
which physical structures and institutional norms are made and sustained (based on presumptions about inability
to perform), but also can create additional disability by making it harder for such individuals to feel
good about themselves. For instance, Jenny Morris raises concerns about how Ball the undermining messages, which we receive every day of our lives from
the nondisabled world which surrounds us, become part of our way of thinking about ourselves^ [quoted in 7, p. 22]. The impairment/disability
relationships. They
distinction is powerful in lending support to people with disabilities who face unjust treatment
and the tendency to medicalize their problems. In the words of one disability activist, it tells us that ableism needs the
cure, not our bodies.^ [quoted in 12, p. 18]. Indeed, as Crow acknowledges, the social model has done wonders for the
disability rights movement. It has enabled a vision of ourselves free from the constraints of
disability (oppression) and provided a direction for our commitment to social change. It has played a
central role in promoting disabled people’s individual self-worth, collective identity, and political
organization. I don’t think it is an exaggeration to say that the social model has saved lives^ ([2], p. 207). We should not,
however, lose sight of the fact that people living with impairments can experience negative
effects tied more directly to their bodily conditions. People with impairments that involve, for example, fatigue,
pain, depression, or chronic illness may want both to overcome social barriers and discrimination that oppress
all people with disabilities, and to voice their desire to remove or address the troubling
accompaniments of their impairments, through medical or other means. They may want attention to what have been called impairment effects^
[13]. No doubt, many medical professionals who might be sympathetic to the disability rights movement in general also see the downside of impairment effects and aim to
address them with their medical expertise.
Framing - Posthumanism
In the context of disability, frame your impacts through a posthumanist lens
Goodley 14 (Dan Goodley, Rebecca Lawthom and Katherine Runswick Cole, Dan Goodley is
Professor of Disability Studies and Education at the University of Sheffield. Recent texts include
Dis/ability Studies (Routledge, 2014) and Disability Studies (Sage, 2011). His work engages
critical studies of ableism and disablism to interrogate the gains and losses of those working at
the dis/ability complex. Rebecca Lawthom is Professor of Community Psychology at Manchester
Metropolitan University. Her work engages at the intersections of feminism, disability and
migration. Publications include Community Psychology (Wiley Blackwell, 2011, with Kagan,
Burton and Duckett) and Qualitative Methods in Psychology: A research guide (Open University
Press, 2012, with Banister, Bunn, Burman, Daniels, Duckett, Parker, Runswick Cole, Sixsmith and
Goodley). Katherine Runswick-Cole is Senior Research Fellow in Disability Studies and
Psychology at Manchester Metropolitan University, UK. Her research and publications focus on
the lives of disabled children and their families, this includes Disabled Children’s Childhood
Studies (2013, Palgrave, edited with Tillie Curran) and Approaching disability: Critical issues and
perspectives (2014, Routledge, with Mallett). " Posthuman disability studies", 2014, Subjectivity,
[T]he proper study of the posthuman condition is the posthuman itself. This new
knowing subject is a complex assemblage of human and non-human, planetary and cosmic,
given and manufactured, which requires major re-adjustments in our way of thinking (Braidotti, 2013: 159)
(2) The posthuman condition
Were one to take a glance across Braidotti’s body of work (1994, 2002, 2003, 2006, 2013) a discernable philosophical contribution to social theory and activism resides in her willingness to remain upbeat and
imaginative about a future post-human. The crisis of humanism (the realisation, as we see it, that we all fail to dance to the beat of the ableist drum associated with ideal/ised ‘big Subject of Man’) means that
‘structural others of the modernist humanistic subject re-emerge with a vengeance’ (Braidotti, 2013: 37). The great ‘emancipatory movements of postmodernity’ (Ibid: 37) have their ‘fires stoked by structural
others such as the pro-environment, anti-nuclear, anti-globalisation’ and, we would add, disability movements. Each has the potential to engage in ‘a radical estrangement from notions like moral rationality,
unitary identity, transcendent consciousness or innate and universal moral value’ (Ibid: 92). Let us now introduce three key theoretical moves of Braidotti’s 2013 The Posthuman. The first relates to life beyond the
self and the need for a new theory of the human subject that ‘takes stock of the posthuman turn and hence acknowledges the decline of Humanism’ (Ibid: 51). This decline should be celebrated because it opens
A posthuman subject embraces ‘affirmative
politics’ which combine ‘critique with creativity’ in the pursuit of alternative ways of living with
one another. Continental philosophy of the late 20th Century is characterised by Braidotti as creating valued and othered versions of the self. The time is ripe for refiguring and reconfiguring the self.
up the self as an extended, distributed, interconnected and relational entity ‘embodied and embedded’ (Ibid: 51).
What it means to be a reflexive self seeks to end a ‘parochial’ notion of the self (born and bred in Western European and North American, White Anglo Saxon Protestant contexts) and embrace ‘renewed claims to
Braidotti (2006,
2013) offers a process-oriented political ontology. Rather than conceptualising ontology as an
internalised phenomenon of an individual subject, we are asked to think of the kinds of
connection between and within one another. Hence, the posthuman turn is a move ‘beyond
lethal boundaries’ (Ibid: 37). Here ‘the crisis of humanism means that the structural others of the modern humanistic subject re-emerge with a vengeance’ (Ibid: 37), creating
community and belonging by singular subjects who have taken the critical distance from humanist individualism’ (Ibid; 39). In emerging out of the confines of anti/humanism,
‘other visions of the self’ (Ibid: 38), ‘experimenting with new models of the self’, devising ‘renewed claims to community and belonging by singular subjects who have taken critical distance from humanist
beyond the species, directly contests anthropocentrism that puts humanist man (anthropos)
before other species and the environment (as an egocentrism). Humanism situates anthropos as elite species, occupying a sovereign position. A posthuman turn
challenges such elitism, reminding us that the superior human ideal is of course only that; a utopian ideal. Moreover,
the pure organic entity that was anthropos has now been ‘technological mediated to an
unprecedented order’ (Ibid: 57) subjected to ‘the four horsemen of the posthuman apocalypse:
nanotechnology, biotechnology, information technology and cognitive science’ (Ibid: 59). The human species has
become expanded, meaning that ‘the boundaries between ‘Man’ and his others go tumbling down, in a cascade effect that opens up
individualism’ (Ibid: 39), stressing a ‘radical relationality, nonunitary identities and multiple allegiances’ (Ibid: 144). This is a self beyond its traditional fixed moorings; a posthuman self. The second,
unexpected perspective …. relinquishing the demonic forces of the naturalised others’ (Ibid: 66-67). These others include animals, insects, plants, environment and the cosmos as a whole. For Braidotti,
posthumanity moves beyond the species (and the speciesism or anthropomorphism of humanism), freeing up solidarities with
non-humans including animals and the wider natural environment. Post-anthropocentricism is
the posthuman response. There is more to life than the human being. Theme three, life beyond death, pushes Braidotti to
consider the centrality of death to any theorisation of life. A posthuman analysis is mindful of the biopolitical apparatus that mobilise ‘not only generative forces but also new and subtler degrees of death and
extinction’ (Ibid: 115). Here we can think of drug treatments, prostheses, genetic testing, and the human genome project that seek to enhance life but also are often working alongside death. Indeed, she notes, ‘a
The biopolitics of life now
includes not simply ‘errant humans’ (think the mad, disabled, deviant) but the nonhuman
(animal, mineral, machine). And key to the maintenance of a healthy population is the political, cultural and social necessity to identify those who are dying, unhealthy and facing
degeneracy. Hence, biopower involves the management of lives that are living (Zoëpolitics) and lives
that are dying (necro-politics). We are, then, entering a time of thanatopolitics (Rose, 2001) in
our late biopolitical times that raise huge questions around the kinds of living lives and dying
lives that we denigrate or value. The posthuman condition, for Braidotti, is as much about death as it is about life: ‘bio-power and necro-politics are two sides of the same
whole under-class of socially under-insured disposable bodies is engendered both within the Western world and in the emerging economies’ (Ibid: 118).
coin’ (Braidotti, 2013: 122). We need to value (our relationships with) death as much as we do life. Let us now consider how these theoretical moves resonate and connect with our distinct political and theoretical
The fast-changing field of disability studies is almost
emblematic of the posthuman predicament. Ever mindful that we do not yet know what a body
can do, disability studies combine the critique of normative bodily models with the advocacy of
new, creative models of embodiment’ (Bradotti, 2013: 146). Braidotti’s passing reference to disability studies recognises at least acknowledges the promise of
interests, which we associate with critical disability studies. (3) Enter critical disability studies
disability to exemplify the posthuman. Our analysis fits well with the emerging scholarship and activism of the critical disability studies field which we read as questioning traditional and normative understandings
of the human individual and, as way of response, offering new, collectivist and crip alternatives that fit well with the posthuman manifesto outlined by scholars such as Braidotti and Haraway (e.g. McRuer, 2006;
Campbell, 2009; Shildrick, 2009, 2012; Meekosha and Shuttleworth, 2009; Goodley, 2007, 2011, 2013; Kafer, 2013; Slater, 2013; Liddiard, 2012, 2014; Mallett and Runswick Cole, 2014; Feely, 2014).
with physical, sensory or cognitive impairments are plugged into a myriad of cultural,
professional, disciplinary and political practices that shape their embodied selves and
interrelationships with the world. One common theme of critical disability studies is that disability necessarily demands and
affirms interdependent connections with other humans, technologies, non-human entities,
communication streams and people and non-peopled networks. Disability is but one cultural
artifact that signifies the ‘demise of humanism’ (Braidotti, 2013: 151) precisely because disability demands
non-normative and antiestablishment ways of living life. To use the language of McRuer (2006), disability crips what it means to be a human
being. Quite simply, disability complicates the myopic perspective and non-representative nature offered
by humanism. Our sitpoint is that disability is the quintessential posthuman condition: because it calls for new ontologies, ways of
relating, living and dying. Posthuman and critical disability studies share an antithetical attitude towards the taken-for-granted, ideological and normative under-girdings of what it
means to be a valued citizen of society. Take for example McLaughlin et al’s (2008) study of disabled babies and their families. All the babies represented had extensive relational networks, most starkly captured
by the baby with the label of Down’s syndrome who by the age of one had had contact with over 120 health, social care and educational professionals. When Braidotti (2013) calls for a politics of becoming
predicated on ‘interdependence with multiple other’ (Ibid: 101) she could be speaking about those relationships demanded of and by those working at the face of the disability complex. If the posthuman
condition is characterised by assemblages that connect the subject to her/his outsides (Ibid: 165) then disability allows us to think across binaries of self/other, nature/technology and human/machine. We do not
readily nor unquestionably accept 120 professional-child connections. Instead, through recognising their interconnection, we consider the value and worth of these lines of interaction. Why are professionals tied
up with children? To what ends and for what service? What kinds of desirous or disgusting offerings are opened up by these inter-relationships? What kinds of disciplinary practices are evoked? As Feely (2014) has
demonstrated; turning our attention to the details of disability assemblages allows us to ask important questions about power, authority and resistance. Occupying a posthuman position requires ‘the knowing
subject disengaging itself from the dominant normative vision of the self’ becoming ‘relational in a complex manner that connects it to multiple others’ (Ibid: 167). Critical disability studies analyses have already
Who has the moral, political or ethical right to trouble the
human? Should the activist or the theorist be leading these debates? What of those theorists that ignore the very fact that
made these conceptual moves though this has not come without debate.
disabled people have never been permitted to occupy the category of the human? Does the posthuman advocate ignore the power of humanist ideals of independence, choice, autonomy and associated human
Is a turn to the posthuman yet another examples of a theoretical fancy on the part of
an academic that is divorced from everyday fights with oppression (Graby and Greenstein, 2013)? Disability
scholars and activists have long made the point that disabled people are denied access to being
human: a reality for many of one Billion disabled people across the world. Indeed, people with the label of intellectual disabilities have long embraced People First as their slogan and disabled young
rights at his/her peril?
people continue to fight under the mantra of independence; choosing to redefine rather than abandon this word (Slater, 2013). While beyond the scope of this paper, we want to acknowledge that many disabled
people work either side of the dis/ability and posthuman/human binaries whilst enacting their politics (see for further discussion Goodley, 2014; Goodley and Runswick Cole, in press)iii.
The neg’s humanist perspective is inherently anthropocentric and ableist
Goodley 14 (Dan Goodley, Rebecca Lawthom and Katherine Runswick Cole, Dan Goodley is
Professor of Disability Studies and Education at the University of Sheffield. Recent texts include
Dis/ability Studies (Routledge, 2014) and Disability Studies (Sage, 2011). His work engages
critical studies of ableism and disablism to interrogate the gains and losses of those working at
the dis/ability complex. Rebecca Lawthom is Professor of Community Psychology at Manchester
Metropolitan University. Her work engages at the intersections of feminism, disability and
migration. Publications include Community Psychology (Wiley Blackwell, 2011, with Kagan,
Burton and Duckett) and Qualitative Methods in Psychology: A research guide (Open University
Press, 2012, with Banister, Bunn, Burman, Daniels, Duckett, Parker, Runswick Cole, Sixsmith and
Goodley). Katherine Runswick-Cole is Senior Research Fellow in Disability Studies and
Psychology at Manchester Metropolitan University, UK. Her research and publications focus on
the lives of disabled children and their families, this includes Disabled Children’s Childhood
Studies (2013, Palgrave, edited with Tillie Curran) and Approaching disability: Critical issues and
perspectives (2014, Routledge, with Mallett). " Posthuman disability studies", 2014, Subjectivity,
II. Life beyond the species: Rethinking animal If one of the exciting moments of the posthuman condition entails the ‘displacement of anthropocentrism
and the recognition of trans-species solidarity’ (Braidotti, 2013: 67) then one need only to turn to the disability world. One
of the most
significant contributions of critical disability studies has been the dislodging and deconstruction
of the fantasy of ableist human one-ness. Disability demands mutuality, support and interdependence. Such qualities are valued
elements of Braidotti’s posthuman ‘not-Oneness, which is constitutive of the non-unitary subject anchors the subject in an ethical bond to alterity, to
the multiple and external others that are constitutive of that entity which, out of laziness and habit, we call the ‘self’’ (100). If becoming animal is about
displacing anthropocentricism then Rod Michalko’s beautiful 1999 text captures becoming animal and human together: a complex and affirming hybrid.
Too often, Braidotti (2013: 668) writes, drawing in the work of Borges, we
think of animals in terms of a taxonomy of
three groups: those we eat, those we watch TV with and those we are scared of. We confine animals into
a host of instrumental, Oedipal or phantasmagorical relationships. But how might we think again about our alliances with
animals? One answer, clearly, is through our interconnection and vitality of bond associated with us sharing a planet. ‘ This vital
interconnection posits a qualitative shift of relationship away from species-ism and towards an
ethical appreciation of what bodies (human, animal, others) can do’ (Braidotti, 2013: 71). Shildrick and Price
(2004/2005) demonstrate such as an appreciation. The disabled woman who relies on an assistant or carer to help her prepare for a sexual encounter –
be it in terms of dressing appropriately, negotiating toilet facilities, or requiring direct physical support in a comfortable sexual position – is not
different in kind from other women, but simply engaged more overtly in just those networks that Deleuze and Guattari characterise as desiring
production. Similarly a reliance on prosthetic devices - the linkages between human, animal and machine – would figure not as limitations but as
transformative possibilities of becoming other along multiple lines of flight (Shildrick and Price, 2005/2006, np). Back to Michalko (1999), and his ethicopolitical account of life with a guide dog and companion animal, we are encouraged to ask; what do we ask of animals? What are our ethical rights to
do so? How
do humans and animals become together? Such questions resonate with a posthuman
view of ‘subjectivity as an assemblage that includes non-human agents’ (Braidotti, 2013: 82). Human-animal
relationships are inherently touching (Shildrick, 2009) and they function to ‘break up the fantasy of unity, totality and one-ness’ (Braidotti, 2013: 100).
Animal rights, Green and Disability Politics meet in a ‘post-anthropocentric space, recognising the ‘inter-relation human/animal as constitutive of the
identity of each’ (79). We are faced, as Michalko (1999) alerts us to, matters of slavery, abuse and work that animals are subjected to which contrast
markedly with the touching moments of humananimal interconnection (articulated well by Shildrick, 2009). Braidotti (2013: 89) argues that ‘the crisis
of humanism inaugurates the posthuman by empowering the sexualised and racialised human ‘others’ to emancipate themselves from the dialectics of
master-slave relations and this includes naturalised others such as animals’. She continues, ‘this hails a post-anthropocentric period of time in which
alliances are made between humans and non-humans; ‘between the organic and the inorganic, the born and the manufactured, flesh and metal,
electronic circuits and organic nervous systems’ (Ibid: 89). So let us think again about the animal/human relationship and, indeed, our deployment of
the term ‘animal’ as constitutive of the human; precisely because the animal is Other to human. Recently, the right wing British tabloid newspaper, The
Daily Mail, reported the following about the shocking abuse cases at Winterbourne View residential hospital, in Bristol; Whistle-blower at centre of
'barbaric' care home abuse exposé raised alarm last year - but was ignored by regulator The Government has ordered a report into how warnings of
systematic abuse towards vulnerable adults at Winterbourne View residential hospital, in Bristol, were not acted upon by local authorities and
England's social care regulator the Care Quality Commission (CQC) ... Care workers dragged vulnerable patients around like animals at the
Winterbourne View private care home in Bristol Winterbourne shocks because humans were treated like they were animals. One assumes it would be doubly shocking to treat
non-disabled people as if they were animals? It would appear that there
is an unconscious human desire to view animals
as less than human and in some cases treats certain categories of human as if they were not (i.e.
Non-human = people with learning disabilities). This anthropocentric position upholds ‘transcendental human
exceptionalism’ (Braidotti, 2013: 86) and has the potential to expel those others that fail to match up to
its standards (whether they be animals or those considered lesser humans, akin to animals). We need a qualitative shift of our collective
imaginings, or a ‘shared desire for transformations’ (Braidotti, 2013: 89). The
problem is not that some categories of
human are treated like animals; the problem resides in the unconscious desire of the human
condition to treat animals in inhumane ways; and treat some humans as if they were animals. We think that
reinvigorating discussion around human/animal relations around disability might provide the
necessary conditions and impetus for revaluing animals and humans as sharing a posthuman
space of becoming.
The neg’s framing of death is inherently problematic and ableistreconceptualizing death within a framework of disability enables positivity in
death that solves all their reasons why extinction outweighs
Goodley 14 (Dan Goodley, Rebecca Lawthom and Katherine Runswick Cole, Dan Goodley is
Professor of Disability Studies and Education at the University of Sheffield. Recent texts include
Dis/ability Studies (Routledge, 2014) and Disability Studies (Sage, 2011). His work engages
critical studies of ableism and disablism to interrogate the gains and losses of those working at
the dis/ability complex. Rebecca Lawthom is Professor of Community Psychology at Manchester
Metropolitan University. Her work engages at the intersections of feminism, disability and
migration. Publications include Community Psychology (Wiley Blackwell, 2011, with Kagan,
Burton and Duckett) and Qualitative Methods in Psychology: A research guide (Open University
Press, 2012, with Banister, Bunn, Burman, Daniels, Duckett, Parker, Runswick Cole, Sixsmith and
Goodley). Katherine Runswick-Cole is Senior Research Fellow in Disability Studies and
Psychology at Manchester Metropolitan University, UK. Her research and publications focus on
the lives of disabled children and their families, this includes Disabled Children’s Childhood
Studies (2013, Palgrave, edited with Tillie Curran) and Approaching disability: Critical issues and
perspectives (2014, Routledge, with Mallett). " Posthuman disability studies", 2014, Subjectivity,
III. Life beyond death: Rethinking death At the heart of my research project lies an ethics that respects vulnerability while actively constructing horizons
of hope (Braidotti, 2013: 122). In
a recent research project, we were fortunate to talk with some young
disabled people who were living with life limiting and life threatening impairments (LL/LTIs)vi. Their
perspectives on the value of their (short) lives were incredibly productive. They shared with us their concerns, worries and their sadness. They told us
of how difficult their families found their prognoses. But crucially they also told us jokes, shared familial narratives, ambitions and exciting projects they
were involved. They demanded that we rethink how we put together words such as ‘valued’, ‘quality’, ‘life’ and ‘living’. They also asked us to revisit
our unproblematic and inherently deficit-leaning thoughts around death. Their approach to life
and death shared much with the affirmative approach of Braidotti’s posthumanism. They got us
to think about how we might speak positively, affirmatively and productively about death,
disability and short lives. Jasbir Puar (2009: 165-166) proposes that all contemporary global citizens are ‘living in prognosis with their own
debility’. Perhaps, nowhere is this more apparent than in the case of children and young people with LL/LTIs. If social theory,
professional practice, community discourse or social policy speak of these young people at all
then this tends to be in terms of tragedy, negativity and sadness. In contrast, recent
developments in feminist, queer, postcolonial, disability and death studies have provided new
vocabularies for speaking of and celebrating the lives and death of ‘non-normative’ human
beings (e.g. McRuer, 2006). Being disabled is not a tragedy but a possibility, an affirmation, a ‘queer’ or
‘crip’ space for rethinking what it means to be human, to live a quality life and a life with quality.
Death is a difficult subject and discussing the death of a child is more difficult still. Social embarrassment around death and disability means that a
silence is often imposed upon families. However, we need to talk about death before and after a child dies. In what ways can we promote valued
understandings of real bodies facing death? How can death, disability and short lives be conceptualized in less liminal and pathological ways that
honour the contributions of children with LL/LTIs? How can social sciences articulate the ways in which medicine and palliative care value short lives
and transform services for children with LL/LTIs and their families? To what extent does a consideration of death, disability and short lives extend social
and natural science understandings of well being and humanity? While this is not the place (and there is not the space) to adequately answer these
questions, we might be able to sketch out a theoretical landscape that encourages productive answers. Our concern relates to the common assumption
that disabled children with LL/LTIs are occupying a borderland between life and death, between the human and the inhuman. Like asylum seekers and
refugees, these children risk being cast out as ‘disposable humanity’ or ‘undignified monuments of posthuman inhumanity’ (Braidotti, 2013: 127). In
contrast, then, what
we require is a politics of becoming (rather than an assumed positionality of
necropolitical destruction) that ‘thinks with rather than against death’ (128, our italics). Children with
LL/LTIs may be seen as pioneers of a posthuman approach to death that redraws the
parameters and criteria of what counts as a valued life and death. They conspicuously hit us with the reality, held
by all members of contemporary society, that ‘we live to recover from the shocking awareness that this game [life and living] is over even before it
started. The proximity to death suspends life, not into transcendence, but rather into the radical immanence of ‘just a life’, here and now, for as long as
we can and as much as we can take’ (Braidotti, 2013: 132). Traditional notions (or notions obsessed with ‘Zoë’ rather than thanatos) such as ‘quality of
life’, ‘living a full life’, ‘filling a life before death’ are reappraised not only through children with LL/LLIs. ‘ Death
is the event that has
always taken place at the level of consciousness ’ (that is we are always thinking of death when alive) and ‘life is passing and
we do not own it; we just inhabit it, not unlike a time-share location’ (133) (living is constantly in flux and movement). Death and short lives
are pulled from a depressive human position into a productive posthuman space because
‘posthuman critical thought does not aim at mastery, but at transformation of negative into
positive passions’ (p134). It can be argued then that ‘life as Zoë also encompasses what we death. As a result,
what we humans most deeply aspire to is not so much to disappear, but rather to do in the
space of our own life and in our own way’ (p135). Unsurprisingly, children and young people with LL/LTIs have plenty to say
about how they would like to die, how their funerals should be planned and the hopes they have for how they are remembered. This latter point hints
at their capacities for what Braidotti (2013: 137) terms ‘becoming-imperceptible’ ‘part of the cycles of becoming, yet another form of
interconnectedness, a vital relationship that links one with other multiple forces’ (137). We
do connect even when we are no
longer physically around. Add to this the reality that many children with LL/LTIs are plugged into a host of human and non-human
assemblages – at times test-cases for new medical and technological interventions aimed at preserving life or aiding a death with dignity – then our
young people are swept into the growing population of dynamic non-unitary assemblages. Children-with-LL-LTIs-as-cyborg
assemblages are very real living examples of posthuman social theory. Death and short lives are
no longer read in terms of lack nor figuration but in terms of plenitude, desire and possibility:
over-flowing with hither to unknown future inter-relationships and connections with others. This is
not to deny the tragedy of young people dying far too early. But it is about inviting an alternative conceptualisation of life and death. If we can
affirm death, one could argue, we can affirm anything. In between the binaries of life and death
we find affirmation. This is a matter of life and death emboldened by ‘relational vitality’ (188).
AT: T- Quota and Grounds of Inadmissibility
We meet—public charge is included with the INA’s grounds of inadmissibility
Bruno 16 (Andorra Bruno, specialist in immigration policy, Congressional Research Service, “Refugee Admissions
and Resettlement Policy,” 11/30/16, pg. 7,
In order to
be admitted to the United States, a prospective refugee must be admissible under
immigration law. The INA sets forth various grounds of inadmissibility, which include healthrelated
grounds, security-related grounds, public charge (i.e., indigence), and lack of proper documentation.25 Some inadmissibility grounds (public
charge, lack of proper documentation) are not applicable to refugees. Others can be waived for humanitarian purposes, to assure family unity, or when
it is otherwise in the public interest.26 Of particular relevance to the admission of refugees are certain health-related and security-related grounds of
AT: Regulation =/= Restriction
Public Charge is a legal restriction
Legal Information Institute No date (Legal Information Institute, Open Access to Law
since 1992, “8 U.S. Code § 1182 - Inadmissible aliens,” [Cornell Law School], accessed: 7/16/18,
Classes of aliens ineligible for visas or admission
aliens who are inadmissible
under the following paragraphs are ineligible to receive visas and ineligible to be admitted to
the United States: Health-related grounds
Except as otherwise provided in this chapter,
(A) In generalAny alien— (i) who is determined (in accordance with regulations prescribed by the Secretary of Health and Human Services) to
have a communicable disease of public health significance; [1] (ii) except as provided in subparagraph (C), who seeks admission as an immigrant, or who seeks adjustment of status to the status of an alien lawfully admitted for permanent residence, and who has
failed to present documentation of having received vaccination against vaccine-preventable diseases, which shall include at least the following diseases: mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza type B and hepatitis B, and
any other vaccinations against vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices, (iii) who is determined (in accordance with regulations prescribed by the Secretary of Health and Human Services in consultation with
the Attorney General)— (I) to have a physical or mental disorder and behavior associated with the disorder that may pose, or has posed, a threat to the property, safety, or welfare of the alien or others, or (II) to have had a physical or mental disorder and a history of
behavior associated with the disorder, which behavior has posed a threat to the property, safety, or welfare of the alien or others and which behavior is likely to recur or to lead to other harmful behavior, or (iv) who is determined (in accordance with regulations
prescribed by the Secretary of Health and Human Services) to be a drug abuser or addict, is inadmissible. (B) Waiver authorized For provision authorizing waiver of certain clauses of subparagraph (A), see subsection (g). (C) Exception from immunization requirement
for adopted children 10 years of age or youngerClause (ii) of subparagraph (A) shall not apply to a child who— (i) is 10 years of age or younger, (ii) is described in subparagraph (F) or (G) of section 1101(b)(1) of this title; 1 and (iii) is seeking an immigrant visa as an
immediate relative under section 1151(b) of this title, if, prior to the admission of the child, an adoptive parent or prospective adoptive parent of the child, who has sponsored the child for admission as an immediate relative, has executed an affidavit stating that the
parent is aware of the provisions of subparagraph (A)(ii) and will ensure that, within 30 days of the child’s admission, or at the earliest time that is medically appropriate, the child will receive the vaccinations identified in such subparagraph. (2) Criminal and related
grounds (A) Conviction of certain crimes (i) In generalExcept as provided in clause (ii), any alien convicted of, or who admits having committed, or who admits committing acts which constitute the essential elements of— (I) a crime involving moral turpitude (other
than a purely political offense) or an attempt or conspiracy to commit such a crime, or (II) a violation of (or a conspiracy or attempt to violate) any law or regulation of a State, the United States, or a foreign country relating to a controlled substance (as defined in
section 802 of title 21), is inadmissible. (ii) ExceptionClause (i)(I) shall not apply to an alien who committed only one crime if— (I) the crime was committed when the alien was under 18 years of age, and the crime was committed (and the alien released fro m any
confinement to a prison or correctional institution imposed for the crime) more than 5 years before the date of application for a visa or other documentation and the date of application for admission to the United States, or (II) the maximum penalty possible for the
crime of which the alien was convicted (or which the alien admits having committed or of which the acts that the alien admits having committed constituted the essential elements) did not exceed imprisonment for one year and, if the alien was convicted of such
crime, the alien was not sentenced to a term of imprisonment in excess of 6 months (regardless of the extent to which the sentence was ultimately executed). (B) Multiple criminal convictions Any alien convicted of 2 or more offenses (other than purely political
offenses), regardless of whether the conviction was in a single trial or whether the offenses arose from a single scheme of misconduct and regardless of whether the offenses involved moral turpitude, for which the aggregate sentences to confinement were 5 years
or more is inadmissible. (C) Controlled substance traffickersAny alien who the consular officer or the Attorney General knows or has reason to believe— (i) is or has been an illicit trafficker in any controlled substance or in any listed chemical (as defined in section 802
of title 21), or is or has been a knowing aider, abettor, assister, conspirator, or colluder with others in the illicit trafficking in any such controlled or listed substance or chemical, or endeavored to do so; or (ii) is the spouse, son, or daughter of an alien inadmissible
under clause (i), has, within the previous 5 years, obtained any financial or other benefit from the illicit activity of that alien, and knew or reasonably should have known that the financial or other benefit was the product of such illicit activity, is inadmissible. (D)
Prostitution and commercialized viceAny alien who— (i) is coming to the United States solely, principally, or incidentally to engage in prostitution, or has engaged in prostitution within 10 years of the date of application for a visa, admission, or adjustment of status,
(ii) directly or indirectly procures or attempts to procure, or (within 10 years of the date of application for a visa, admission, or adjustment of status) procured or attempted to procure or to import, prostitutes or persons for the purpose of prostitution, or receives or
(within such 10-year period) received, in whole or in part, the proceeds of prostitution, or (iii) is coming to the United States to engage i n any other unlawful commercialized vice, whether or not related to prostitution, is inadmissible. (E) Certain aliens involved in
serious criminal activity who have asserted immunity from prosecutionAny alien— (i) who has committed in the United States at any time a serious criminal offense (as defined in section 1101(h) of this title), (ii) for whom immunity from criminal jurisdiction was
exercised with respect to that offense, (iii) who as a consequence of the offense and exercise of immunity has departed from the United States, and (iv) who has not subsequently submitted fully to the jurisdiction of the court in the United States having jurisdiction
with respect to that offense, is inadmissible. (F) Waiver authorized For provision authorizing waiver of certain subparagraphs of this paragraph, see subsection (h). (G) Foreign government officials who have committed particularly severe violations of religious
freedom Any alien who, while serving as a foreign government official, was responsible for or directly carried out, at any time, particularly severe violations of religious freedom, as defined in section 6402 of title 22, is inadmissible. (H) Significant traffick ers in persons
(i) In general Any alien who commits or conspires to commit human trafficking offenses in the United States or outside the United States, or who the consular officer, the Secretary of Homeland Security, the Secretary of State, or the Attorney General knows or has
reason to believe is or has been a knowing aider, abettor, assister, conspirator, or colluder with such a trafficker in severe forms of trafficking in persons, as defined in the section 7102 of title 22, is inadmissible. (ii) Beneficiaries of trafficking Except as provided in
clause (iii), any alien who the consular officer or the Attorney General knows or has reason to believe is the spouse, son, or daughter of an alien inadmissible under clause (i), has, within the previous 5 years, obtained any financial or other benefit from the illicit
activity of that alien, and knew or reasonably should have known that the financial or other benefit was the product of such illicit activity, is inadmissible. (iii) Exception for certain sons and da ughters Clause (ii) shall not apply to a son or daughter who was a child at
the time he or she received the benefit described in such clause. (I) Money launderingAny alien— (i) who a consular officer or the Attorney General knows, or has reason to believe, has engaged, is engaging, or seeks to enter the United States to engage, in an
offense which is described in section 1956 or 1957 of title 18 (relating to laundering of monetary instruments); or (ii) who a consular officer or the Attorney General knows is, or has been, a knowing aider, abettor, assister, conspirator, or colluder with others in an
offense which is described in such section; is inadmissible. (3) Security and related grounds (A) In generalAny alien who a consular officer or the Attorney General knows, or has reasonable ground to believe, seeks to enter the United States to engage solely,
principally, or incidentally in— (i) any activity (I) to violate any law of the United States relating to espionage or sabotage or (II) to violate or evade any law prohibiting the export from the United States of goods, technology, or sensitive information, (ii) any other
unlawful activity, or (iii) any activity a purpose of which is the opposition to, or the control or overthrow of, the Government of the Unit ed States by force, violence, or other unlawful means, is inadmissible. (B) Terrorist activities (i) In generalAny alien who— (I) has
engaged in a terrorist activity; (II) a consular officer, the Attorney General, or the Secretary of Homeland Security knows, or has reasonable ground to believe, is engaged in or is likely to engage after entry in any terrorist activity (as defined in clause (iv)); (III) has,
under circumstances indicating an intention to cause death or serious bodily harm, incited terrorist activity; (IV) is a repr esentative (as defined in clause (v)) of— (aa) a terrorist organization (as defined in clause (vi)); or (bb) a political, social, or other group that
endorses or espouses terrorist activity; (V) is a member of a terrorist organization described in subclause (I) or (II) of clause (vi); (VI) is a member of a terrorist organization described in clause (vi)(III), unless the alien can demonstrate by clear and convincing evidence
that the alien did not know, and should not reasonably have known, that the organization was a terrorist organization; (VII) endorses or espouses terrorist activity or persuades others to endorse or espouse terrorist activity or support a terrorist organization; (VIII)
has received military-type training (as defined in section 2339D(c)(1) of title 18) from or on behalf of any organization that, at the time the training was received, was a terrorist organization (as defined in clause (vi)); or (IX) is the spouse or child of an alien who is
inadmissible under this subparagraph, if the activity causing the alien to be found inadmissible occurred within the last 5 y ears, is inadmissible. An alien who is an officer, official, representative, or spokesman of the Palestine Liberation Organization is considered,
for purposes of this chapter, to be engaged in a terrorist activity. (ii) ExceptionSubclause (IX) of clause (i) does not apply to a spouse or child— (I) who did not know or should not reasonably have known of the activity causing the alien to be found inadmissible under
this section; or (II) whom the consular officer or Attorney General has reasonable grounds to believe has renounced the activity causing the alien to be found inadmissible under this section. (iii) “Terrorist activity” definedAs used in this chapter, the term “terrorist
activity” means any activity which is unlawful under the laws of the place where it is committed (or which, if it had been committed in the United States, would be unlawful under the laws of the United States or any State) and which involves any of the following: (I)
The highjacking or sabotage of any conveyance (including an aircraft, vessel, or vehicle). (II) The seizing or detaining, and threatening to kill, injure, or continue to detain, another individual in order to compel a third person (including a governmental organization) to
do or abstain from doing any act as an explicit or implicit condition for the release of the individual seized or detained. (III) A violent attack upon an internationally protected person (as defined in section 1116(b)(4) of title 18) or upon the liberty of such a person. (IV)
An assassination. (V) The use of any— (a) biological agent, chemical agent, or nuclear weapon or device, or (b) explosive, firearm, or other weapon or dangerous device (other than for mere personal monetary gain), with intent to endanger, directly or indirectly,
the safety of one or more individuals or to cause substantial damage to property. (VI) A threat, attempt, or conspiracy to do any of the foregoing. (iv) “Engage in terrorist activity” definedAs used in this chapter, the term “engage in terrorist activity” means, in an
individual capacity or as a member of an organization— (I) to commit or to incite to commit, under circumstances indicating an intention to cause death or serious bodily injury, a terrorist activity; (II) to prepare or plan a terrorist activity; (III) to gather information on
potential targets for terrorist activity; (IV) to solicit funds or other things of value for— (aa) a terrorist activity; (bb) a terrorist organization described in clause (vi)(I) or (vi)(II); or (cc) a terrorist organization described in clause (vi)(III), unless the solicitor can
demonstrate by clear and convincing evidence that he did not know, and should not reasonably have known, that the organization was a terrorist organization; (V) to solicit any individual— (aa) to engage in conduct otherwise described in this subsection; (bb) for
membership in a terrorist organization described in clause (vi)(I) or (vi)(II); or (cc) for membership in a terrorist organization described in clause (vi)(III) unless the solicitor can demonstrate by clear and convincing evidence that he did not know, and should not
reasonably have known, that the organization was a terrorist organization; or (VI) to commit an act that the actor knows, or reasonably should know, affords material support, including a safe house, transportation, communications, funds, transfer of funds or other
material financial benefit, false documentation or identification, weapons (including chemical, biological, or radiological weapons), explosives, or training— (aa) for the commission of a terrorist activity; (bb) to any individual who the actor knows, or reasonably
should know, has committed or plans to commit a terrorist activity; (cc) to a terrorist organization described in subclause (I) or (II) of clause (vi) or to any member of such an organization; or (dd) to a terrorist organization described in clause (vi)(III), or to any member
of such an organization, unless the actor can demonstrate by clear and convincing evidence that the actor did not know, and s hould not reasonably have known, that the organization was a terrorist organization. (v) “Representative” defined As used in this
paragraph, the term “representative” includes an officer, official, or spokesman of an organization, and any person who directs, counsels, commands, or induces an organization or its members to engage in terrorist activity. (vi) “Terrorist organization” definedAs
used in this section, the term “terrorist organization” means an organization— (I) designated under section 1189 of this title; (II) otherwise designated, upon publication in the Federal Register, by the Secretary of State in consultation with or upon the request of the
Attorney General or the Secretary of Homeland Security, as a terrorist organization, after finding that the organization engages in the activities described in subclauses (I) through (VI) of clause (iv); or (III) that is a group of two or more individuals, whether organized
or not, which engages in, or has a subgroup which engages in, the activities described in subclauses (I) through (VI) of clause (iv). (C) Foreign policy (i) In general An alien whose entry or proposed activities in the United States the Secretary of State has reasonable
ground to believe would have potentially serious adverse foreign policy consequences for the United States is inadmissible. (ii) Exception for officials An alien who is an official of a foreign government or a purported government, or who is a candidate for election to
a foreign government office during the period immediately preceding the election for that office, shall not be excludable or subject to restrictions or conditions on entry into the United States under clause (i) solely because of the alien’s past, current, or expected
beliefs, statements, or associations, if such beliefs, statements, or associations would be lawful within the United States. (iii) Exception for other aliens An alien, not described in clause (ii), shall not be excludable or subject to restrictions or conditions on entry into
the United States under clause (i) because of the alien’s past, current, or expected beliefs, statements, or associations, if such beliefs, statements, or associations would be lawful within the United States, unless the Secretary of State personally determines that the
alien’s admission would compromise a compelling United States foreign policy interest. (iv) Notification of determinations If a determination is made under clause (iii) with respect to an alien, the Secretary of State must notify on a timely basis the chairmen of the
Committees on the Judiciary and Foreign Affairs of the House of Representatives and of the Committees on the Judiciary and Foreign Relations of the Senate of the identity of the alien and the reasons for the determination. (D) Immigrant membership in totalitarian
party (i) In general Any immigrant who is or has been a member of or affiliated with the Communist or any other totalitarian party (or subdivision or affiliate thereof), domestic or foreign, is inadmissible. (ii) Exception for involuntary membership Clause (i) shall not
apply to an alien because of membership or affiliation if the alien establishes to the satisfaction of the consular officer when applying for a visa (or to the satisfaction of the Attorney General when applying for admission) that the membership or affiliation is or was
involuntary, or is or was solely when under 16 years of age, by operation of law, or for purposes of obtaining employment, food rations, or other essentials of living and whether necessary for such purposes. (iii) Exception for past membershipClause (i) shall not apply
to an alien because of membership or affiliation if the alien establishes to the satisfaction of the consular officer when applying for a visa (or to the satisfaction of the Attorney General when applying for admission) that— (I) the membership or affiliation terminated
at least— (a) 2 years before the date of such application, or (b) 5 years before the date of such application, in the case of an alien whose membership or affiliation was with the party controlling the government of a foreign state that is a totalitarian dictatorship as of
such date, and (II) the alien is not a threat to the security of the United States. (iv) Exception for close family members The Attorney General may, in the Attorney General’s discretion, waive the application of clause (i) in the case of an immigrant who is the parent,
spouse, son, daughter, brother, or sister of a citizen of the United States or a spouse, son, or daughter of an alien lawfully admitted for permanent residence for humanitarian purposes, to assure family unity, or when it is otherwise in the public interest if the
immigrant is not a threat to the security of the United States. (E) Participants in Nazi persecution, genocide, or the commission of any act of torture or extrajudicial killing (i) Participation in Nazi persecutionsAny alien who, during the period beginning on March 23,
1933, and ending on May 8, 1945, under the direction of, or in association with— (I) the Nazi government of Germany, (II) any government in any area occupied by the military forces of the Nazi government of Germany, (III) any government established with the
assistance or cooperation of the Nazi government of Germany, or (IV) any government which was an ally of the Nazi government of Germany, ordered, incited, assisted, or otherwise participated in the persecution of any person because of race, religion, national
origin, or political opinion is inadmissible. (ii) Participation in genocide Any alien who ordered, incited, assisted, or oth erwise participated in genocide, as defined in section 1091(a) of title 18, is inadmissible. (iii) Commission of acts of torture or extrajudicial
killingsAny alien who, outside the United States, has committed, ordered, incited, assisted, or otherwise participated in the commission of— (I) any act of torture, as defined in section 2340 of title 18; or (II) under color of law of any foreign nation, any extrajudicial
killing, as defined in section 3(a) of the Torture Victim Protection Act of 1991 (28 U.S.C. 1350 note), is inadmissible. (F) Association with terrorist organizations Any alien who the Secretary of State, after consultation with the Attorney General, or the Attorney
General, after consultation with the Secretary of State, determines has been associated with a terrorist organization and int ends while in the United States to engage solely, principally, or incidentally in activities that could endanger the welfare, safety, or sec urity of
Public charge
alien who, in the opinion of the consular officer at the time of application for a visa, or in the
opinion of the Attorney General at the time of application for admission or adjustment of status,
is likely at any time to become a public charge is inadmissible. (B) Factors to be taken into
account (i) In determining whether an alien is inadmissible under this paragraph, the consular
the United States is inadmissible. (G) Recruitment or use of child soldiers Any alien who has engaged in the recruitment or use of child soldiers in violation of section 2442 of title 18 is inadmissible. (4)
(A) In general
officer or the Attorney General shall at a minimum consider the alien’s— (I) age; (II) health; (III)
family status; (IV) assets, resources, and financial status; and (V) education and skills. (ii) In
addition to the factors under clause (i), the consular officer or the Attorney General may also
consider any affidavit of support under section 1183a of this title for purposes of exclusion
under this paragraph.
Public Charges are considered restrictions in the context of legal immigration
DOJ 99 (Department of Justice, a cabinet-level agency responsible for enforcing the laws of the
United States federal government, “Inadmissibility and Deportability on Public Charge Grounds,”
[U.S. Citizenship and Immigration Services], DOCUMENT NUMBER: FR26-99, FEDERAL REGISTER
CITE: 64 FR 28676, May 26th of 1999, accessed: 7/15/18,
Welfare Reform and Other Significant Factors That Limit Potential for Aliens to Become "Public Charges" The proposed rule is not
expected to alter substantially the number of aliens who will be found deportable or inadmissible as public charges. Deportations on
public charge grounds have always been rare due to the strict Matter of B- requirements that agencies first must demand
repayment, assuming they have a legal right to do so, and the obligated party or parties must have failed to pay. This is unlikely to
change. Several recently enacted welfare and immigration reform measures have also contributed to reducing the possibility that
aliens will be found likely to become public charges under section 212(a)(4) of the Act. Due
to the increased restrictions
of the welfare reform law, as amended, many aliens are no longer eligible to receive some
public benefits formerly available to them. For example, one significant new restriction prohibits
legal, "qualified aliens" from receiving Federal means-tested public benefits, with some exceptions, for 5
years if they arrive after August 22, 1996. 8 U.S.C. 1613. Combined with the 5-year limitation in section
237(a)(5) of the Act, the welfare reform restriction means fewer aliens are likely to become
deportable public charges. Under new "deeming" rules, some aliens who might otherwise have
been able to obtain certain Federal, State, or local means-tested public benefits can no longer
do so because their sponsors' resources may now count as resources available to the aliens (i.e., t
he sponsors' resources are "deemed" available to the alien), which would normally raise the alien's income over the benefit
eligibility threshold. 8 U.S.C. 1631, 1632. In addition, the
requirement of a legally binding Affidavit of Support
obligating sponsors to support their immigrating family members above the poverty level before
they will be granted admission or adjustment has significantly raised the bar for people who
might, in the past, have entered and become public charges. These new laws work toget her to limit the
potential for immigrants to become dependent on the Government. The proposed rule defining "public charge"
will not change or negatively affect the operation of these provisions.
AT: T-Legal immigration
We meet—public charge applies to immigrants who are applying/have already
received lawful permanent status
USCIS 17 (USCIS, “Public Charge,” Q: What is a public charge and when does it apply? US Citizenship and
Immigration Services, 6/26/17,
Under Section 212(a)(4) of the Immigration and Nationality Act (INA), an individual seeking admission to the
United States or seeking to adjust status to that of an individual lawfully admitted for
permanent residence (green card) is inadmissible if the individual, "at the time of application for
admission or adjustment of status, is likely at any time to become a public charge." Public charge does
not apply in naturalization proceedings. If an individual is inadmissible, admission to the United States or adjustment of status is not granted
We meet- public charge rules limit legal immigration to the U.S- even if we
don’t meet it proves none of their ground offense applies
Macchi, 18, (Victoria Macchi, Proposed Rule May Affect US Legal Immigration 7-10-2018,
By the end of July, the
Trump administration is expected to take a step closer to another sweeping
policy shift that could block millions of foreigners from coming to the United States or from
staying in the country if they have had access to certain public benefits, like children's health
care. One team of analysts says the revamped “public charge” policy could lead to U.S. citizens in mixed-status families not getting
crucial services they need and are entitled to out of fear that it could jeopardize a relative’s immigration status. It all comes
down to how the U.S. government defines a “public charge,” and the Department of Homeland Security (DHS)
is pushing for a change. Draft versions of the document leaked to media outlets earlier this year reveal the U.S. government intends
to broaden which immigrants could be considered “inadmissible” or barred from obtaining permanent residency — that is, a green
card. The DHS proposal indicated the modification to the rule would be published in July, at which time it would be available for
public comment and response from the agency. The draft rule was sent to the Office of Management and Budget for review in late
March, and there it remains as of July 10. Who and how As it stands, when it comes to determining whether an immigrant is likely to
become a “public charge,” immigration officials — those inside the U.S. judging cases where immigrants want to adjust their status,
and those outside the U.S. adjudicating visas — weigh whether the applicant has received cash assistance from the government or
has been institutionalized long term at the government’s expense. The new rule, according to the leaked drafts, could significantly
expand that definition. The March version of the document, if kept as is, would jump from affecting 3 percent of noncitizens to 47
percent, according to a June report from the Migration Policy Institute, a nonpartisan organization that regularly analyzes data and
shifts in U.S. immigration policy. Chilling effects According to leaked drafts, the Trump administration is considering a
rule that
could have sweeping effects on both legal immigration to the United States and the use of public
benefits by legal immigrants and their families.
Counter-interpretation- immigration includes public benefits and public charge
grounds for denial
Boswell 95 (Richard A. Boswell, Professor of Law and Director of the Immigrant Rights Clinic,
The University of California, Hastings College of the Law, “RESTRICTIONS ON NON-CITIZENS'
The subject of public benefits and its intersection with immigration law has been a topic of
much discussion since the enactment of the earliest immigration laws.
The political debate that has become a major topic in recent elections is
not at all new to American politics. Public benefits and alien eligibility have been at issue for nearly as long as there has been a discussion of border enforcement. At the center of t his discussion is whether or not there really is an illegal immigration crisis, and
An additional and overarching question that punctuates
[*1476] this discussion is the degree to which important moral issues have been left out of these
debates on United States immigration policy.
whether or not there is widespread abuse of public benefit programs by foreigners in the United States.
The recent debates and political initiatives relating to immigrant access to public benefits are part of a recurrent historical pattern in which
increased attention has been focused on immigrants during periods of perceived economic downturn. n1 Political leaders unable to adequately deal with painful rising unemployment and fluctuations in the economy have often scapegoated those members of the
society least able to protect themselves. n2 The breakup of the Soviet Union has caused major political and economic realignments, all of which have left the American body politic with an uneasy sense of what might be in store for the future. In the past, during
similar difficult political and economic periods, politicians have [*1477] blamed immigrants. n3 But immigrants were not the cause of the country's problems in the past, just as they are not the cause of the present dislocation. n4 The real policy debate should not be
about immigration and alien access to public benefits, but how an industrial superpower can make its transition to a peacetime economy. Even the most strident advocates for restricting alien access to public benefits do not sincerely believe that the imposition of
additional eligibility requirements will really remedy any of the underlying causes of the economic problems facing the country. n5 The suggested solutions presented in the ongoing immigration debate, while attacking immigration and attempting to increase the
level of hostility towards immigrants, will neither expand the economy nor increase employment opportunities. As in other periods of economic downturn and general insecurity, immigrants have taken the heat for dissatisfaction over a host of other issues. Today,
The current immigration debate is
a symptom of general national insecurity about the future of the American economy.
The premise of the current
debate is that alien eligibility for public benefits must be restricted to keep the public well from
running dry.
Newly arrived lawful permanent residents who apply for and receive
benefits place their status in jeopardy. In addition, a panoply of exclusion and deportation laws
either prohibit the admission of persons who are likely to become public charges or require their
removal from the United States.
immigrants are being blamed for unemployment, crime, and more generally for draining the public coffers by leeching off of governmental health and welfare programs.
The debate should not be
about immigration, but about the underlying causes of unemployment, why there has been a general downturn in the economy, and how these problems can be resolved. n6
In this paper, I will briefly explore the history of some of the public benefits [*1478] programs. n7 As I will detail, alien eligibility for public benefits is already severely restricted for both undocumented and documented aliens.
Undocumented aliens are only eligible for limited emergency assistance.
In order to issue all but emergency benefits, states are required to verify that the person granted the benefits is entitled to receive them. Therefore, to the extent that undocumented aliens participate
in benefit programs, the only explanation for their participation is that they have misrepresented their status, or the benefit worker has failed to determine the person's ineligibility. An additional issue in the immigration/public benefits debate is the extent to which the denial of benefits to undocumented persons may either cause a greater public health
problem or result in unanticipated injuries to United States citizens. Ineligible aliens most often defer medical treatment until their problems have become life threatening and thereby more costly. Moreover, there are benefits such as primary education and school food programs that protect the society at large as much as assist the individual recipients
of the benefit. Allowing undocumented aliens to participate in these programs is in the long term in the interest of the general population, especially where it is likely that they will become fully legalized members of the society. The manner in which immigration policy is discussed and defined determines the very na ture of who we are as a nation. It
demonstrates whether we are compassionate or punitive, and whether we are swayed by appeals to passion and prejudice, or susceptible to a more reasoned decisionmaking. It is only fitting then that questions involving immigration be addressed in moral terms. The current debate has brought forth draconian proposals, which attempt to limit access
to benefits to all except United States citizens, irrespective of their ties or length of residence in this country. The debate itself is based on a faulty premise -- that our current economic ills are caused by immigration. Even worse, the debate has reduced [*1479] the discussion to balancing the relative costs and benefits of immigration, and has ignored the
real-life human consequences of such punitive measures. While the political debate that became especially charged during the most recent political campaign season is not new, it has focused on a range of false issues. n8 I believe eligibility by aliens for public benefits is one of these false issues. Upon careful scrutiny, the debate is more about the larger
issue of federal compensation to the states for what some would argue is a federal obligation. n9 Even before the 1980 census, states were very adept at assuring that all persons, including undocumented aliens within their borders, were accurately accounted for. n10 With reduced federal burden-sharing and political resistance to state tax measures,
the states began to fight harder for an ever dwindling share of the federal dollar. Even when viewed from a constitutional standpoint, the political debate has revolved around the following issues: (1) whether persons born in the United States should be U.S. citizens; (2) whether states have the right to preclude undocumented persons from receiving
access to a number of different public benefit programs; and (3) whether states are entitled to a greater share of the federal dollar when the federal programs which they administer are used by undocumented aliens within the state. The first issue is well settled by the Constitution. The second issue is open to different interpretations. The most
definitive statement, Graham v. Richardson, n11 only resolved the matter for lawful permanent residents. The [*1480] third issue, while interesting and important, is not one of immigration law or policy but revolves around notions of federalism. I. HISTORY The history of U.S. immigration law can be described as falling into three important periods. n12
The first period, from the nation's founding until 1875, was largely characterized by few if any federal restrictions. n13 In the second period, from 1875 until 1952, there were increasing restrictions imposed on those coming to the United States, beginning with legislation enacted in 1875 barring the admission of convicts and prostitutes. n14 The third
period, which began in 1952, is commonly regarded as the beginning of contemporary immigration law. n15 This period, which has been characterized as a period when immigration law was comprehensively codified, did not dramatically change from the earlier policy of restrictive migration through a regime of fixed quotas, extensive exclusion and
deportation grounds. Within this third period of U.S. immigration law, there have been some modifications which have attempted to provide order to the admission of those fleeing persecution, n16 to impose greater controls at the border, n17 and to realign the quota system. n18 [*1481] Economic bases for exclusion and deportation have been part of
U.S. immigration law since the earliest enactments. n19 Besides the wholesale exclusion of Chinese through the Chinese Exclusion Act, n20 a provision enacted in that same year barred the admission of persons likely to become public charges. n21 An 1893 statute barred the admission of a number of groups, including those described as "paupers." n22
A 1903 statute added "professional beggars" to an ever-growing list of persons who were to be excluded, and provided for the deportation of persons who became public charges within two years after their entry. n23 A 1907 statute further excluded persons suffering from physical or mental defects which might affect their ability to work gainfully. n24
In 1917, Congress further expanded the deportation provisions by extending from two to five years the period within which a person could be subject to deportation for becoming a public charge. n25 These provisions prohibiting the admission of persons unable to provide for themselves and requiring the deportation of those who had fallen into
distress were incorporated into the immigration statute which was enacted in 1952. n26 The Immigration Reform and Control Act of 1986 restricted the opportunity to become lawful residents to undocumented persons able to show that they would not need federal assistance. It also precluded many who [*1482] received legal status from participation
in public benefit programs in the future. n27 The Act included a requirement that the government establish that the person had become institutionalized at public expense because of a mental disease, defect, or deficiency; however, in 1990, the Act was amended to require only that deportation occur where the person has become a public charge
within five years after entry from causes not affirmatively shown to have arisen since entry. n28 II. EXCLUSION AND DEPORTATION OF "PUBLIC CHARGES" Notwithstanding the symbol emblazoned on the Statue of Liberty calling for the tired, poor, huddled masses, and wretched refuse yearning to breathe free to come to America, the United States has
hardly welcomed the poor of the world to its shores. n29 Indeed, one of the broadest forms of exclusion has been the exclusion of those likely to become public charges. n30 The provision is so far-reaching that there are hardly any guidelines [*1483] that control its application to those seeking admission to this country. All that is required of INS and
consular officers is that they believe that the person who is seeking permission to enter the United States is "likely" to become a public charge at some distant point in the future. n31 The expansive breadth of the exclusion statute which applies to those "likely to become public charges" is surpassed only by the virtual non-reviewability of the consular
officers' decisions by the judicial branch or even by the Department of State. n32 The Immigration and Nationality Act further allows the INS or consular officer to require that a person who is believed [*1484] likely to become a public charge post a bond or cash deposit with the government. n33 In addition to precluding the admission of would-be
immigrants, public charge exclusion can be used against lawful permanent residents returning to the United States. Under the well-established "reentry" doctrine, a permanent resident who might no longer be deportable because five years have passed since her original entry, could later be found excludable. n34 Under the reentry doctrine, a
permanent resident who makes a voluntary "departure" in a "manner which [could] be regarded as meaningfully interruptive of [her] permanent residence" is treated as an applicant for admission to the United States and therefore subject to the exclusion laws. n35 [*1485] An additional consideration in this analysis is that there is a certain amount of
fluidity in the concept of lawful permanent residency. For example, while a person might carry the documentation evidencing lawful permanent residence, in actuality she could be subject to exclusion or deportation as someone who has lost or abandoned her status. n36 It has been said that the deportation provisions are only few in number; however,
in actuality there are more than one thousand different grounds upon which a foreigner might be removed from the United States. n37 The deportation provisions, working in tandem with the exclusion provisions, allow the government to force the removal of persons who have become a public charge within five years of their admission for reasons
which existed prior to their original admission. n38 The only persons who have even a minimal amount of protection from later removal or exclusion [*1486] for "becoming poor" are lawful permanent residents of more than seven years who are returning to the United States. n39 The meaning of the term "public charge," which triggers the application
of the exclusion and deportation provisions, is not precisely defined either by the statute or decisions. n40 The Board of Immigration Appeals attempted to clarify the meaning of "public charge" as used in the immigration statute when it held that the acceptance of services provided by a state to its residents, for which no specific charges are made, does
not in and of itself make the alien a public charge and therefore subject to removal. n41 One rule of thumb used by the Department of State is that programs which are supplementary in nature, such as providing training, services, or food to enhance the standard of living, as opposed to providing direct support, do not constitute the type of assistance
which would result in a characterization of its recipients as potential public charges. n42 What is clear, however, [*1487] is that in order for a deportation order to be sustained the following three elements must be satisfied: (1) the state or other governing body must impose a charge for the services rendered to the alien; (2) the state or governing body
must make a demand for payment of the charges upon the respondent; and (3) there must be a failure to pay for the charges. n43 Therefore, it seems that an important consideration in whether or not a person can be deported is whether or not the person was eligible for the benefits he or she received. n44 III. FEDERAL BENEFIT PROGRAMS There are
more than seventy different federal programs which provide either cash or noncash aid for low income persons. n45 These programs were first enacted at the time of the Great Depression, a period of worldwide economic havoc in which the very foundations of democratic capitalism were being tested. While it is not the purpose of this discussion to
explore all of the federal assistance programs, I will briefly explore some of the major federal benefit programs and discuss their eligibility requirements. Before examining the various benefit programs it is important to distinguish between need-based assistance programs such as Medicaid and Supplemental Security Income (SSI), and insurance-like
programs such as workers compensation, unemployment compensation, and social security. A third category of programs are those whose primary purpose is to fulfill another larger federal objective, such as the food stamp program, and "Women Infants and Children" (WIC). n46 [*1488] Critical to any understanding of public benefit programs is the
term "permanently residing in the United States under color of law" (PRUCOL), n47 a term which refers to aliens actually living in the United States without any formal immigration status who may be eligible to receive benefits. n48 Characterization as PRUCOL requires that the person is in the United States with the INS's tacit, if not explicit, permission
to remain. n49 PRUCOL is relevant to analyzing alien eligibility for the following programs: Aid to Families with Dependent Children (AFDC), Medicaid, Unemployment Compensation, and Supplemental Security Income (SSI). Because PRUCOL is not clearly defined in either the benefit statutes or in the immigration laws, alien eligibility for these benefit
programs is difficult to determine. n50 Persons who are generally regarded as PRUCOL are persons admitted as refugees or granted asylum, aliens paroled into the United States, those granted suspension of deportation, applicants for registry, and Cuban-Haitian entrants. Others who are sometimes considered to be PRUCOL are persons granted
extended or indefinite voluntary departure, beneficiaries of approved immediate relative petitions, those for whom adjustment of status may be pending, persons under deferred action status, and those with priority dates within sixty days of being current. n51 [*1489] A. Aid to Families with Dependent Children (AFDC) Aid to Families with Dependent
Children (AFDC) is a federal program established in 1935 which gives funds to states to provide financial assistance, rehabilitation and other services to needy dependent children and parents or relatives with whom the children are living. The stated goal of AFDC is to strengthen the family and enable the parents or relatives caring for the child to attain
self-support and independence. n52 The intended beneficiaries of the AFDC program are children whose parent(s) are either absent from the home or are disabled or unemployed. In order to be eligible, a dependent child and all in his or her "assistance unit" must be either U.S. citizens, lawful permanent residents, or PRUCOL. n53 Amendments enacted
in 1986 preclude Special Agricultural Workers (SAW) and other legalized persons from receiving AFDC for five years after they have been accorded their legal status. n54 While the precise meaning of PRUCOL as applied to AFDC cases is not entirely clear, it seems that deportable persons who are present and allowed to remain in the United States with
the knowledge of the INS may be eligible to receive benefits under PRUCOL. n55 [*1490] B. Food Stamps The food stamp program was enacted both to assure that individuals in low income households receive adequate nutrition and to strengthen the agricultural economy. n56 This program enables certain low income individuals to purchase more food
and thereby improve their diets. The program is administered through state welfare and social service agencies under regulations promulgated by the Federal Department of Agriculture. The states are required to follow federal guidelines in determining eligibility. In order to be eligible, a household income must not be greater than 130% of the federal
Poverty Income Guidelines, and the head of household must register for and accept any suitable employment. n57 Recipients of food stamps must be either U.S. citizens, lawful permanent residents, registry applicants, refugees, asylees, persons granted withholding of deportation, or parolees. n58 C. Supplemental Security Income (SSI) The
Supplemental Security Income (SSI) program is a federally funded, need-based cash assistance program for low income persons who are over the age of sixty-five or are blind or disabled. n59 Like AFDC, SSI was established in 1935. n60 Unlike AFDC, SSI is operated directly by the federal government. Blindness is defined as vision in one eye which is not
better than 20/200 with corrective lenses. n61 Disability is broadly defined as a physical or mental impairment such that there is no work which the person could perform for a period of twelve continuous months. In addition to these requirements, the person's income must be at or below a set level. n62 In order to receive benefits, a person must either
be a U.S. citizen, a lawful permanent resident or PRUCOL, and may not be outside the country for [*1491] more than one month. n63 SSI regulations define PRUCOL as persons who have been granted the following immigration benefits: asylum or refugee status, parole, stays of deportation, suspension of deportation, deferred action, withholding of
deportation, or indefinite periods of voluntary departure. n64 Persons who are eligible for SSI are also eligible for Medicaid benefits. n65 D. Medicaid Medicaid, which was instituted in 1935, provides medical care to the needy through a program jointly funded by the federal and state governments. n66 The assistance comes not in the form of payment
to the individual, but as a reimbursement to the health care provider. The federal government sets minimum requirements in the form of eligibility, services and protection for the beneficiaries of the program as a condition to its participation. While financial eligibility requirements vary from state to state, persons eligible for AFDC or SSI are
automatically eligible for Medicaid. n67 Until 1986, the Medicaid statute did not deal with the question of alien eligibility. As the result of a federal district court decision holding that Medicaid regulations were promulgated without statutory authority, n68 Congress enacted legislation limiting participation in Medicaid to U.S. citizens, lawful permanent
residents and PRUCOL aliens. n69 The 1986 Medicaid legislation provides further that all aliens, irrespective of their status, are eligible for emergency care under the Medicaid program, as long [*1492] as they meet the other requirements of the program. n70 Under the statute, emergencies are defined as medical conditions with acute symptoms that
place the patient's health in serious jeopardy, could result in serious impairment to bodily functions, or cause serious dysfunction of any bodily organ or part. n71 E. Unemployment Compensation Insurance Unemployment compensation insurance is a joint federal-state program designed to provide unemployed persons with temporary relief while in
between jobs. n72 Federal and state funds are used primarily to administer a trust fund into which all employers contribute according to tax formulas which vary from state to state. Eligibility is not based on an individual's income, but on her earning record before becoming unemployed. As in many federal-state programs, federal law establishes the
minimum requirements for unemployment programs, including eligibility. n73 Only U.S. citizens, lawful permanent residents, PRUCOL aliens, commuter aliens, nonimmigrants with work visas, and persons with INS-issued work authorizations, with the exception of H-2, F, J, M, and Q aliens, are eligible. n74 The Immigration Reform and Control Act of
1986 created significant changes which further restrict alien access to unemployment compensation insurance. n75 IV. RESTRICTIONS ON ACCESS TO BENEFITS It was not until approximately 1972 that Congress began to enact restrictions on access to benefit programs based on either immigration or [*1493] citizenship status. n76 While it can generally
be said that prior to 1971 Congress had not prohibited state governments from limiting access to public benefits based on alienage, Congress had imposed its own alien access restrictions even before 1956. n77 For example, social security benefits had previously been restricted during periods when an alien was outside the United States. n78 Additional
exclusion provisions precluded aliens from receiving benefits if they were not lawful permanent residents or if they were permanent residents and convicted of a variety of crimes. n79 Another provision, enacted in 1954, provides that persons who are deported from
the United States are ineligible to receive social security old age
In 1965 the Social Security Act was amended to require that in order to be
eligible, an alien must have been lawfully admitted to permanent residence and have resided
continuously in the United States for at least five years immediately before [*1494] applying for
benefits. n81 Six years later in Graham v. Richardson, n82 the Supreme Court held that stateimposed restrictions on alien access to public benefits were unconstitutional because they
violated the Fourteenth Amendment's Equal Protection Clause and encroached on Congress's
exclusive power to regulate immigration.
benefits even when they have paid into the program. n80
Chilling effect
The chilling effect deters immigrants from health centers
Galewitz 12 (Phil Galewitz, "Migrant Health Clinics Caught In Crossfire Of Immigration
Debate", 6-6-2012, Kaiser Health News,
Many of the Mexican men and women picking green beans, peaches and strawberries in this lush, southeast corner of the state are fearful about
seeking health care since a
tough new immigration law was enacted last year. Marisela Clemente, outreach coordinator
from Slocomb Family Health Center, is trying to ease those fears —one farm at a time. She joins eight workers taking a break at a shaded picnic table at
150-acre Aplin Farms. Dressed in blue scrubs, she jokes with the men and women in Spanish, asks after their health and urges them to visit the nearby
migrant clinic where the staff speaks their language and no proof of citizenship is required. “We have to go to them because they
are afraid to
come here to the clinic,” says Clemente, describing workers’ worries they will be stopped by police and
asked for papers. Such clinics, part of a 50-year-old federally funded program to treat migrant
and seasonal farmworkers, have become the latest flash points in the national immigration
debate. Health center officials across the country describe how local, state and national law
enforcement authorities have staked out migrant clinics, detained staff members transporting
patients to medical appointments and set up roadblocks near their facilities and health fairs as
part of immigration crackdowns. “We are looking at a growing climate of fear where folks really
think long and hard about accessing basic services,” says Milton Butterworth, who oversees outreach migrant health
services for Blue Ridge Community Health Services in Hendersonville, N.C. Even many legal workers do not seek care at the
health centers because they are fearful of exposing family members who are not legal residents,
says Tara Plese, a spokeswoman for the Arizona Association of Community Health Centers. “There is a big fear factor and it’s a big
concern from a public health perspective.” Those concerns include making sure farmworkers’ children are vaccinated, stopping
the spread of infectious diseases like AIDS and treating those with chronic problems such as diabetes, officials say. Many farmworkers avoid seeking
care except in emergencies.
Clarity that health care use can’t affect deportation key to fear and stopping
disease spread
Adams 18 (Rebecca Adams, Roll Call journalist, 1/25/18, “Immigration Crackdown Raises Fears
of Seeking Health Care”,
Immigrants around the country who are on edge about broader enforcement under the Trump
administration have been skipping appointments, questioning whether enrolling in governmentfunded health care coverage could undermine their immigration applications and showing
anxiety about visiting unfamiliar physicians, according to nearly two dozen medical providers
and lawyers interviewed recently. Isaura, an undocumented mother of two children living in the Washington, D.C.,
metro area, described the deep apprehensions some immigrants feel about venturing out in the current political climate. “Now I
feel scared to even go to a new doctor because you don’t know what can happen. You have to
give all the information — give your address and personal information — and if I don’t know
somebody, I don’t go,” Isaura said. Her older son is asthmatic and has allergies. “I’m very nervous to go to a
new doctor or new place because I’m scared to drive, and everyone else feels the same.
Everyone feels threatened because the police can stop you,” said Isaura, who asked that her last name not be
used. So far, her family hasn’t had to visit a new physician. She feels comfortable taking her children to familiar clinicians that serve a
large number of immigrants, but would be concerned about getting care elsewhere. With
fears of arrest causing
undocumented residents to recalibrate their everyday lives — including fewer trips for medical
care — the consequences could cascade beyond the immigrant population. Skipped vaccinations
or treatments could hasten the spread of infectious diseases. Avoiding treatment for chronic
ailments invites a cascade of potential trouble, including more expensive and invasive care later.
And when the patient is uninsured, those costs often are absorbed either by government health
programs or by hospitals, which may cover the expense by hiking prices for insured patients.
“Immigrants are no more dangerous than anyone else, but when we craft policies that drive any
population underground, it puts all of the rest of our health at risk, particularly for contagious
diseases,” said Georges Benjamin, the executive director of the American Public Health Association. Karen Mountain, the chief
executive officer for the Migrant Clinicians Network, a nonprofit medical network, said thousands of clinicians are reporting higher
no-show rates and a reluctance by immigrants, both those here legally and illegally, to get needed care. “I’m in the business of trying
to help people when they are ill, and I am unable to do that effectively when people are too afraid to seek care,” Mountain said.
When patients are “scared to death” to seek even routine care, she adds, that “should be a
concern to all taxpayers.” Among those affected are children, including many born in America:
88 percent of children living with an immigrant parent are U.S. citizens.
CHCs Fail
CHCs at max capacity now- disparities are from uninsured and homeless rates,
not quality of care
Kaiser Foundation 13 (Henry J. Kaiser Family Foundation, The Kaiser Commission on
Medicaid and the Uninsured, June 2013, “Quality of Care in Community Health Centers and
Factors Associated With Performance”,
Federally funded community health centers are a key source of comprehensive primary care for medically underserved
communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA)
expanded the health center
program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain
health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of
keen interest. Most
research shows high performance by health centers relative to various
standards, but some gaps have also been found, and suitable benchmarks for assessing the
quality of care provided by health centers, which serve a uniquely disadvantaged population,
have been lacking. Recently, the Kaiser Commission on Medicaid and the Uninsured (KCMU) partnered with the George
Washington University to analyze health center performance relative to Medicaid managed care organizations (MCO), which also
serve a low-income population, on important measures of quality of care – diabetes control, blood pressure control, and receipt of a
Pap test in the past three years. The study also aimed to identify factors that
differ significantly between highperforming and lower-performing health centers. Using data reported in the federal 2010 Uniform Data System
(UDS) by health centers and the 2008 Healthcare Effectiveness Data and Information Set (HEDIS) for Medicaid MCOs, we defined
health centers as “high-performing” if their rates exceeded the 75th percentile of Medicaid MCO HEDIS scores on all three of our
quality measures. We defined health centers as “lower-performing” if their rates were below the mean Medicaid MCO HEDIS score
on all three measures. Key findings » More
than 1 in every 10 health centers was high-performing; few
were lower-performing. In all, 12% of health centers (130) met our definition of high performance, ranking above threequarters of Medicaid MCOs on all three of our quality measures. Fewer than 4% of health centers (41) met our definition of lower
performance, lagging behind the average Medicaid MCO on all three measures. 2 » High-performing health centers reported a
diabetes control rate of 79%, compared to the Medicaid MCO high-performance benchmark of 62%, and their rates were also
roughly 10 percentage points above the Medicaid MCO high-performance benchmarks on the other two measures. However, the
lower performers health centers lagged about 10 percentage points behind the average Medicaid MCO on the chronic care
measures and much further behind on Pap testing. » Most health centers met or exceeded the Medicaid MCO high-performance
benchmarks for the two chronic care measures, but lagged behind the average Medicaid MCO on the Pap test measure. When
health center performance is analyzed measure by measure, rather than on the basis of all three measures together, the data show
that 80% of health centers exceeded the Medicaid MCO high-performance benchmark on diabetes control, and over half exceeded
that standard on blood pressure control. However, 70% of health centers had Pap test rates below the mean Medicaid MCO score
on this measure. » High-performing
health centers were concentrated in certain states, as were
lower performers. Although the 130 high-performing health centers were located in 35 states, one-third of
them were in California (24), New York (10), and Massachusetts (10)—states that are home to just
18% of all health centers. In these three states and eight others where high performers accounted for at least 1 in 5 of all
health centers in the state, there were no lower-performing health centers. The 41 lower-performing health centers
were sprinkled across 23 states, but nearly one-third were in three southern states – Louisiana (5), Texas (4), and
Florida (4). Louisiana had, by far, the largest share of lower performers relative to its total number of health centers (23%), and it
had no high performers. No significant difference in urban-rural location was found between high- and lower performers. »
Lower-performing health centers had a significantly higher uninsured rate than high performers,
and an extremely high homeless rate. While both health center groups had high rates of uninsured patients, the rate
was significantly higher among the lower performers – 50% versus 36%. The share of patients with Medicaid was roughly one-third
in both groups, but lower-performing health centers had significantly smaller shares of patients with Medicare and privately insured
patients. The homeless rate was 40% in lower-performing health centers – ten times the average rate in the high performers. »
Although total revenues per health center patient did not differ between high- and lower-performing health centers, both the
Medicaid share of total revenues and Medicaid revenues per Medicaid patient were greater in the high-performing group. Medicaid
provided over one-third of total revenues in highperforming health centers, but a quarter of total revenues in lower performers.
Medicaid revenues per Medicaid patient were 30% higher in high-performing health centers – $652, compared to $496 in lowerperforming health centers. The two health center groups were similar in their ratios of physicians and enabling services providers to
patients. Implications Medicaid MCO high performance is a demanding benchmark to use for health centers, considering that all
MCO patients are insured, whereas a large share of health center patients are uninsured, making timely preventive care and
successful management of their chronic conditions harder to achieve. In this light, the finding that more than 1 in 10 health centers
were consistently high-performing, and that most performed well relative to Medicaid MCOs in managing diabetes and high blood
pressure, is notable. Focused study of high-performing health centers may inform current efforts to understand the foundations of
high-performing systems of care more generally. 3 The
very high uninsured and homeless rates associated
with lower-performing health centers point to the possibility that the lower performance of
these facilities reflects the challenging profile of their patients rather than the quality of care
they provide. At the same time, the higher rates of private and Medicare coverage associated with high performers suggest
that the ACA’s coverage expansion could help usher improvements in health center performance. In any case, risk-adjusting quality
measurement may help to ensure that health centers serving those who are most difficult to reach and treat are evaluated fairly.
Looking ahead, even highly effective health center strategies cannot fully overcome the
pressures posed by systemic shortages of primary care providers and specialists in medically
underserved communities and the burden of high uninsured rates and homeless rates in many
health centers. Stable and adequate support for the health center program, as well as effective implementation of the
expansion of Medicaid and federally subsidized private coverage under the ACA, will be vital to ensure that this mainstay of the
primary care safety-net remains strong and resilient.
The CP fails—too expensive, low reimbursement rates, staffing shortages,
limited capacity, unsustainable funding, and political turbulence
Capital Link and Capital Fund 14 (Capital Link is a national, non-profit organization that has worked with
hundreds of health centers and Primary Care Associations over the past 15 years to plan capital projects, finance
growth, and identify ways to improve performance, Capital Fund supports the growth and development of
community-based health centers serving low-income and uninsured populations by providing capital structured to
meet health centers’ needs, Community Health Center Financial Perspectives, Issue 5, “Identifying the Risks of Health
Center Failure: A Guide for Health Centers,” pg. 7, 2014,
Pressure to Integrate Mental Health and Substance Abuse Services: One of the core tenets of the ACA is an attempt to ensure that all health insurance
options cover at least a core package of health care services— known as Essential Health Benefits. One of the essential health benefits is mental health
and substance abuse services. While health centers have been slowly integrating behavioral health services into their practices, the ACA will accelerate
that process. Unfortunately, in many states, reimbursement
rates for mental health and substance abuse
services are notoriously low. In addition, there is a growing shortage of mental health providers due
to the sudden increase in demand for their services as the health care system begins to finally acknowledge the frequent
existence of co-occurring mental and physical disorders (especially in the “hot-spotter” population —those who are the highest utilizers of emergency
rooms and other subsidized health care services). While the broader provision of behavioral health services will be essential to achieving the national
goal of reducing overall health care costs, the
delivery of these services at the clinic level can be expensive and
may put negative pressure on operating margins. Pressure to Expand to Serve Almost Twice the Current Patient Base: As
stated, the goal of the current administration is to eventually grow the number of patients served
by health centers to nearly 35 million. Given the aforementioned provider shortages, this level
of growth will be a challenge to accomplish. However, this growth mandate is reflected in HRSA’s ongoing effort to provide
grant opportunities to all health centers. As described in more detail in this analysis, it appears that poorly planned or implemented
capacity growth may have contributed to some of the financial problems experienced by the test group. Finally, there
are two basic characteristics of the health center business model that have nothing to do with the changing healthcare environment but still must be
evaluated or acknowledged: Heavy Reliance on Government Grants and Government Payers (Medicaid/Medicare): Given the importance of federal
Section 330 operating grants and Medicaid/Medicare as payers to health centers, a chance
taken on any given health center is
a chance taken on the federal budget and on the longevity of a social safety net that is broadly
(but not universally) popular. Mounting political pressures due to the cost of these two large
entitlement programs will challenge health centers to navigate through potentially turbulent
waters. Significant Reliance on Donated Goods and Services: Despite what is arguably a viable basic business model, many health
centers need to raise charitable donations and/or secure donated goods and services in order to
break even. It is not uncommon for health centers to secure low- or no-rent space from their local hospital or a government entity, and these
arrangements represent true cost savings. In some newer and/or more rural health centers, local doctors may
donate their time. This has a positive financial impact on the center, but also adds uncertainty as it relies on the
donor’s continued generosity.
FQHCs are unsustainable—staff and funding shortages, lack of access to
specialty care, and failure to coordination prevent effectiveness
Russell 13 (Laura Russell, “Federally Qualified Health Centers: Are They Effective,” Center for Healthcare Research
& Transformation, 7/23/13,
Overall, FQHCs appear to be achieving their original legislative goals. They face significant challenges, however, including long-term
sustainability, clinical staff shortages, lack of access to specialty care and insufficient
collaboration with hospitals and other safety net providers. Having experienced significant appropriations cuts,
adequate funding for health centers remains a challenge for their long-term sustainability. As
millions of people obtain coverage, health centers expect substantial clinical staff shortages, including primary care
physicians, nurses, dentists and mental health professionals.26 They continue to have difficulty securing specialty
referrals for health center patients, often due to specialists’ refusal to accept Medicaid or uninsured patients. Finally, health
centers often find it challenging to coordinate with other health care and social service
providers. These issues need to be addressed for health centers to fully achieve their goals.
CHCs fail- care quality is significantly worse than the country average and
immigrants don’t seek adequate care
Galewitz and Monies 12 (Phil Galewitz and Paul Monies, "Community Health Centers Under
Pressure to Improve Care", 4-17-2012, Kaiser Health News,
Oakhurst Medical Center, just 20 percent of kids have received all their
recommended immunizations by age 2. Adults don’t fare much better at this community health
center, which provides primary care to 14,000 mostly poor people in a town famous for its granite monolith and “Confederate
Mount Rushmore,” just east of Atlanta. Less than half of the diabetics and a little more than a third of
those with high blood pressure had their conditions under control in 2010 — far below national
averages for the entire adult U.S. population, the latest federal data show. “We can do better,” says
Oakhurst Chief Executive Officer Jeffrey Taylor, who ticks off some of his challenges: high obesity rates; many
African immigrants unaccustomed to seeking vaccinations and other preventive care, and 40
percent of patients without health insurance. While Oakhurst is an extreme example, hundreds of the
nation’s nearly 1,200 federally funded community health centers fall short on key quality of care
measures, according to federal data analyzed by KHN and USA Today. The centers’ performance
most often lagged national averages on helping diabetics keep their blood sugar under control
and screening women for cervical cancer. 20 Million Patients Seen After doubling the number of patients served in
the past decade to more than 20 million people a year, the mostly privately run, nonprofit centers are coming under increased
pressure as they gear up for a major expansion under the health care law. Beginning in 2014, about 30 million Americans are
expected to gain health coverage, half through Medicaid, the state-federal insurance program for the poor. Congress
authorized $10 billion to expand the centers’ capacity on the assumption many of the newly
covered would seek care there. Since 2008, they have also been required to report data to the federal government on six
performance measures, including how well they care for their patients with diabetes and high blood pressure, screening rates for
cervical cancer, vaccination rates for children, provision of timely prenatal care and rates of low birth-weight babies. A KHN-USA
Today analysis of the 2010 health center data, obtained through the U.S. Freedom of Information Act, shows the level of care varies
widely, including by region: Centers in the South generally perform worse than those in New England, the Midwest and California.
The analysis also found that: — Nearly 75 percent of centers performed significantly worse — at least 10 percent below the national
average for the entire U.S. population — for cervical cancer screening rates. While
75 percent of U.S. women had at
least one Pap test for cervical cancer in the past three years, the average was 58 percent for
women in community health centers, according to federal data. –About 73 percent performed
significantly below average in helping diabetics maintain their blood sugar levels. — About 28
percent of centers performed significantly below average for immunizing 2-year-olds. — Georgia
was the only state to rank near the bottom on four of the six quality measures. — Four other states — Louisiana, Virginia, Kansas
and Kentucky — ranked near the bottom for three measures. “Of course this raises a concern for us,” says Cindy Zeldin, executive
director of Georgians for a Healthy Future, an Atlanta-based consumer health advocacy group. “We
have so many
uninsured for whom the community health centers are one of the few places where they can go
for primary care.” Still, Zeldin says she is not surprised that patients at Georgia’s 27 health centers fare worse given the state’s
high rates of obesity and diabetes.
AT: States CP
States fail- BIA tricks and federal overlap
Moore 17 (Andrew F. Moore, Associate Professor of Law at the University of Detroit, 2017,
CARE”, Albany Law Review, LexisNexis)/CWB
Again, however, those
advocating for states to aid immigrants must be aware of hidden traps in the
immigration system. These courts may also require immigrants to plead guilty. n342 Some
operate on a suspended sentence approach, or provide for an expungement after successful
completion of a program. n343 The INA has a far more expansive definition of the term "conviction" than is commonly
understood. n344 Any plea or admission of facts sufficient for a finding of guilt coupled with "some form of punishment, penalty, or
restraint" is a conviction for immigration purposes. n345 Moreover, the
BIA has decided that post-conviction relief,
such as expungements or deferred adjudication, does not count to erase a conviction if it is
granted to alleviate consequences in the immigration system. n346 Therefore, while under
[*118] state law there is no conviction, under federal immigration law there is and that
conviction can support deportability on criminal grounds. The above example captures the unfortunate
approach by the federal immigration system to work at cross purposes to state attempts to protect
and rehabilitate those with mental health and addiction issues. It is particularly unfortunate given the proven effectiveness of
mental health and drug courts. n347 Therefore, states
must be careful if they want to re-craft diversionary programs to
truly aid immigrants, which has already been proposed outside of the immigration context. n348 Most importantly, such
programs should operate at the earliest pre-trial stages to avoid plea requirements of any kind.
AT: Hospitals DA
No Link
No turns – immigrants don’t suck up resources – prefer studies
Mohanty et al. 5 (Sarita, MD, MPH, Executive Director, Community-Clinical Care Integration
for Kaiser Foundation Health Plan, Northern California, with a region-wide focus on operations,
strategy, and care management and coordination for MediCal and Dual-Eligible populations. Dr.
Sarita Mohanty has over 15 years of experience in health care delivery, utilization management,
care management, quality improvement, pharmacy, disease management, and health services
research. Her key areas of expertise include integration and care coordination for safety net
systems of care, chronic disease management, palliative care, and specialty care access,
including the integration of physical health, behavioral health, and the non-medical/social care
needs. She completed her Internal Medicine/Primary Care training at Beth Israel Deaconess
Medical Center and a research fellowship at Harvard Medical School and Cambridge Health
Alliance. Subsequently, she joined the faculty at the University of Southern California (USC) as
Assistant Professor of Medicine. At USC, she conducted health services research focused on
barriers to access faced by safety net patients. American Journal of Public Health, August 2005.
“Health Care Expenditures of Immigrants in the United States: A Nationally Representative
Analysis”) NREM/Lil’ GBN
Objectives. We compared the health care expenditures of immigrants residing in the United States
with health care expenditures of US-born persons. Methods. We used the 1998 Medical
Expenditure Panel Survey linked to the 1996–1997 National Health Interview Survey to analyze
data on 18398 US-born persons and 2843 immigrants. Using a 2-part regression model, we
estimated total health care expenditures, as well as expenditures for emergency department
(ED) visits, office-based visits, hospital-based outpatient visits, inpatient visits, and prescription
drugs. Results. Immigrants accounted for $39.5 billion (SE=$4 billion) in health care expenditures. After
multivariate adjustment, per capita total health care expenditures of immigrants were 55%
lower than those of US-born persons ($1139 vs $2546). Similarly, expenditures for uninsured and publicly
insured immigrants were approximately half those of their US-born counterparts. Immigrant children had
74% lower per capita health care expenditures than US-born children. However, ED expenditures were more than 3
times higher for immigrant children than for US-born children. Conclusions. Health care
expenditures are substantially lower for immigrants than for US-born persons. Our study refutes
the assumption that immigrants represent a disproportionate financial burden on the US health
care system.
Immigrants use less healthcare
Goldman et al. 6 (Dana, Director and Leonard D. Schaeffer Director’s Chair, Schaeffer Center
for Health Policy & Economics Distinguished Professor, University of Southern California
Professor, Price School of Public Policy and USC School of Pharmacy. Health Affairs, 25, no.6
(2006):1700-1711 , “Immigrants And The Cost Of Medical Care,”) NREM/Lil; GBN
doi: 10.1377/hlthaff.25.6.1700
Several salient dimensions of the “medical cost crisis” have received much attention, but one neglected topic
involves the role of immigrants in shaping levels and trends in the costs of providing medical care.
Notable research demonstrated lower medical care use among undocumented Latinos; however, it did not
estimate the comparative medical costs of all types of immigrants.1 Similarly, other research has
documented lower per capita health spending by the foreign-born but was unable to distinguish
among the foreign-born by their naturalization or legal status.2 The relative absence of reliable cost numbers
partly reflects the strong emotion surrounding immigration throughout U.S. history. Emotional pleas by advocates on both sides of
the immigration divide are given especially free rein when scientific
evidence is incomplete. Immigrants are a
rapidly growing part of the population. According to the 2000 census, there were thirty-two million foreign-born
people living in the United States—one in nine of the total U.S. population. Estimates indicate that the U.S. population will add 120
million people by 2050, 80 million of whom are or will be here as the direct or indirect consequence of immigration.3 An equally
dramatic trend is the rapidly changing fraction of undocumented immigrants. Among immigrants in the United States for less than
five years in 2002, almost half were un1700 November/December 2006 DataWatc h DOI 10.1377/hlthaff.25.6.1700 ©2006 Project
HOPE–The People-to-People Health Foundation, Inc. Dana Goldman is a corporate chair and director of the Bing Center for Health
Economics, RAND, in Santa Monica, California, and the National Bureau of Economic Research (NBER). James Smith
([email protected]) is a corporate chair and senior economist at RAND. Neeraj Sood is an associate economist at RAND and the NBER.
by guest Downloaded from by Health Affairs on November 5, 2014 documented. In 1970 the figure was
less than 5 percent.4 Rival concerns have been raised about the costs of providing health care to immigrants—especially those who
are here illegally. The
relative unavailability of health insurance raises concerns about long-term
health effects if immigrants do not obtain needed medical care. But the costs of providing
health care to immigrants could be large, especially where they are heavily concentrated. Los
Angeles County is the largest such community in the country. We employed novel data on health status and use of
services, place of birth, and legal status of a representative sample of residents of Los Angeles
County in 2000. These data allowed us to estimate service use and costs of care for nonelderly
adults by nativity and type of immigrant, including the undocumented. Because of a dearth of objective cost
estimates for the foreign-born, we also extrapolated our results to the entire United States.
Although our cost estimates are by no means insignificant in absolute terms, the expense of providing medical care
to the foreign-born—especially the public-sector cost—is much less than their population
representation. This gap is largest for the undocumented.
Hospitals Fail
Hospitals fail – multiple shortcomings
Paalova 17 (Alia, reporter for Becker’s Hospital Review. Becker’s Hospital Review, 9-9-2017.
“The importance of preventive care strategies in a changing healthcare environment”)
Hospital leaders face numerous challenges to implementing preventive care strategies, with one of the
most daunting being the shift from the traditional fee-for-service delivery model, according to Dr. Bulger.
"We have a sick-care system in the country, not a healthcare system, and that's our first problem," he said. Dr.
Bulger referred to how physicians were traditionally trained to treat the disease or crisis at hand rather than
preventing the disease in the first place. Value-based medicine essentially reverses that value
model, meaning physicians are rewarded for keeping patients out of the hospital. Navigating this
profound culture change is extremely difficult for all stakeholders and could slow efforts to
implement adult vaccination programs. Another challenge is leadership through this transition to
value-based models, according to Dr. Nygaard. "[The industry] is struggling with leadership development to manage all of
these changes," he said. Finally, another barrier that curbs use of vaccinations is the subjective nature with
which physicians can view the value or necessity of immunization. Though this is not a tangible barrier, Dr.
Silvers said it can be a challenge to reinforce objectivity in the medical community about vaccinations
and preventive medicine. All three speakers agreed that a lack of education about the importance of
preventive medicine contributed to the challenges.
AT: USCIS Disads
Public charge denials increasing- wastes time and money separating families
Gray 5/24 (Lindsay Gray, partner at Whitlock and Gray LLC, immigration law firm, 5/24/18,
“Keeping Families Apart: Trump’s Update to the Public Charge Provision”,
In another attempt to keep families apart, the Trump Administration has updated the legal
guidance governing who is inadmissible because they are “likely to become a public charge.” This
post covers the new guidance and what we’ve seen so far. Public Charge: The Old Standard It used to be that when
someone petitioned for a family member who was living abroad, the public charge grounds of
admissibility was fairly straightforward to address. The petitioner would file a Form I-864 and provide supporting
documentation like tax returns, W-2s, and pay stubs to show that he or she met the income requirements to support that person. So
long as the petitioner could show that he or she made more than 125% of the federal poverty guidelines for the household
(including the intending immigrant), not much more was said. And if the petitioner did not meet this requirement, one could simply
go find a U.S. citizen or green card holding friend of family member to file as a “joint sponsor” and all would be well. Public Charge:
the Changes Past Receipt of Public Assistance The
new foreign affairs manual (FAM) guidance says that a
consular officer may consider “past or current receipt of public assistance of any type” in
determining whether an applicant is likely to become a public charge, although officers must
make a determination based on the present circumstances. While this is intended to make sure that officers
consider the timing and circumstances of the public assistance, this discretion can also result in some officers
finding that anyone who has previously received public assistance is inadmissible on public
charge grounds. I-864 Affidavit of Support is no longer enough Where it used to be sufficient, the
affidavit of support is no longer enough. The updated FAM says that a “properly filed and sufficient, non-fraudulent” Affidavit of
Support by itself may not satisfy the INA 212(a)(4) public charge requirement. Now, the I-864 is only considered to be one factor in
the totality of the circumstances. The things a consular officer can consider include (a) age, (b) health, (c) family status, (d) assets,
resources, financial status, and (e) education and skills. In the end, its up to the officer’s discretion to determine if someone is
inadmissible or not, instead of simply comparing numbers on the I-864 and its supporting documents. What We’re Seeing We’re
already beginning to see an increase in denials on public charge grounds, especially out of Ciudad Juarez
(CDJ), which processes all of the immigrant visas in Mexico. Denying a case on public charge grounds also
revokes any approval of an I-601A, which is a huge detriment to applicants because it becomes
wasted months, time, and money. It also means that immigrants who are denied on public
charge grounds need to file a waiver of inadmissibility outside the United States, and the
current processing times are over a year. This could prove to tear families apart and unduly
burden hardworking Americans who need their loved ones in the U.S.
Form I-864 Turn
Form I-864 to prove applicants meet public charge restrictions adds delay to
Williams Law 16 (Dylan Williams Law LLC, 5/28/16, “Immigrant Visa Process: Delays and
Delays and Setbacks Backlog in the Preference Categories The priority date marks the applicant’s
place in the visa queue. In family-sponsored, preference categories, the priority date is the date USCIS received the Form I130, Petition for Alien Relative, or in certain cases, the Form I-360, Petition for Amerasian, Widow(er) or Special Immigrant. In
employment-based categories, the priority date is the date the Department of Labor (DOL) received the application for alien labor
certification or the date USCIS received the I-140 petition (if no alien labor certification is required). In certain cases, it’s the date
USCIS received the Form I-360 petition (EB-4, fourth preference category) or the Form I-526, Immigrant Petition by Alien
Entrepreneur (EB-5, fifth preference category). In October 2015, the Department of State made changes to the monthly Visa Bulletin
so there are now two different dates to track: the Application Final Action Dates (AFAD) and the Dates for Filing Applications (DFA).
AFADs are the cut-off dates that determine when an immigrant visa becomes available. If your priority date is earlier than the cut-off
date in the AFAD chart, or the AFAD is “current” (“C”) for the preference category and country of chargeabilty, you may receive an
immigrant visa following completion of the application process. DFAs are the cut-off dates that determine when the applicant should
receive instructions from the NVC to submit documents for consular processing. When your priority date is earlier than the cut-off
date in the DFA chart, you may submit required documents to the NVC, following receipt of instructions to do so. When demand
exceeds supply of visas for a given year in a given category or country, a visa backlog forms. It usually takes several years for a visa to
become available. In the F4 (brother or sister of adult U.S. citizen) category, for example, the wait for a visa to become available is
usually 10+ years. Challenges with Submitting Required Forms and Documents At the appropriate time, the
NVC will send
instructions to the visa applicant to pay the appropriate fees: Form DS-260, online immigrant visa application
fee, and Form I-864, Affidavit of Support fee (in all family-based immigration cases and in certain employment-based
immigration cases). After the fees are paid, the NVC will request the visa applicant to submit the
required documents, including DS-260 application form and civil documents (e.g. birth certificate, police certificate, and
photocopy of valid passport biographic data page). Visa applicants must also submit a Form I-864 and
supporting financial documents proving they will not become a public charge to the U.S.
government (in all family-based immigration cases, and in certain employment-based
immigration cases where a U.S. citizen or permanent resident relative filed the Form I-140
petition or where such a relative has a significant ownership interest in the entity that filed the
petition). The NVC will issue a Request for Evidence if the visa applicant fails to submit all the
required documents, such as his birth certificate, police certificate, and Form I-864 with
supporting financial evidence.
Physicals Turn
Public charge restrictions require physicals which add to the delay and backlog
Morales nd (Jeanne Morales, JD from Texas Tech, immigration attorney, not dated,
“Renewing Green Cards”,
Jeanne Morales: With
most things that we submit to the government, there’s no firm timeline.
There’s a huge demand for these types of things, depending on which service center. The
government splits the work between different centers in the United States. They all have different processing times. The only thing
that does have a deadline is a work permit. Those have to be processed in 90 days. Other than that, the processing can take 90 days
to nine months. It
depends on what’s going on with the backlog. If there’s anything wrong with your
situation, if since the last time you renewed your green card, you’ve gotten a criminal record or
something like that, will cause a delay for sure. Sometimes the delay is just a backlog. Initial Physical
Interviewer: Does a person have to submit to any sort of tests, like medical tests? Jeanne Morales: To get the initial green
card you, as part of the process, you’ll have to get an immigrant physical. There are two main goals in
requiring the immigrant physical. 1) Is to make sure you have all necessary inoculations and you are not currently contagious with
something like tuberculosis or things like that. You only have to do complete the physical once, when you first get your green card.
2) As part of the initial process, the
person sponsoring you has to file some paperwork showing that the
household has sufficient income to insure that you won’t become a public charge. There are
documents about income and tax returns that your sponsor must file in order to prove to the
government that you’re not going to enter the United States, then immediately go on welfare.
AT: Crime DA
The neg’s internal link is morally and statistically wrong—immigrants are less
likely to commit crimes than native citizens—their crisis rhetoric replicates the
same xenophobic rhetoric which was employed to exclude immigrants on the
basis on mental health
Moore 17 (Andrew F. Moore, associate professor of law at the University of Detroit Mercy School of Law, Lexis
Nexis, “The Immigration Paradox: Protecting Immigrants Through Better Mental Health Care,” V. Ways to Address the
Problem, 2017, pg. 12-13)//jy
V. Ways to Address the Problem The main challenge to advocating for expanded access to mental health care for immigrants comes in the age-old
framing of the issue as one of unworthy immigrants draining national resources. n309 For
opponents of increased expenditures
for mental health, the removal statistics above only strengthen the argument for having a more aggressive
removal system. n310 Their belief is that immigrants are more likely to be dependent and commit
crimes that disrupt the fabric of our society. n311 The reasons for these misperceptions stretch
back to the beginnings of this country and reappear with particular force at particular times. n312 [*113] It is a bitter irony that
professional psychological studies show exactly the opposite of the above assumptions. n313
Immigrants arrive in the United States with stronger mental health statistics and a lower-thanaverage manifestation of mental problems and substance abuse problems. Their mental health and
substance abuse problems increase the longer they are in the United States. n314 Likewise, the perceptions about criminality are
contradicted by voluminous data showing that crime does not increase with immigrant
concentration and, overall, the crime rate among immigrants is lower than among native-born
Americans. n315 There are plenty of sources attempting to strengthen these misperceptions, n316 including the Trump administration's efforts
at portraying immigrant crime as particularly bad by directing the U.S. Department of Homeland Security to post anecdotal numbers on the crimes
committed by immigrants. n317 There is also a tragic loop of consequences. As noted in the psychological studies, immigrants
are less
likely to turn to mental health assistance for a variety of reason, including the fear that it [*114]
will be used against them in the immigration system. n318 At the same time, immigrants are perceived as having a
greater reliance on public support programs that would include mental health care. n319 Untreated issues result in behavior that
reinforces misperceptions about immigrants, promoting the belief that they commit more
crimes. n320 Immigration law's emphasis on low-level offenses such as drug possession completes the cycle by requiring their removal. n32
AT: Ks
Political engagement is necessary and can create effective legal change – being
critical of squo government policy is different from becoming part of the
Block et al. 15, Pamela - Professor and Director of the Concentration in Disability Studies for the Ph.D. Program in Health
and Rehabilitation Sciences “Occupying Disability: Critical Approaches to Community, Justice, and Decolonizing Disability” Pg. 59-60
The question then arises how
do we create a culture of equality for people who have some
disadvantage in life? We start at the beginning and to make sure people are included in the
initial concepts of policy development not just at the final process. Organizations must have the
common thread of involvement & engagement embedded within all aspects of the institution or
government body, where from the Chief Executive Officer and chairperson to the front line staff all have a passion and drive
for inclusion. Making sure it’s real, not just a shiny publication that looks great, but sits on the shelf gathering dust. This is a job
for everyone and the culture may need to shift which can be very challenging for individuals and
organizations as a whole, but can be made real if the drive for change is apparent. To give an
example, a mental health trust had a historical lack of involvement and procedures in engaging
with its users and carers. A new CEO and Chairman on the board both had a real commitment to
turn this around. They considered the need for a user and career council in which the trust would invest. This was not
only set up, but from it a sense of culture change was apparent which was fed down to all areas
of the trust. It was not without its issues but gave a real voice to people who were not only
isolated but their illness meant their health fluctuated and found it challenging to engage. So
both culture and investment were initiated by key people within the organization. People are the experts not only in their own
disability or health issues, and also know what is needed to create an environment in which they would feel happy to contribute to
debate, policy, and service reform. Many
of these aspects are not actually difficult to do and just need
some thought and reflection of making sure they users that are used by some organizations.
These may well have options such as being involved as a volunteer, making a small one off payment or indeed paying by invoice as
someone may be freelance or self-employed, down to making sure people have the taxi fare in cash to get to a venue. This may
seem very simple but in many organizations people have had to wait a month or more and go through the accounts system to
receive the £5 it cost for travel. While many organizations policies do not allow them to do this, some voluntary organizations can
give cash on the day. This comes down to organizations being more flexible. While
accounting systems may be
complex and have to follow national legislation and guidance, if the will is there it can be
managed and changed. Of course engaging experts by experience to deliver training within organizations around inclusion
and equality is the gold standard and many examples of this have been found. One very interesting case involves a NHS trust who
had some involvement but a was long way from best practice. By creating new policies for people to be involved with the induction
process for new staff, training teams, being part of the training of health professionals it created, if but slowly, a culture where staff
expected input by the ex/users of the service. When given a lecture by a mixture of presenters they said it was in fact the users’ talk
which provided the most powerful and thought provoking stories and gave them better understanding of the issues people really
face. Top ten tips for inclusion and collaboration I believe are: Involvement from the start of any research (ideally). Creating an equal
platform with users and academics/managers. Clear and robust induction. Getting the communication right. Getting the payment
systems correct before you start. Creating a team that works- regular team meetings and development- collaboration is key.
Addressing issues as you go and not leaving to fester. Academics & Managers letting go a bit more. Service users/researchers being
able to adapt and not expect everything will go right. Being open and transparent. So its takes drive and a willingness to create the
procedures and policy to develop the inclusive and supporting environment people must have to be able to contribute effectively
and to sustain this engagement. Individuals
need to feel that they are not just a tick in a box and that
their involvement will make a real difference. This applies to everyone in the health and social care setting whether
social workers or occupational therapists to clinical psychiatrists to managers and chief executives. Everyone has a part to play in the
creation of a system that automatically refers and includes the users of services. The more we do this the more it becomes ingrained
in the culture of organizations and individuals. With one caveat though, to make sure that continued development and drive for best
practice is carried out and not to become complacent. On
reflection, in my own personal experience these
initiatives can work and people can influence policy. Why should we have to resort to marching
down the streets and demonstrations to get heard or our views across? While this may be of
use when pushed into a corner and indeed long term radical action may be needed to actually
change for the better, we should not have to do this. Making sure people are seated at the
table and are included in discussions, and people listen and create action that individuals can
see actually happening is vital. We also must remember the fine line we tread when dealing with
government policy- while we need to be a critical friend we do not cross the line to become just
another part of the establishment. Having the independence is a critical feature in all this potential change. I have seen
people and organizations that start off with the best intentions but then get absorbed in the system and then their credibility is lost.
For my own personal journey I have come across many negative attitudes and stone walls which needed knocking down. Saying this,
those organizations
and individuals who actually engaged and went beyond their roles to create
the positive change made such a difference. Recovery can also be a part of this process if implemented in the right
way and helps with healing and management of health conditions. There is a huge resource of people out there who have gained
experiential knowledge of their own health and disability. Make
sure that the core part of any policy and
practice is to involve and engage these people in order to develop the core needs of health professionals’ research
projects and training. Not everyone will want to be involved but give them the choice and they will take you from textbook theory to
real life and beyond.
A focus on epistemology is infinitely regressive and prevents reorientation
towards a democratic community—pragmatism is a prerequisite to an effective
politics of difference
Danforth 6 (Scot Danforth, Sage Journals, 11/1/6, “From Epistemology to Democracy: Pragmatism and the
Reorientation of Disability Research,” pg. 338-339)//jy
new opportunities for special educators would arise only after the field sets
aside the traditional search for an epistemological foundation. It may be that dropping the need for an
epistemological foundation will allow special educators to focus on creating community and building
solidarity across lines of disability and difference. Our identification with our community—our society,
our political tradition, our intellectual heritage—is heightened when we see this community as ours rather than
Nature’s, shaped rather than found. . . . In the end what matters is our loyalty to other human beings clinging together against the dark, not our
hope of getting things right. (Rorty, 1982, p. 166) Losing our epistemology, so to speak, could open doors for a
reorientation of the field away from philosophical foundations and toward democratic
community—away from an obsession with being right and toward the social hope of being
together. In this article, the American philosophy called pragmatism is offered as a way for special educators to constructively evade
the thorny epistemological question in order to simultaneously seek ends that are both practical
and democratic. Guided by pragmatism, special educators can eschew epistemological quagmires in favor of
seeking practical solutions to problems confronting students, families, teachers, and schools. Armed with diligence, hope, and
thoughtfulness, pragmatic special educators can work to create inclusive democratic communities of equality and
respect. Drawing from pragmatism, this article traces an initial, constructive reorientation of the field of special education away from the impractical quest for
Pressing the argument a step further, it is possible that
philosophical bedrock and toward the ambitious challenge of creating liberal democratic communities. This article concludes with a series of concrete proposals for the field of
disability research in light of this reorientation. These limited proposals do not exhaust the possibilities of pragmatism or democratic experimentation. They are offered in the
spirit of encouraging a diverse, ongoing conversation about how educators might create communities that are more democratic and supportive to all persons without reliance
With great frequency and passion, special education researchers have returned
to the same philosophical conundrum. Over the past 3 decades, special education researchers have supplied a steady stream of arguments
on an epistemological anchor.
supporting a variety of philosophies of social inquiry (Danforth, 2001; Forness & Kavale, 1987; Gallagher, 1998; Gerber, 2001; Greenwood, 2001; Heward, 2003; Heshusius, 1982,
1984, 1988, 1989; Iano, 1986, 1987; Kauffman, 1999, 2002; Kavale & Mostert, 2003; Mostert & Kavale, 2001; Poplin, 1987, 1988; Sasso, 2001). Researchers have returned time
and again to debate philosophy of inquiry issues in the pages of disability research journals, repeatedly seeking to provide a firm philosophical foundation for special education
The fundamental problem in these many discussions concerns epistemology. Paul (2005, p. 329)
defined epistemology as the theory of knowledge, or the study of the nature of knowledge. Important questions focus on the nature of knowledge; the place of experience in
generating knowledge and the place of reason in doing so; relationships between knowledge and certainty and between knowledge and error; and the changing forms of
knowledge that arise from new conceptualizations of the world. Guba (1990) described three primary epistemological positions (paradigms, in Kuhnian terms) in educational
research: postpositivism, critical theory, and constructivism. Paul (2005) went much further, detailing nine different perspectives on social research, each asserting and putting
into practice a different theory of knowledge. The many philosophical positions proposed by disability researchers address the central epistemological question, “What counts as
knowledge?” This epistemological question matters deeply in terms of the kinds of research and scholarship produced and valued—or not produced and not valued— in the
special education field. For example, epistemological positions taken by research journal editors and grant funding agencies have a profound influence on the nature of special
education knowledge, the social purposes of the profession, the accepted theories of disability, and the promulgated practices used by teachers. In recent years, editors at one
research journal have claimed positivism as the official epistemological posture of the journal (Kauffman & Brigham, 1999). Likewise, the U. S. Department of Education in the
current Bush administration has taken a “hard science” stance on what counts as knowledge, calling for experimental designs that are more common to medical research than to
educational inquiry. In sharp contrast, another journal editor made a public declaration of multiparadigmatic pluralism—an acceptance of research operating from many
theories of knowledge (Taylor, 2001). Each of these philosophical stances matters in terms of determining what forms of scholarship are elevated and privileged and what
The 3 decades of epistemological debates among disability researchers have been both
beneficial and redundant. On the beneficial side, frank discussions marked by openness and candor have
placed important issues, tensions, and disagreements on the table for all to consider. Researchers and practitioners alike have
genres are silenced and ignored.
been able to learn much about the values and beliefs that unite and divide the field, hopefully facilitating thoughtful discussions at many levels about
the purposes of special education research and practice. Paul (2002) stated that special educators should spend more time and effort becoming
educated about and discussing philosophy of inquiry issues in order to better comprehend the meaning of changes in social inquiry in the past 30 years.
Yet the persistent goal of securing a bedrock philosophical foundation for special education
knowledge has remained unfulfilled. Redundancy within the epistemological debate has become
evident as these published discussions have failed to forge a philosophical consensus—failed to
produce a superior epistemology for the field. The pattern of epistemological debate in the special education field bears
similarity to the tired redundancy of watching what Dewey (1969) once called “the weary treadmill which [philosophers]
pursue between sensation and thought, subject and object, mind and matter” (p. 6). The treadmill runs
repetitiously onward, spinning out theories of knowledge with no satisfactory resolution. The epistemologist’s problem is,
indeed, usually put as the question of how the subject can so far “transcend” itself as to get
valid assurance of the objective world. . . . The entire epistemological industry is one—shall I say it—of a Sisyphean nature.
(Dewey, 1976, p. 122) Like tortured Sisyphus pushing rocks up the hill, each epistemological articulation
tries to resolve the knowledge question by championing a supposedly superior theory of
knowledge—a more logically argued and rationally conceived definition of what kind of knowledge should be produced and privileged within
the field. Like the great philosophers Descartes, Hume, and Kant, special education researchers are unable to master the
epistemological question once and for all.
Progress Possible
Progress is possible – we can tackle ableism by first addressing the flawed logic
of the laws and social contexts in which it exists
Hirschman and Linker 15, Nancy - Professor of Politics at the University of Pennsylvania; her specialties are the
history of political thought, analytical philosophy, feminist theory, disability theory and Beth - Associate Professor at the University
of Pennsylvania in the Department of the History and Sociology of Science “Civil Disabilities” Disability, Citizenship, and Belonging: A
Critical Introduction pp. 4-5//mr
To begin with, it is always important to note that neither
citizenship nor disability is a static or universal
concept. Readers new to disability will find a variety of definitions in any number of texts, ranging from the United Nations
Convention on the Rights of Persons with Disabilities to activist websites to articles and books in a wide variety of academic
disciplines. Th authors of the essays in the present volume consider different specific instances of physical and intellectual disability,
such as mobility impairment, blindness, deafness, tuberculosis, and cognitive and psychological impairment. So offering one
overarching understanding of the concept may not be appropriate, and most of the essays here do not
define what they mean by the term “disability.” But all the authors— and indeed most disability scholars— subscribe to at least
some form of the
“social model of disability.”11 For readers new to disability studies, this model holds that
disability is not a physical condition pertaining to a “defective” or “inferior” or “abnormal” body
but rather a social condition brought about by social norms, practices, and beliefs; it is both
socially produced and socially experienced. What makes something a disability is thus not bodily
difference per se— not my impaired vision, or my deafness, or my weak or missing limbs, or my autism— but rather the social
contexts in which they exist; disability is constituted by the interaction between environmental factors and the
particularities of specific bodies. The fact that I have difficulty walking and use a wheelchair, for instance, does not in itself constitute
a “disability”: rather, the fact that most buildings have stairs rather than ramps and lack elevators and automatic doors is what
disables my body from gaining access to the building. Because of
the ways in which social relations, the built
environment, laws, customs, and practices are structured and organized, certain bodies are
disabled by those environments, while other bodies are facilitated and supported. “Impairment” is a term that
refers to a natural part of biological life rather than an “abnormal” part and is generally incorporated into a person’s sense of self.
“Disability,” by contrast, refers
to what society, social conditions, prejudices, biases, and the built
environment have produced by treating certain impairments as marks of inferiority. As Disability,
Citizenship, and Belonging 5 Devlin and Pothier put it, “Disability is not just an individual impairment but a systematically enforced
pattern of exclusion.”12 “Disability” does not describe the body per se, but the body in a hostile social environment. Among
disability studies scholars, the
social model has been an important corrective to the more dominant
way of understanding disability, dubbed the “medical model,” which views disability as a
pathology found in a particular individual body that must be fixed or cured. Disability in this
model is seen as both intrinsic to the body that “suffers” from it, which must be made to adapt to the
preexisting environment; and simultaneously alien to the body, a hostile force that undermines the individual’s
true preferences. “The body” that is held up as the standard against which it is measured is what feminist disability scholar
Rosemarie Garland Thomson calls the “normate”— male, white, perfect in health and physical attributes, a standard that almost
everyone fails to meet but nevertheless informs our assumptions about the body and how it should function in the world.13 Th e
terms “social” and “medical” models are referred to throughout these essays, so the reader who is new to disability studies will want
to keep this distinction in mind. For most disability scholars today, the social model is largely accepted as the preferred way of
understanding disability, whereas the medical model tends to be disparaged.
State Inevitable
The disability movement cannot choose between engaging inside or outside
institutions—the only coherent praxis is to work within civil society to change
state policies while also developing dynamic conceptions of disability and selfconsciousness
Oliver and Zarb 7 (Mike Oliver and Gerry Zarb, Mike Oliver is a disability rights activist and professor of Disability
Studies at the University of Greenwich, Gerry Zarb is a disability rights activist and author, The Politics of Disability: A
New Approach, 2/23/7, Taylor & Francis Online, pg. 234-236)//jy
But in order to
challenge what might be called attitudes (Finkelstein, Cornes), The Politics of Disability 2 3 5 mentality (Davis) or more
disability movement must work out an appropriate
political strategy. As has already been indicated, this cannot be done through traditional political
participation in parties or pressure groups, but has to be addressed in terms of the relationship
between the disability movement and the State, the second element within Gramsci's (1971) framework. The relationships
of these new social movements in general to the State have been considered in some detail and raise crucial issues of political strategy. If social
movements carry forward a revolt of civil society against the state-and thus remain largely
outside the bourgeois public sphere-they typically have failed to engage the state system as
part of a larger democratizing project. In the absence of a coherent approach to the state,
political strategy is rendered abstract and impotent. (Boggs, 1986, pp. 56-57) On the other hand, to
engage in an uncritical relationship to the State, is to risk at best, incorporation and absorption,
and at worst, isolation and marginalisation and perhaps, ultimately, oblivion. Leaving aside the question of
whether the State represents specific interests or is relatively autonomous, the disability movement has to decide how it
wishes such a relationship to develop. Should it settle for incorporation into State activities with
the prospect of piecemeal gains in social policy and legislation with the risks that
representations to political institutions will be ignored or manipulated? Or, should it remain
separate from the State and concentrate on consciousness-raising activities leading to long-term
changes in policy and practice and the empowerment of disabled people, with the attendant
risks that the movement may be marginalised or isolated? In practice it cannot be a matter of
choosing one or the other of these positions, for the disability movement must develop a
relationship with the State so that it can secure proper resources and play a role in changing
social policy and professional practice. On the other hand, it must remain independent of the
State to ensure that the changes that take place do not ultimately reflect the establishment view and reproduce
paternalistic and dependency-creating services, but are based upon changing and dynamic
conceptions of disability as articulated by disabled people themselves. Such is the nature of a crucial issue facing the
disability movement over the next few years and the complexities of the task should not be underestimated. In order, however , to develop an
appropriate relationship with the State, all new social movements, including the disability movement, must
establish a firm basis within civil society. The important point is that these movements, as emergent, broad-based agencies of
social change, are situated primarily within civil society rather than the conventional realm of pluralist democracy. Further, the tendency
toward convergence of some movements (for example, feminism and the peace movement) gives them a radical
potential for greater than the sum 2 3 6 M. Oliver & G. Zarb of particular groups. Even though their capacity to overthrow any
properly, in the context of this analysis, ideology, then clearly the
power structure is still minimal, they have begun to introduce a new language of critical discourse that departs profoundly from the theory and practice
of conventional politics. (Boggs, 1986, p. 22) Thus,
because these movements are developing within the separate sphere
of civil society, they do not risk incorporation into the State, nor indeed do they need to follow a
political agenda or strategy set by the State. Hence, they can engage in consciousness raising
activities, demonstrations, sit-ins and other forms of political activity within civil society.
Further, they can develop links with each other so that their potential as a whole is greater than
that of their constituent parts. Finally, the relationship to organised labour needs to be renegotiated, which means that labour will
have "to confront its own legacy of racism, sexism and national chauvinism" because the complex relationship between labour and social movements,
class and politics-not to mention the recomposition of the work force itselfinvalidates any scheme that assigns to labour a hegemonic or privileged role
in social transformation. (Boggs, 1986, p. 233) As far as the disability movement is concerned, its growth and development have been within the realm
of civil society. It has used consciousness and self-affirmation as a political tactic and has begun to be involved in political activities such as
demonstrations and sit-ins outside the realm of State political activities. By
reconceptualising disability as social restriction
or oppression, it has opened up the possibilities of collaborating or co-operating with other
socially restricted or oppressed groups.
Our affirmative is a prerequisite to their critical framework – only the aff can
interrogate and challenge the framework for broader systems of immigration
exclusion in the U.S., which sets the foundations for deconstructing unethical
Sekerci and Altiraifi, Kristin ‘18 (researcher on Islamophobia at Georgetown University and Azza – award
winning disabled Afro-Arab organizer based in Washington DC whose advocacy centers on radical inclusion and
access, racial and disability justice and collective deliberation “A U.S. Immigration History of White Supremacy and
Ableism” Al Jazeera
"[They] all have AIDS" - US President Donald Trump grumbled in June 2017. According to areport by the New York Times, this is how
the president reacted when he learned that around 15,000 Haitians received visas to enter the United States in 2017. After this
remark, and President
Trump's more recent "shithole" comments about immigration from African
and black-majority nations, there has been a great deal of commentary about the US' racist and
white supremacist immigration history. Glaringly absent from these analyses, however, has been
a robust understanding of the co-foundational framework for immigration exclusion in the US ableism. Namely, discourses and structures that have created a process and system by which
people have been banned based on real and perceived mental and physical disabilities, as well
as for prevailing notions of inferiority, deviancy, threat and unproductivity . Immigration policy in the
US currently consists of Muslim bans, a DACA rescission , severe restrictions on refugee resettlement, calls for "extreme" or
"enhanced" vetting, and ongoing threats to Temporary Protected Statuses, the Diversity Visa programme, and family-based
immigration. In the not-so-distant past, let us remember, US immigration policy included the "war on terror"
screening programme National Security Entry-Exit Registration System (2002 - 2016), HIV+ and AIDS travel and immigration bans
(1987 - 2009), the "Asiatic Barred Zone" (1917 - 1952), a ban on Chinese nationality (1882 - 1943), and bans on
the "idiot",
the "imbecile", the "feeble-minded" and the "pervert" (19th - 20th century). And, of course, this country's
horrific proto-immigration laws - the colonisation and genocide of Native people and exterminationist
policies of "Indian removal" (1492 - present); and the enslavement and forced migration of African
people and their descendants into lifelong chattel slavery (15th - 19th century). Underpinning many of these
immigration and proto-immigration laws has been a formulation by which value and therefore
worth are ascribed to people based solely on their ability to accelerate economic growth for
the state. But let's take that one step further. The notion that some people produce more (or less) for the
economy and are, therefore, more (or less) valuable - is ableism. Disability justice activist and educator Lydia
X Z Brown defines ableism as "oppression, prejudice, stereotyping, or discrimination against disabled people on the basis of actual or
presumed disability". Furthermore, Brown argues, ableism is "the belief that people are superior or inferior, have better quality of
life, or have lives more valuable or worth living on the basis of actual or perceived disability." Unsurprisingly, undergirding
many US immigration laws, for instance, are theories of "scientific" racism and eugenics - namely,
on ideas of racial superiority/inferiority, gendered, sexual and psychopathic deviancy, and
prevailing notions of "common sense" racism. Such arguments construct a knowledge system
that ties the worth of people to their productivity and proximity to normative constructions of
whiteness. To be sure, then, ableism is part and parcel of white supremacy. According to critical race theorist
Frances Lee Ansley, white supremacy is "a political, economic and cultural system in which whites overwhelmingly control power
and material resources." Furthermore, according to Robin DiAngelo, a scholar of Whiteness Studies, white supremacy defines white
people "as the norm or standard for human, and people of colour as an inherent deviation from that norm." Prior
to the
rescission of DACA by the Trump administration in September 2017, some proponents of the
policy argued against its repeal by framing the issue as one of economics. Myriad studies were cited to
demonstrate that DACA recipients benefit the economy (or, conversely, that deportation would be costly). Others
that this framing is dehumanising. For instance, in a New York Times op-ed , Masha Gessen discussed how the DACA
programme and even the Muslim bans were qualified through a cost/benefit analysis to the economy: " When the president threw
his support behind a reform plan that would drastically reduce immigration to this country, editorial writers argued against it by
pointing out that immigrants benefit the economy." Gessen makes an important point. And yet, some may wonder: What's so wrong
with keeping out immigrants who won't benefit the economy? Let's again return to Gessen: "If
immigration is debated
only in terms of whether it benefits the economy," she argues, "politicians begin to divide people
into two categories: 'valuable' and 'illegal.'" Furthermore, as DACA recipient Joel Sati explained in a Washington
Post op-ed, immigration policies that illegalise human beings require immigrants to "grovel for a
humanity that ought to be presupposed." In other words, immigration policy that links admissibility
to worth and productivity, and inadmissibility to illegality and threat, is an inherently
dehumanising (and ableist) process that prioritises economic profitability over human dignity. In
addition to the Muslim bans and the rescission of DACA, Republican Senators Tom Cotton and David Perdue in February 2017
proposed legislation, the Reforming American Immigration for Strong Employment (RAISE) Act , to drastically cut immigration and
refugee resettlement. In remarks in support of the proposed legislation, President Trump declared that the RAISE Act "will favour
applications who can speak English, financially support themselves and their families, and demonstrate skills that will contribute to
our economy." Like discussions around DACA, the RAISE Act ties immigration to the economy and regulates it with ableist discourse.
The proposed legislation does so by purporting to maximise economic profitability by drastically restricting immigration. Should this
legislation be enacted, the RAISE Act would join a long history of immigration law that has, to various degrees, "regulated"
immigration by weighing its costs or contributions against the financial well being of the economy-state. For
deemed unproductive, undesirable and/or dangerous, admission was denied. From 1882 to 1917,
various legislation codified into law numerous categories of perceived deviancy and divergence.
These ableist classifications, along with bans by nationality and geographic origin, have shaped
the legal basis for US immigration exclusion. For instance: The Immigration Act of 1882 prohibited entry to any
"lunatic, idiot, or any person unable to take care of himself or herself without becoming a public charge." The Alien Immigration
Act (1903) added for exclusion "insane persons, epileptics, and persons who have been insane within five years previous; persons
who have had two or more attacks of insanity at any time previously," among other categories. The Immigration Act of
1907 added "imbeciles" and "feeble-minded persons," people suffering from tuberculosis, and people "certified" by an immigration
official "as being mentally or physically defective," among other categories. The Immigration Act of 1917added people who
experienced just one "attack" of insanity (down from two in 1903), and people with "chronic alcoholism" and "constitutional
psychopathic inferiority," such as "moral imbeciles, pathological liars, many of the vagrants and cranks, and persons with abnormal
sex instincts". Also known as the Asiatic Barred Zone Act or the Literacy Test Act, this legislation barred immigration from much of
the continent of Asia (excluding Japan, eastern China and the Philippines), and islands off the coasts of the continent. It also
implemented a literacy test for the first time. This
long history of excluding immigrants on the basis of
perceived or real disabilities set the stage for another form of immigration exclusion:
immigration quotas on the basis of national origin. Enacted for the first time in the Immigration Act of 1924,
these quotas had the effect of severely limiting immigration from southern and Eastern Europe. Notably, southern and Eastern
Europeans did not fit the US racial formation of whiteness at the time. Moreover, ethnic groups from the
region, such as Italians ("dwarfish"), Jews ("very poor in physique ... the polar opposite of our pioneer breed"), Portuguese, Greeks
and Syrians ("undersized"), and Slavs ("slow-witted"), were
barred entry on the basis of their supposed
pathologies and their characterisation as "defective races". The Immigration and Nationality Act of 1990,
which established Temporary Protection Status and the Diversity Visa programmes, also finally lifted the ban on "sexual deviants",
which targeted LGBTQIA+ people. In 2009, the ban on US immigration for HIV+ individuals was finally lifted, after being in place for
22 years. This
discriminatory law disproportionately targeted LGBTQIA+ immigrants and stifled
research into HIV and AIDS treatment. Let us here recall President Trump's comments that Haitians "all have AIDS",
which, incidentally, was reported on just a few weeks after the administration's decision to terminate TPS protections for Haitians.
Numerous immigration laws to this day continue to target and violate the rights of disabled
persons by subjecting them to invasive mental and physical examinations. Whether assessed as
likely to become a public charge (therefore tying their value to their ability to produce), or a threat
to persons and property (potentially a burden of the state through carceral institutions), disabled people who apply for
immigration to the US face numerous obstacles to admission. Furthermore, these discriminatory policies do
not simply end at the border. Undocumented immigrants in the US who are mentally disabled make up about 15 percent of those in
immigration detention. Abuse
is rampant and unjust deportations occur often, as the immigration
system does not guarantee an individual's right to due process protections that are afforded to
criminal defendants. The history of immigration to the US has ensured the fundamental quality
of the country as a white supremacist-capitalist state, "protected" from an influx of disabled and
"deviant" people designated as either threats or burdens. The state's economic power rests on
the perpetual existence of a large labour force that can produce at low costs. This is a process
that renders disabled individuals, and particularly black, native, brown, Asian, Muslim, queer
and other multiply marginalised disabled individuals, as inherently disposable. It is a system that
justifies, even celebrates, the banning of people deemed unable to "produce", "add value" or who might threaten the economystate as a result of perceived inferiorities, deficits and deviancies. So, the next time arguments surrounding immigration policy are
couched within a cost/benefit economic analysis, remember that these are ableist arguments made in order to determine who can
produce and therefore whose lives are worthwhile. Furthermore, bear in mind that analyses of
immigration history
that address policies solely through a framework of racism are incomplete. Indeed, ableism is a
foundational framework, along with white supremacy, that has shaped, and continues to inform, US
immigration policy.
The neg’s framework is fatalistic and results in policy paralysis—while not
perfect, the political project of self-advocacy has not been completed—it’s
try/die for participation in political arenas to reposition people with disabilities
in a neoliberal society
Dowse 9 (Leanne Dowse, “’Some people are never going to be able to do that.’ Challenges for people with
intellectual disability in the 21st century,” Disability & Society, 7/22/9, pg. 573-574)//jy
The emphasis on the achievement of individual independence and productivity precipitated by
globalisation and embedded in neo-liberalism effectively renders people with intellectual
disability, who are often unable to attain self-sustainability, problematic. The new technologies of welfare are
economically driven and actively directed toward investing in the individual pursuit of
independence, framing inclusion in terms of productivity and contribution, rather than selffulfilment or quality of life. This has differential impacts on the range of people with intellectual disability, including those who are able
to participate in the employment market and those with high support needs who will not be part of the labour market. Cognitive limitations
and prescribed incompetence deem at least some people with intellectual disability to be
inadequate choice makers. This deficit approach presumes an incapacity to reason and results in
the relinquishing of claims for justice, where equality and rights become constrained or redirected (Wasserman
2001). Perceived as unable to achieve independence, such people are then seemingly relegated to dependency
relationships where they are likely to be continuously placed under protective moral
custodianship whereby their ‘best interests’ are determined by more competent others. Protections
which set out who can take decisions on behalf of another, under what circumstances and how this may be done are exemplified in statutory
frameworks such as the UK mental capacity Act 2005 or the range of state-based guardianship legislation in the Australian context. While
operating at one level to protect individuals with intellectual disability, these frameworks also
contain the risk that participation in the public arena may be restricted, denied or exempt.
Developments in social policy over the past half century have made progress towards improving the material conditions of people with intellectual
disability by giving them access to more ‘normal’ or ‘better quality’ lives. Some
approaches have also recognised, in part,
the political agency of people with intellectual disability. The political project of self-advocacy
has, over the past 30 years, worked to cultivate the voices and knowledges of people with
intellectual disability. Access to recognition, legitimacy and participation in the political arenas
where issues to do with their social management are debated continues to be complex for
people with intellectual disability as a collective. A focus on the support of this representation
must be a fundamental underpinning to the repositioning of people with intellectual disability
in a globalised world.
AT: Neolib
AT: Root Cause - Neolib
Reject totalizing root cause claims – ableism has been shaped by aesthetics,
cultural norms, and history just as much as economic factors – purely structural
analysis neglects the nuances of everyday reality of those with disabilities
Patterson and Hughes 10, Kevin - School of Science, Glasgow and Bill - awarded a BA (Hons) in sociology (1st Class)
from the University of Stirling in 1979 and a PhD in political philosophy from the University of Aberdeen in 1985 “Disability Studies
and Phenomenology: The Carnal Politics of Everyday Life” School of Social Science, Glasgow Caledonian University, City Campus
Taylor and Francis Ltd.//mr
The discipline of sociology has consistently failed to regard disability as a subject
deserving serious examination in its own right. The hope that the sociology of the body would present a more
adequate account of disability than medical sociology has not been realized (Shakespeare & Watson, 1995a; Abberley, 1997). Such
intellectual neglect is yet another manifestation of exclusion, another manifestation of
disablism. For example. Turner (1992) argues that a phenomenology of the body or `embodiment’ is of particular importance in
that it provides sociologists with a sensitive and sophisticated perspective on issues such as pain, disability and death. It might
reasonably be expected from this argument that the `disabled body’ (or, rather, the impaired body) would be central to any
theoretical and conceptual innovations (Oliver, 1996b). Unfortunately, Turner’s analysis relies upon a medicalised and individualised
understanding of disability. Given this intellectual context, engagement between disability studies and the sociology of the body is
confounded by theoretical and political tensions. Nevertheless, it
is possible to tread a path that challenges
the disablism of the sociology of the body on the one hand, while utilising
phenomenology to overcome the social model’s disembodied view of disability on the
other. We would also argue that an embodied view of disability can provide a basis for a
sociology of impairment. It should be noted that impairment, in discussions of disability as social oppression, has not
been completely absent. Finkelstein argues (1980) that the concept of disability assumes a relationship
between impairment and social structure, and Abberley (1987) argues that a social theory of
disability must recognise, even emphasise the social origin of impairment. This standpoint,
however, seems to possess only rhetorical value. It is based on a view of the social and the biological as binary opposites in the
typical mould of Enlightenment thought. The problem with this dualistic position is that it requires the social model to embrace a
disembodied view of disability and an asocial view of impairment. Abberley’s consideration of impairment is very much a precursor
to Oliver’s (1990) position, in which the social origin of impairment is acknowledged by way of a structuralist account and then set
aside as non-problematic. This approach seals the social model’s distinction between impairment and disability. In response to the
charge that disability studies presents a disembodied view of disability, Oliver has been keen to acknowledge Abberley’s assertion
that a social theory of disability must take impairment into account However, while Oliver (1996a)
recognises there may be a need for a `social model of impairment’, he clearly has strong reservations about it and would prefer to
distance himself from such a project. As a response to the (re)introduction of impairment into disability studies, Finkelstein’s ideas
(1996) have been rather doctrinaire. He sees important differences between the contemporary politics of disability and the more
palpable radicalism of the 1980s. Originally,
disabled people concentrated on challenging the
disabling barriers in the `world outside’, rather than exploring the attitudes and
emotions that came from experiencing discrimination. The focus of attention was
`outside in’, rather than `inside out’. Since then, in Finkelstein’s view, disabled academics and
researchers have `hijacked’ the disability movement’s agenda to serve their own
priorities, replacing the active vision with passive theoretical abstractions. The elevation
of the importance of personal, psychological experience has led to what Finkelstein believes is now
a clear split in the disability movement between two social models of disability - an active
one (outside in) and a passive one (inside out). Yet radical politics - whatever its specific content - is in a process of turmoil and
reorientation. The Marxist certainties of the past have given way to post-Marxism and post-modernity, to a context in which politics
spills into culture, if not amorphousness. Where Finkelstein sees reaction one might just as easily see realignment. The
reliance on Cartesian modes of thinking about impairment and disability ignores the fact
that the somatic society has dissolved the modernist separation of the body from
politics. The body is not a passive component in politics. It may well be shaped by
social relationships, but it also actively contributes to the shape that they take. In this
context there is no dualistic outside/in or inside/out models of emancipation. Politics
today, is as much about aesthetics (formed and forming bodies) as it is about economic and
public life. The assortment of `Pride movements’ - Black, gay, disability - are all forms of
a politics of proprioception; a contemporary politics of bodies, in which aesthetic, as
well as political and economic, tyrannies are deconstructed by excluded groups (Hughes &
Paterson, 1997). They `work’ simultaneously on the inside and the outside. Their project is transformation of self
and society, a declaration of self respect which is, a challenge to prejudice and
oppression. The politics of `outside in’- the `standard’ politics of the disability
movement - have tended to stay `outside’ and never get `in’. To argue that the impaired body has
disappeared from disability studies does not register a failure to recognize a whole body of work where disabled people have
discussed their experience of impairment (see, for example, Campling, 1981; Oliver et al., 1988; Morris, 1989; Hales, 1996). Yet
within disability studies, the term `body’ tends to be used without much sense of bodiliness as if the body were little more than flesh
and bones. This tendency carries the danger of objectifying bodies as things devoid of intentionality and intersubjectivity (Csordas,
1994). Such
tendencies miss `the opportunity to add sentience and sensibility to our
notions of self and person, and to insert an added dimension of materiality to our
notions of culture and history’ (Csordas, 1994, p. 4), A sociology of impairment that is
phenomenological would facilitate the scholarly task of illustrating that the impaired
body has a history and is as much a cultural phenomenon as it is a biological entity. It
would offer disability studies the opportunity to formulate theories of culture, self and
experience, with the body at the centre of its analysis. Much of the work which features disabled people
talking about their bodies is done within interactionist perspectives. Such approaches have been criticized for offering mere
descriptions of the discrimination faced by disabled people, rather than examining the conditions which produce their experience of
oppression (Finkelstein, 1980; Abberley, 1987, 1993). However, just as interactionist perspectives can be criticized for their microanalysis of disability at the expense of any macro analysis, the converse can be said of disability studies’ approach to understanding
disability. It suggests that research should be concerned with spotlighting the ways in which society disables people with
impairments rather than the effects on individuals (Oliver, 1992, Zarb, 1992). Here,
the everyday reality of lived
experience is neglected in favour of a purely structural analysis of disability (Shakespeare, in
Shakespeare & Watson, 1995b). Indeed, the critique of interactionism from the perspective of the social model of disability (Oliver,
1990) is limited by its structuralist fixation. Abberley (1987) recognizes that any systematic study of the importance of the body in
Western society has been absent (with the exception of feminist literature) until recently. `For
disabled people the
body is the site of oppression, both in form, and in what is done with it’ (Abberley, 1987, p. 14).
The impaired body is depicted here as a passive recipient of social forces. But what about the body as agency and activity? As Imrie
(1996, p. 145) points out, disabled people are `not merely passive recipients of the built environment, but actively seek to challenge
and change it.’ New
social movements are moving away from theoretical perspectives which
regard the body as a thing subjected to forces in which it has no formative role (Lyon &
Barbalet, 1994). Disability studies must also address the fundamental issue of bodily agency. As Crossley (1995, p. 60) states, `To be
a body is to be both a locus of action and a focus of power.’
Disability is not simply reducible to a set of social and economic conditions –
ableism is also rooted in a construction of the “Other” and biological
Hughes 99, Bill- awarded a BA (Hons) in sociology (1st Class) from the University of Stirling in 1979 and a PhD in political
philosophy from the University of Aberdeen in 1985 The Constitution of Impairment: Modernity and the aesthetic of oppression,
Disability & Society, 14:2, 155-172//mr
The social model of disability is largely a product of the critique of capitalism (Oliver, 1990). It
is, however, largely neglectful of the critique of modernity. In this paper, I want to suggest that this neglect restricts the
analytical power and `reach’ of disability studies: in particular, it confounds the
possibility of developing a social theory of impairment which is largely dependent on
escape from the confines of Cartesian categories. I am not suggesting that the social model of
disability embrace post-modernism. I am, however, suggesting that it should adopt a strategy of
epistemological pragmatism (Turner, 1992) which includes the priority of setting aside its
own conceptual imperatives, if and when, alternative perspectives can help to
illuminate the forms of oppression and discrimination that characterise the lives of
disabled people. A more, shall we say, `aesthetic view’ of the value and nature of social
theory is required. Pragmatism and perspectivism may not fit the Marxist hue of the
social model, but in the epistemological crisis which marks the contemporary world
and obliges new social movements to interrogate the very foundations of
emancipatory politics: there is little value in epistemocracy. This position is of particular importance
with respect to the current debate within disability studies about the relevance of impairment and the body, the neglect of which
has been a feature of the social model (Hughes & Paterson, 1997). The body has become central to contemporary social and
philosophical thought (Turner, 1996; Lowe, 1995; Shilling, 1993; Synnott, 1993) and its exclusion to date is usually related to the
modernist and enlightenment preoccupation with the ontological supremacy of reason and cognition. Critiques of modernity, which
often thrive in counter-enlightenment examinations of the body as a social construct have had little impact on the social model of
disability. Consequently, impairment,
in the social model, is usually conceived in naturalistic and
essentialist terms as a pre-social given. This cuts off theoretical access to what Terry Eagleton
(1990, p. 13) has called `the aesthetic’ ; that `which takes root in the gaze and the guts and all
that arises from our most banal, biological insertion into the world’ . In particular, it divorces the
social model of disability from developments in the sociology of the body, from issues of carnality, intercorporeality, perception and
the senses which, I will argue, could have a profound bearing on the transformation of impairment [1] from a reactionary to an
emancipatory concept. An
application of the critique of the `visual culture’ (Jenks, 1995) which
constitutes the contemporary form of the `scopic regime’ (Jay, 1994; Jay & Bannan; 1996) of
modernity can unpack the social constitution of impairment as a category which
denotes negativity and invalidation. The oppressiveness of what Sartre (1958), long before Foucault (1973), called
`le regard’ (the gaze) is part, for sure, of the experience of impairment but it is also constitutive of it. In short, in this paper, I want to
examine - with respect to impairment- the ways in which vision is disfiguring. This is predicated on the challenge to the neutrality of
vision which is developing through a critical sociology of the senses and the epistemological uncertainties of the contemporary
world. As Jenks (1995, p. 12) argues: The senses have, through modernity, become in fiated indicators of the real, but none more so
than vision. As a direct consequence of this elevation, the
staring optics of humankind act as the final
arbiters of truth, beauty, desire and goodness. Modernity has a particularly pervasive
capacity to produce strangers; people, that is, who disturb its fragile `cognitive, moral
and aesthetic’ boundaries and challenge its rather overbearing sense of order . The
stranger is constructed by the limits of tolerance and conformity, and by the tendency
of modernity to homogenize and annihilate the differences it invariably produces. These
limits are constituted in both perception - through the gaze - and in discourse [2]. Furthermore, the modern disciplines
(including sociology) are, themselves, key players in this game of exclusion (Bauman, 1997). The stranger
is conceived as a threat. She is produced by the categorising and normalising
propensities of knowledge (Foucault, 1973), and either condemned to `pass as normal’ (Goffman, 1978) or wither in
`total institutions’ (Goffman, 1968); in the, `cities of the damned’ which became the modern equivalent of leprosaria. This
generic construction/treatment of the stranger in modernity can easily be applied
specifically to disabled people. Anthropophagic (or assimilationist) and anthropoemic (or
exclusionary) strategies (Bauman, 1997) have been applied to disabled people throughout the
modern period. Segregationist policies were an example of the latter, while community
care was an example of the former, and both hinge upon the gaze that composes
impairment as disorder. To cast out or to remake in the image of normality are the two extremes (of policy response)
that characterise modernity. These strategies are not the product of observational or perceptual indifference and objectivity, but the
outcome of a powerful `will to order’ in which the perception of impairment is continuously constituted and reconstituted in terms
of invalidation. To
be impaired is to be perceived as invalid, to be seen to be anomalous or
contrary to order: Every preference for a possible order is accompanied, most often
implicitly, by the aversion for the opposite order. That which diverges from the
preferable in a given area of evaluation is not the indifferent but the repulsive or more
exactly, the repulsed, the detestable. (Canguilhem, 1991, p. 240.) This binary marking out of the world, first, in
the interests and `innocence’ of classification and then (inevitably) in the name of moral order, was a key feature of nineteenth
century positive sociology. Normality and abnormality, function and dysfunction were the master categories that provided sociology
with its window on the world. The gaze that sponsored the sociological imagination from Comte to Parsons is compelled to search
for `social pathology’ which `refers to maladjustments in social relationships’: an ocularcentric epistemological position which `is
based on the analogy of bodily maladjustment of function in the organ’ (Gillan & Blackmar, 1930, p. 24). For
sociology, the
medicalized body was an attractive way of making sense of the social body. The former
was a natural, organic object of analyzable, calculable, spatio-temporal forces and
motions, in which the normal and pathological competed for hegemony. In the context
of industrialization and urbanization and, more importantly, the `need’ - as Nietzsche might have
it- to constitute these new social phenomena in `regimes of truth’, positive sociology
developed a way of seeing which, like biomedicine itself, was normative and normalising
(Canguilhem, 1991). The `observations’ of nineteenth century medical science pathologised
and invalidated impairment. The capitalist economy, with its accent on labour power,
validated this invalidation (Finkelstein, 1980) and positive social science, by virtue of its disembodied
discourse of handicap and (in the twentieth century) its disablist concepts of the impairment and rehabilitation role (Oliver, 1996)
stamped the exclusion order. This suggests that the perceptual and discursive
constitution of impairment is important in the material construction of disabling
barriers. The impaired body is rendered disorderly (and thus repulsive and detestable)
by the `positive’ observational practices that produce it. The sociological fascination with strangers,
outsiders, pariahs, those existing on the margins of society is deeply rooted in the voyeuristic tradition of symbolic interactionism - a
species of theory and method that translates the Anglo-American, Liberal love of the underdog into a sociology of the
misunderstood. The many and fascinating ethno-texts, ground out by the judicious mix of observation and participation, produced
by the Chicago School were perceived as a challenge to these misunderstandings. This was, in itself, an anthropophagic strategy
guided by an ethic of liberal tolerance and founded methodologically on a gaze that was both visually penetrating and corporeally
active. In this tradition, impairment is a primary deviance and disability refers to the secondary processes in which it is amplified by
negative social reactions. Normative order (convention!) is treated uncritically as an empirical given - constituted by the vigilance
and lucidity of the gaze - and deviance derived from it. The
primacy of (albeit situational) conformity - that
which is seen to generally characterize social relationships - automatically confers
discredited status or otherness. The strangers are thus produced by observational
practice but re-presented (in the rhetoric of tolerance) as not so bad after all. However, their strangeness or their `social
deviance’ is never called into question (save in a situation where `their’ conventions are the modus operandi). The purity and
objectivity of the empirical gaze is never called into question. They ARE outsiders, but `we’ should exercise magnanimity and let
them in. The `we’ describes the source of the gaze, and also refers to a dominant social group and a comfortable social space - the
non-disabled, WASP heartland of western liberalism. Alterity, be it impairment or some other form of primary deviance, provokes a
charitable and tolerant disposition but it has already been constituted by an ocularcentric (Jay, 1994) scientific practice which is
blind to the discriminatory nature of its own vision
The negative’s totalizing theory pushes out any analysis of the role of
impairment and the eugenic gaze
Hughes 99, Bill- awarded a BA (Hons) in sociology (1st Class) from the University of Stirling in 1979 and a PhD in political
philosophy from the University of Aberdeen in 1985 The Constitution of Impairment: Modernity and the aesthetic of oppression,
Disability & Society, 14:2, 155-172//mr
This approach to the stranger ran out of steam in the 1970s, partly because it could not transcend the disablist language of stigma
and the process of labelling that it articulated and partly because some of the underdogs had decided to take matters into their own
hands. Disabled people, for example, recognised that they could articulate their viewpoint and perspective rather better than the
well meaning social scientists and disability experts who had hitherto taken up arms (or should it be alms) for them. Disabled
people, as Oliver (1990, p. 68) argues, have `preferred to reinterpret their collective experiences in
terms of structural notions of discrimination and oppression rather than interpersonal
ones of stigma and stigmatization’. Yet this is not only a paradigm or epistemic shift (which
changes the content of knowledge about disability). It is also a profound refusal to be constituted by the
vision of others. It is a refusal to accept the false lucidity and penetrating curiosity of the
gaze of the disciplines . It is a refusal to be objectified and invalidated by the abstract and external corporeality of the eye
of power. It marks the moment of the storming of the watchtower of modernity and the appropriation of the objectifying gaze.
The gaze is deflected, by disabled people, from impaired bodies to the social body
which, hitherto a model of innocence, is now identified as the source of disorder . It marks
the beginning of an assault on the `tyranny of perfection’ It is no accident that the rise of the Independent Living Movement and the
decline of labelling theory are historically co-terminous. Civil rights began to replace sociological civility. As the politics of disability
began to take shape, its own theory (after the fashion of the Owl of Minerva) followed. Disabled
people began to
argue that disability had to be conceived as a form of social oppression (UPIAS, 1976; Sutherland,
1981; Oliver, 1986). This suggests a perspectival shift; the re-visualisation of disability from the viewpoint of people with
impairments. As the intellectual expression of the social movement of disabled people, the social model of disability (Oliver, 1983)
proposed a theory of disability praxis and a materialist model of emancipation which validated and valorised the intellectual and
practical activity of disabled people themselves (Oliver, 1990). Patronage was no longer acceptable; the stranger - through collective
action - had discovered an autonomous point of view and set about the task of putting an end to the hegemony of the charitable
gaze of bourgeois paternalism- particularly, in its institutional forms. Disability
was no longer conceived as or
reduced to (as it had been in reactionary biomedical and naive sociological terms) a deficit of the body, but
reconceptualized as a product of social organization or, more specifically, as a
consequence of the social relationships of production in a capitalist society (Oliver, 1990).
However, the qualitative advances precipitated by the social model of disability and the radicalisation of disability studies have not
yet developed into epistemological diversity and an open-ended critique of modernity. The
`turn to culture’
characteristic of contemporary sociology is, however, beginning to boom within disability studies
(Hevey, 1992: Shakespeare, 1994; Barnes, 1996) and the new emphasis on (indeed, infatuation with) the body which has had a
profound effect on sociology and the human sciences are slowly becoming influential (Abberley; 1996: Shakespeare and Watson,
1995a,b,c). The
radical separation of impairment and disability in which the former is
regarded as pre-social and the latter socially produced is an axiom of the social model
and the theoretical source of its reluctance to articulate the social constitution of
impairment (Hughes & Paterson, 1997). One might argue that the epistemological, essentially historical materialist, roots of
the social model of disability have become something of an epistemocracy and a brake on its development. Indeed, the
contemporary epistemological crisis (post- modernity) might be faced more fruitfully by
theoretical pragmatism rather than retrenchment and repetition of first principles.
Disability studies needs to develop a radical sociology of impairment (in the context of a critique of
modernity) which can only benefit by engaging more fully with contemporary ideas about
culture and embodiment, and by adopting a more flexible attitude to anti-cartesian
theoretical traditions like phenomenology and post-structuralism (Hughes & Paterson, 1997), particularly where
they can be used to illustrate oppression and exclusion. The structuralist emphasis of
the social model of disability leaves it poorly placed to develop a sociological analysis of
impairment and the body. The model is dualistic since it draws a clear distinction between nature and the social, with
impairment consigned to the former domain and disability to the latter. While the production of disability, mapped out in the form
of excluded spaces, disabling barriers (Swain et al., 1993), institutional discrimination (Barnes, 1991) and oppressive social
relationships provides the theoretical core of the social model, its vision of the carnal, the lebenswelt and the role of impairment in
the constitution of oppression is limited by the very focus which makes it such a powerful tool of analysis. To analyse variations in
the cultural response to impairment (Barnes, 1996) from within the political economy perspective that characterises the social
model, provides a valuable contribution to the sociology of impairment but it tells us little about how the impaired body is
constituted as alterity and disorder, and therefore invalidated not through responses to it, but in the interpretive act of perception
that produces it. This suggests an appeal to an epistemological position that is essentially foreign to the social model of disability.
The social model does not problematise the senses. It does not problematise the visual .
It employs a correspondence theory of perception in which vision provides immediate access to the external world. Ideas or
mental representations are, thus, an exact reflection of reality or where Marxist realism
is employed to detect the structures and essences behind phenomenal form, ideas
become either scientific (true) or ideological (false). It is, however, this very form of knowing which
privileges the ocular and the specular as the roads to truth and assumes the innocence of perception which underpins the
constitution of impairment as invalidation. An
`aesthetic’ view of the production of knowledge
suggests that observational practices are not neutral. The lucidity of the eye is a myth. Perception and
vision are clouded by interpretation. Vision is a social practice which imposes itself on the field of vision. It is predicated upon a
culturally produced `scopic’ or `ocular regime’ which in modernity has been dominated by `cartesian perspectivalism’- a worldview
which is, itself, ocularcentric (Jay, 1994) since it proposes an unproblematic relationship between seeing and believing, voir and
savoir. But this relationship is problematic. It does not denote the only way to know. It is simply an attitude (the so called `natural
attitude’) to knowledge which is most clearly at work in the fetishism of scienti®c observation which grounds empiricism and
positivism. This plain view of reality is not the royal road to truth. It is, on the contrary, but one way of seeing; one which has,
indeed, dominated the modern era and exists in a precritical relationship to the social model of disability. In the next section, I will
focus on Sartre’s phenomenological ontology (1958), and draw less heavily on the post-structuralist critique of the gaze, in order to
illustrate the association between the constitution of impairment and the oppressiveness of ocularcentric modernity
Focusing solely on elimination of economic conditions leaves behind other
facets of disability and ignores the connection between impairment and
Hughes 99, Bill- awarded a BA (Hons) in sociology (1st Class) from the University of Stirling in 1979 and a PhD in political
philosophy from the University of Aberdeen in 1985 The Constitution of Impairment: Modernity and the aesthetic of oppression,
Disability & Society, 14:2, 155-172//mr
It has to be remembered that personal tragedy theory itself has performed a particular ideological function of its own.
Like deficit theory as an explanation of poor educational attainment, like sickness as an explanation of criminal behavior, like
character weakness as an explanation of poverty and unemployment and like all other victim blaming theories personal tragedy
theory has served to individualize the problems of disability and hence leave
social and economic structures as
untouched. (Oliver, 1986, p. 16.) This position suggests that personal tragedy theory is culturally
produced and, therefore, part of the superstructure of capitalist society, that is an
ideological reflection of a particular mode of production, a distortion that arises from a
particular set of economic conditions. Yet, despite the considerable emancipatory value in
this mode of explanation, impairment (the body) is left out of its frame of reference and
has no part to play in the constitution of (disability as) oppression . The explanatory focus is on the
economic rather than the intercorporeal on how the ideology (of personal tragedy) is naturalised and becomes common sense
rather than on the role of visual perception as an act of rejection and invalidation. The
aesthetic and existential
anxiety (Hahn, 1986) that is the emotional reflex of the ideology of tragedy which is, in
turn, the reflex of economic conditions is not related to the disablist nature of
perception. Emancipation, therefore, rests on the elimination of those economic
conditions and the massive project of reconstituting the despotism of the visual, is left
unchallenged. Disabled people are seen as dependent and deserving of charity - ocularly constructed, day in and day out, by a
way of seeing which has become common sense, authoritative , naturalised. The problem with the structural
account of tragedy adopted by the social model is that it does not give due recognition to the
intercorporeal relationships (the bio-politics) that are constitutive of it. It does not recognise the aesthetic
moment in which the gaze is disfiguring and discriminatory. The connection between
impairment and oppression is lost to the social model of disability because impairment is regarded
as something that is constituted entirely in the domain of nature and is, therefore, a natural fact beyond contestation. In other
words, the
social model concedes that impairment is a disfigurement and therefore
accepts the medico- aesthetic distinction between valid and invalid bodies. This position
actually lends legitimacy to accounts of impairment that are shaped by notions of
tragedy and pity. Such a position hinders the theoretical and practical basis for a politics of pride and difference.
The neg’s claims are too totalizing—capital cannot explain all of ableism—
history proves that immigrants were seen as ‘impaired’ by appearance AND
Baynton 13 (Douglas C. Baynton, “Disability and the Justification of Inequality in American History,” The Disability
Studies Reader, Ch.2, pg. 48, 2013,
Arguments for immigration restriction often emphasized the inferior appearance of immigrants,
and here also ethnicity and disability overlapped and intertwined. Disability scholars have emphasized the uncertain
and shifting line between an impairment of appearance and one of function. Martin Pernick, for example,
has described the importance of aesthetics in eugenics literature—how fitness was equated with beauty and disability
with ugliness. Lennard Davis has maintained that disability presents itself “through two main modalities—
function and appearance.” Restrictionists often emphasized the impaired appearance of immigrants. An Ellis Island
inspector claimed that “no one can stand at Ellis Island and see the physical and mental wrecks
who are stopped there . . . without becoming a firm believer in restriction.”36 A proponent of restriction
avowed, “To the practised eye, the physiognomy of certain groups unmistakably proclaims inferiority of type.” When he observed
immigrants, he saw that “in every face there was something wrong . . . . There were so many
sugar-loaf heads, moon-faces, slit mouths, lantern-jaws, and goose-bill noses that one might imagine a
malicious jinn had amused himself by casting human beings in a set of skewmolds discarded by the Creator.” Most new immigrants were
physically inadequate in some way: “South Europeans run to low stature. A gang of Italian navvies filing along the street
present, by their dwarfishness, a curious contrast to other people. The Portuguese, the Greeks, and the Syrians are, from our point of view ,
undersized. The Hebrew immigrants are very poor in physique . . . the polar opposite of our pioneer breed.”37
The initial screening of immigrants was mostly a matter of detecting visible abnormality. Inspectors, who prided themselves on their ability to make a
“snapshot diagnosis,” had only a few seconds to detect the signs of disability or disease as immigrants streamed past them in single file.
Inspection regulations specified that “each individual should be seen first at rest and then in
motion,” in order to detect “irregularities in movement” and “abnormalities of any description.” If possible,
inspectors watched immigrants as they carried their luggage up stairs to see if “the exertion
would reveal deformities and defective posture.”38 As one inspector wrote, “It is no more difficult to
detect poorly built, defective or broken down human beings than to recognize a cheap or
defective automobile. . . . The wise man who really wants to find out all he can about an
automobile or an immigrant, will want to see both in action, performing as well as at rest.”39
Neoliberalism is not the root cause of ableism and the K is totalizing—many
immigrants who were rejected via public charge were self-supporting workers
who received job offers
Baynton 6 (Douglas C. Baynton, “The Undesirability of Admitting Deaf Mutes: US Immigration Policy and Deaf
Immigrants, 1882-1924,” Project Muse, Sign Language Studies, Volume 6, Number 4, 2006, pg. 411-412)//jy
The exclusion of deaf immigrants grew out of fears that deaf peo-ple would be a burden on the
state and that they would reproduce more of their kind. Both were based upon only very partial truths. Only
about 4 percent of deaf children have one or two deaf parents today, 33 and the percentage was probably much less a century ago,
when deafness was more frequently caused by disease. The eugenicist alarms were as groundless concerning deaf people as they
were for disabled people in general. Keeping out deaf immigrants could have had no measurable effect on the prevalence of
deafness in the country. The
economic issue is more complex. People with disabilities did (and still do)
experience higher unemployment than workers in gen- eral. This is true of deaf people today. The extent to
which it was true at the time is unclear, but it was not an implausible assumption to make. The question, however, was
hardly so straightforward as immigration officials made it appear. To the extent that some deaf
people might indeed have a harder time finding employment than comparably skilled hearing
people, the exclusion of deaf immigrants was based on an assumption that disability was an
individual rather than a social issue and that it was defective bodies that were at fault rather
than the relationship between particular bodies and particular social environments. Immigration
restriction has to be seen in con- text as one element in a larger system of discrimination that made it difficult for deaf people to
compete on an equal basis with hearing people. Even leaving aside the larger question of whether and why deaf people may have
faced difficulty obtaining work, the
economic justi- fication for exclusion remains inadequate. Many of
the deaf immi- grants who were rejected had been self-supporting in their home countries, and
some of them received job offers while awaiting their hearing but still were deported as likely to
become public charges. In these instances, immigration officials were surely responding more to stereotypes than to
individuals. Employers tended to ask more spe- cific questions than did immigration officials: Who is the individual standing before
me, and what skills, abilities, and history does this person bring to the particular work I need done? Prejudice
and presuppositions naturally still intruded but less so than when legislators and immigration officials
tried to construct general policies regarding disability. A skilled deaf granite cutter was essentially a skilled
granite cutter, and deafness a detail. But those who created immigration pol- icy and the officials who
enforced it relied largely upon images they carried in their heads from long cultural
conditioning. Physical differ- ence meant defect, which meant dependency. And in that
simplistic equation originated much injustice and unnecessary hardship.
The neg’s reduction of disability to a singular model/root cause is totalizing and
reinforces a static notion of identity that recreates the conditions for ableist
Shakespeare and Watson 02, Tom - English sociologist and broadcaster and Nicholas - English-Canadian
medievalist, literary critic, religious historian, and author. “The Social Model of Disability: An Outdated Ideology?” ‘Research in Social
Science and Disability’ Volume 2, pp. 9-28 (2002)//mr
The critique of dualism within gender studies has been informed by the work of post-structuralists such as Jacques
Derrida, and post-modernists such as Judith Butler. Mairian Corker (1999) has been a pioneer in applying such ideas
to the field of disability, and we believe that it would be fruitful for disability studies to engage
more extensively with the mainstream of contemporary social theory, while remaining
accessible and politically engaged (see also Cashling, 1993). We would also claim that a modernist theory of
disability – seeking to provide an overarching meta-analysis covering all dimensions of every
disabled person’s experience - is not a useful or attainable goal. For us, disability is the quintessential
post-modern concept, because it is so complex, so variable, so contingent, so situated. It sits at the
intersection of biology and society and of agency and structure. Disability cannot be reduced to
a singular identity: it is a multiplicity, a plurality. Social model theory has worked within a modernist context, and
within rules of logic which are now actively being contested. Nancy Jay writes about the principle of contradiction (nothing can be A
and not-A) and the principle of the excluded middle (everything must be either A or not-A) (Jay, 1981, 42). These modernist
principles have been applied to disability, to deny that both the body and social barriers
together can be the cause of disablement, and to argue against a middle ground between the
medical model and the social model. As an example, look again at the table Mike Oliver provides to show the
distinction between the individual/medical model and the social model (1996, 34). We believe that an adequate social
theory of disability would include all the dimensions of disabled people’s experiences: bodily,
psychological, cultural, social, political, rather than claiming that disability is either medical or
social (Shakespeare & Erickson, 2000). Only and always disabled? 20 “No one today is purely one thing. Labels like
Indian, or woman, or Muslim, or American are no more than starting-points, which if followed
into actual experience for only a moment are quickly left behind.” (Said, 1994, 407) Disability politics,
by its very nature, often rests on a fairly unreflexive acceptance of the distinction disabled/nondisabled distinction. Disabled people are seen as those who identify as such. Non-disabled people are often not welcome.
Disabled leadership is seen as vital. But Liggett argues: “From an interpretative point of view the minority group approach
is double edged because it means enlarging the discursive practices which participate in the
constitution of disability. […] [I]n order to participate in their own management disabled people have had to participate as
disabled. Even among the politically active, the price of being heard is understanding that it is the disabled who are speaking.” (1988,
271ff) Liggett is following those post-structuralist authors who point out the
costs to identity politics. To be an activist whether as a gay person, or a woman, or a disabled person - is to make the label into a badge, to make the
ghetto into a oppositional culture. Yet what about those who wish to be ordinary, not different? Many
disabled people do not want to see themselves as disabled, either in terms of the medical
model or the social model. They downplay the significance of their impairments, and seek access to a mainstream
identity. They do not have a political identity, because they do not see themselves as part of the disability movement either. This
refusal to define oneself by impairment or disability has sometimes been seen as internalised
oppression or false consciousness by radicals in the disability movement. Yet this attitude can
itself be patronising and oppressive. People do have a choice as to how they identify, within
obvious limitations. What is wrong with seeing yourself as a person with a disability, rather than
a disabled person, or even identifying simply as a human being, or a citizen, rather than as a
member of a minority community? After all, identity politics can be a prison, as well as a
haven. The unwillingness to identify as disabled - either in a political sense, or in a medical sense - is very evident in our recent
research with children with impairments (the ‘Life as a disabled child’ project, funded by the UK Economic and Social Research
Council). We started with the intention of imposing our social model perspective on their lives. Yet,
because we were also following the precepts of the new sociology of childhood, and treating children as agents, and their testimony
as reliable, we were forced to rethink our adult-oriented social model assumptions. The children easily identified the social barriers
which they experienced, and were often vociferous in complaining about the treatment which they received. But most of them
wanted to be seen as normal, though different, and actively resisted definition as disabled (Priestley et al, 1999). It has been argued
that many people with learning difficulties resist being defined as disabled or different (Finlay & Lyons, 1998). We hypothesise that
the same might apply to older people with impairments or chronic illnesses, who make up the majority of 'disabled people' in Britain
and America. There is
also the issue of multiple identities. While some people with impairment resist
identification as disabled, because they want to see themselves as normal, others are more likely to identify in terms
of alternative parts of their experience. For 22 example, gender may be more salient, or perhaps
ethnicity, or sexuality, or class, or marital status. Research on disabled sexuality has found gay people, for
example, who prioritise their sexual identity, and ignore their experience of impairment (Shakespeare et al, 1996). Social model
perspectives have not proved very effective in reconciling the dimensions of gender, race and
sexuality within or alongside disability (Morris, 1991, Vernon, 1996). Most people are simultaneously situated in a
range of subject positions. To assume that disability will always be the key to their identity is to
recapitulate the error made by those from the medical model perspective who define people
by their impairment. Any individual disabled person may strategically identify, at different times, as a person with a
particular impairment, as a disabled person, or by their particular gender, ethnicity, sexuality, occupation, religion, or football team.
Identity cannot be straightforwardly read off any more, it is, within limit, a matter of choice.
Link Turn
Aff allows immigrants access to welfare- removes reliance on for-profit health
care that drives biopower/neoliberalism
Mitchell 15 (David T. Mitchell, faculty member in the Department of Disability and Human
Development at the University of Illinois at Chicago, coeditor of Corporealities: Discourses of
Disability, author of Precarity, Geopolitics, and the Matter of Disability, Ed. Sharon L. Snyder,
2015, “The Biopolitics of Disability neoliberalism, ablenationalism, and peripheral embodiment”,
University of Michigan Press,
In this section we want to underscore how the
toxic environments of for-profit health care research
networks participate in this neoliberal social annexation of those peripheral embodiments. Such
research networks promote normalization schemes based on the emptying out of disabilitybased differences and active exclusions from competitive labor environments. Nearly all efforts
in the domain of for-profit medicine serve as components of the bio(political)sphere of disability
influencing global interactions among marginalized forms of citizenship. If biopolitics is most distinctively
characterized by Foucault’s formulation in The History of Sexuality as “the right of death and power over life” (157), then these
collaborative disability domains are seeking to survive experiments of exclusionary (sometimes
death-making) environments manufactured for the maintenance of some privileged lives over
others—those who embody lives that cannot be effectively accommodated within the humanmade toxicity (of attitudes, structures, environments, and practices) of the neoliberal built
biopolitical sphere. In particular we analyze how the rarity of some impairments that require extraordinary
medical care (such as multiple surgeries to reconstruct unviable organs) fail to galvanize enough promise as lucrative
interventions for medical practitioners, pharmaceutical research corporations, and health care systems alike. In neoliberal forprofit medicine a premium is placed upon the numbers of people who might benefit from a
particular treatment regimen in the risk calculations of viability for future medical research, the
procurement of financial backing for the development of treatment technologies and protocols,
and the training of sufficient expertise in medicine to improve viability for those in peripheral
embodiments. In these economically generated measures of who is worth saving, one is left with the immoral quandaries of
which bodies should receive treatment and which ones should not. Often lack of treatment results from the fact that no research
organization has identified a sufficient market-based demand for promoting profit-based research and development (R & D)
explorations. Those
who exist under the classification of “letting die” have been increasingly subject
to participating in the economic press of funding generation schemes to underwrite necessary
treatment, pleading with surgeons and researchers to undertake skills training in necessary
interventions, and, most recently, purchasing in the neoliberal for-profit medical markets to
underwrite potential “cures,” treatments, and medications.
Perm do both
Grass roots organizing and state reform are not mutually exclusive—the USFG
has the power and resources to legitimize disability movements and code their
proposals in federal law
Scotch 88 (Richard K. Scotch, professor at the University of Texas at Dallas, “Disability as the Basis for a Social
Movement: Advocacy and the Politics of Definition,” Section: The Role of the State in Redefining Disability, Journal of
Social Issues, Vol. 44, No. 1, 1988, pg. 166-168)//jy
a prerequisite to such activism was a redefinition of
disabilities as impairments that are limiting only to the extent that constraints are imposed by
the physical and social environment. The activists who created the various dis- ability rights organizations redefined disability in this way and
sought to have this redefinition institutionalized and accepted in public policy and by the general public. However, the political and financial
resources of most of the disability rights organizations were extremely limited. A major proportion of their
The above discussion of barriers to political activism by disabled people suggested that
budgets in the late 1970s was provided by the federal government in the form of grants and contracts, and substantial amounts of this federal funding were used for newly
The political impact of many disability rights
organizations in the late 1970s was extremely dependent on the support of agencies of the
federal government. The contribution of the federal government to the growth of the disability rights movement, however, extended far beyond financial
support. The social movement of disabled people became better organized and more broadly based
as the result of federal civil rights activities. Contracts for training and technical assistance to local groups were received by a wide range of
disability organiza- tions. Disability rights leaders were often sought out by federal policy makers, thus
making lobbying even easier to pursue. Activists were routinely asked to review draft policies
and to testify at congressional hearings. These contacts served the further function of
reinforcing the visibility of disability rights activ- ists and of legitimating their leadership role,
both within the disability communi- ty and outside it. The consultations and meetings organized
by federal officials seeking pol- icy input had another important impact on the disability rights
movement by fostering a network among locally based activists around the country. This
network was also furthered by a number of federal agencies that created advisory committees
on disability rights issues, as well as by the annual PCEH confer- ences. More important still, the government contributed to
the redefinition of disability. Through such legislation as Section 504 of the Rehabilitation Act of 1973
and the Education for All Handicapped Children Act of 1975 (P.L. 94-142), federal policy makers
established disabled people as a class to be protected from discrimination by federal law, and
made it illegal to exclude them from publicly supported programs and activities. The programmatic effects of
these statutes were far-reaching: They dramatically increased the accessibility of public education,
employment, government services, and public facilities to disabled people. Of equal or greater importance,
however, were the definitions included in the new laws, which focused on a broad group of people in a
way that aided the formation of a social movement. There were two types of statutory definitions of disability, both extremely broad.
initiated political activity. (Several organizations were major exceptions, such as the NFB.)
The first, employed in P.L. 94-142, was categorical. Section 121a.5 of the law defined handicapped children as those evaluated as being mentally re- tarded, hard of hearing,
deaf, speech impaired, visually handicapped, seriously emotionally disturbed, orthopedically impaired, other health impaired, deaf- blind, multihandicapped, or as having
specific learning disabilities. P.L. 94- 142 guaranteed these children a free and appropriate public education and related services in the least restrictive possible environment.
Schools were mandated to provide individually appropriate services to children defined as handicapped, but procedurally all disabled children were accorded the same rights.
The second type of statutory definition was more functional in nature. Section 504, for example, defined a handicapped individual as any person who has a physical or mental
impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment. Disabled people falling
within this broad group were protected from discrimination in all federally supported programs and activities. The centrality of government-sponsored definitions is emphasized
the definition of disability is essentially determined by public policy.
In other words, disability is whatever laws and implementing regulations say it is” (p. 5). They point out that
government definitions of disability have historically been influenced by rehabilitation and
medical professionals. However, in the 1970s, federal definitions of disability were specified
with the assistance of disability rights advocates, and in several cases they were actually written by
by Hahn and Longmore (no date), who state that “
representatives of movement organizations (see Scotch, 1984). Conventional interest-group explanations of policy changes characterize
advocacy groups as shaping the development and implementation of public pol- icies. In the case of disability rights legislation in the 1970s, this process was largely reversed.
Advocates for the disability rights movement did not apply political pressure that resulted in the
passage of these laws. Rather, the adoption and implementation of the laws contributed to the
growth of national advocacy organizations representing disabled people and reinforced their
involvement with civil rights issues. Civil-rights-oriented statutes such as, Section 504 and P.L. 94- 142 became
focal points for organizing among disabled people and provided a good opportunity for
establishing policy-oriented coalitions of the new genera- tion of grass-roots disability
organizations. The emphasis in this paper on the role of the state in providing resources and creating networks is consistent with the evolving literature on resource
mobiliza- tion in social movements (Freeman, 1982; McCarthy & Zald, 1977). The impor- tance of network linkages and resource availability, however, has sometimes been
stressed to the exclusion of any emphasis on the role of ideas and symbolic categories in framing issues-e.g., in attempts to argue for structural over so- cial-psychological modes
social-psychological and resourcemobilization models are not mutually exclusive. The disability rights movement is one in which
the way an issue was framed had serious effects on both move- ment participation and the
ability of the movement to influence public policies (as was also the case with the problem of drunk driving-Gusfield, 1981).
of analysis. As Snow, Rochford, Worden, & Benford (1986) have recently pointed out, however,
The plan is not mutually exclusive with the alternative—state reform can be
combined with a counter-framing of social justice that challenges marketdriven definitions of desirability. Absent the plan, immigrants will still be
subjected to the constant fear of deportation and social subordination which
mark their bodies as undesirable
Park 10 (Lisa Sun-Hee Park, “Challenging Public Charge Policy: Coalitional Immigrant Community Strategies, “Project
Muse, Journal of Asian American Studies, Volume 13, Number 3, pg. 383--385, October 2010)//jy
Public charge is a political classification used to exclude or deport those immigrants perceived to
be or to have the possibility of becoming a burden on the state. Pregnancy has long been
categorized as a public burden with respect to low-income immigrant women. Scholars consider this
designation as part of a continuing tradition of “selective immigration” that began in 1875. 18 Since then, public charge—in policy and sentiment— has
existed just beneath the surface in U.S. immigration policy, and it has reared its head at key historical moments. Apparently, moments of high demand
or desirability for immigrant labor is one such moment that al- lows for public charge determinations to become a feasible, formal state response.
Public charge tempers immigrant labor desirability by clearly positioning immigrants as
dependent and undeserving/irresponsible burdens upon citizens and the state. In this way,
“desirability” can be more broadly construed to include a sense of increasing “normality” of
their presence and, consequently, a greater potential for political influence and social belonging.
The mid-1990s, with the passage of major welfare, im- migration, and health legislative reforms at the state and federal levels, was one of these
“corrective” moments in which labor and political desirability is counterbalanced with heightened public policy disavowal. 384 • JAAS • 13:3 The
PED programs assumed immigrant health care use was suspicious from the start and required
surveillance to prove otherwise. In effect, these programs institutionalized greater restrictions
on health care access for immigrants without initiating the far more cumbersome (and democratic) process of
legislative reform. In addition, the state specifically targeted immigrant women’s use of prenatal
care. With the strong support of then governor Pete Wilson and the tidal wave of anti-immigrant sentiment that passed the landmark Proposition
187, DHS and INS viewed the PED pro- grams as an exciting collaborative effort that would lead to greater sharing of information across governmental
agencies. With growing interest from neighboring states, PED increasingly pushed the boundaries of immigrant rights, health care access, and
constitutional due process. Immigration policies like public
charge reinforce the social subordina- tion of
immigrants through programs such as PED, which serve to mark immigrants as in need of surveillance and
control. Pregnant immigrant women find themselves in the midst of an intense political debate over not only immigration control but also state
control of women’s reproduc- tion. Within this predicament, the deeply racialized nature of immigrant women’s reproduction is evident. For
income immigrant women of color, having children is considered a selfish act given their
national role as temporary workers. This is in stark contrast to understanding the in- fertility of
middle-class white women as a “tragedy,” as expressed by many middle-class policy makers and
politicians. 19 Arguments that immigrant women “overuse” health care (meaning they use it at all) and
have babies in order to obtain U.S. citizenship question the motive of low-income women in
having children. Unfortunately, this latest surfacing of public charge tests will likely not be the last. This legal provision is a
powerful tool in its strategic ambiguity and quiet location on the outskirts of public notice. As an
administrative law, public charge is a statutory provision under the jurisdiction of nonju- dicial staff within government and not
subject to oversight by legislatures or courts. Since its inception in the late 1880s, 20 this administrative law has undergone
very little change. The ability to exclude or deport people on the basis of someone potentially becoming a public burden was established as a powerful
tool for social engineering purposes. Despite
its disreputable history as a frequently used mechanism in the
eugenics movement, it continues to exist. This is due in part because public charge provisions
maintain the political and economic vulnerability of low-income immi- grants, thereby keeping
their labor costs down. In this way, the accusation of public burden was particularly powerful in
promoting the neoliberal ideology of personal responsibility. For Asian and Latino/a immigrants in the 1990s, their
criminalization as public burdens recast their legal behavior as “illegal,” regardless of their actual citizenship status. While Latinas were first targeted in
the PED programs as a test case, the focus on Asian immigrants quickly followed. This is further evidence of their shared social location as
“unassimilable aliens and permanent virtual immigrants.” 21 It seems the lessons learned from these health care advocates is appli- cable more
broadly. In their fight for immigrant women’s access to health care, they learned that each method of expulsion requires constant, careful vigilance and
monitoring. There needs to be a systemic analytical approach to these policies to understand the various layers and interconnections of one regulation
to another with the goal of devising an effective chal- lenge that will bring together the appropriate people with the necessary information. This is
essential to repair the trust that is required to ensure health care access. In
the midst of all the many methods of
deportation, public charge remains, quietly waiting in the wings, with the potential to resurface
in various incarnations—some more egregious than others. In the end, the community advocates’ successful actions
perform a crucial democratic function of governmental checks and balances. The story of public charge administration is one of state power defining
who is or is not a burden based upon very narrow and seemingly capricious assessments of a human being’s costs and benefits. In the case of the PED
program, the state made ineligible people who were eligible using pro- cedures that violated its own laws. It
is apparent that social
justice work cannot focus solely on changing the state. There must be a counterframing of
social justice that goes beyond a market-driven definition of responsibility whether of the
state or individual. The bright side of this story is that there are people, as part of their
everyday lives, who work behind the scenes to do just that.
Removing public charge dismantles a vector of neoliberalism—neoliberal
hegemony operates through the triumph of the market over citizenship and
silent submission to productivist priorities—the plan disrupts this by pluralizing
social need and removing restrictions
Hughes 17 (Bill Hughes, professor at Glasgow Caledonian University who specializes in Disability Studies, Taylor &
Francis Online, “Impairment on the move: the disabled incomer and other invalidating intersections,” Neoliberalism
and parasite identities, pg. 475-478, 3/13/17)//jy
Neoliberalism and parasite identities In the neoliberal era, anxiety in relation to the incomer draws on the bank of negative, intersecting scripts that history has lodged in the
The moral majority, in the heartlands of neoliberalism, has come to resent, above
those suspected of making little or no contribution to the commonwealth. Anti-migration populism
archive of disability invalidation.
all else,
(McTernan 2011), including the welfare chauvinism that accompanies it and the despoilment of the deserving status of the disabled claimant, can be located in the same frame
The illegal immigrant, the benefit scrounger and the criminal are not just
parallels … they are intrinsically related both to each other and their shadows, the migrant and
the claimant’ (Anderson 2015, 7). The fear that follows these shadows prevails in the normative imaginary
in the form of ‘bogus’ racialised refugees and disabled ‘counterfeit citizens’ (Hughes 2015). Both representations
of reference. As one commentator noted: ‘
One of the tensions in the experience of social flux associated with the mass
migrations of the neoliberal era is the debate around access to welfare benefits and services: ‘The
of identity embody deception.
growing presence of newcomers … is’, some argue, ‘eroding 476 B. HUGHES the sense of social solidarity on which welfare states are constructed’ (Johnston et al. 2010, 351). In
, the relationship of asylum seekers and refugees to welfare is represented as parasitic (Philo,
Briant, and Donald 2013). The echo of Ellis Island – of the likelihood of a ‘public charge’ – is palpable. Embedded in the popular
this context
imaginary in the United Kingdom is the view that the ‘generous’ welfare system is the reason why the country is attractive to those seeking a life of hand-outs and state-funded
The portrayal of the British Welfare State as a nirvana of ease for the comfort of global waifs
and strays – what Philo, Briant, and Donald (2013, 35–39) call ‘soft touch Britain’ – validates benefit cuts for disabled people
who have been ‘tarred with the same brush’ as ‘alien scroungers’. Punishment for the poor
masquerades under the populist, neoliberal euphemism of ‘welfare reform’. Access to welfare benefits and
services for ‘incomers’ and disabled locals has been subjected to progressive (sic) restriction, with both parties
conflated in common scripts of undesirability in which they are represented as idle by lifestyle
choice. In Boswell’s (2003) view it has become the convention, not just in Britain but throughout Europe, to interpret the
immigrant as a burden who comes uninvited, to drain resources by either seeking an idle life on
benefits or through making demands on housing, education and assistance which local
communities can ill afford. As well as home-grown layabouts, there are ‘hordes’ of ‘alien’ beggars, we hear, waiting at the border. Neoliberal Britain has
made significant headway in dismantling the ‘safety net’ of welfare support that once helped to protect disabled people from the discrimination and exclusion built into the
social fabric. One calculation suggests that from 2010 to 2012 ‘disabled people and their carer’s have seen their income collectively cut by £500 million’ (Butler 2012). Changes
to 13 benefits available to disabled people prior to the welfare ‘reforms’ of 2011 will result, by 2018, in a loss of income of £28.3 billion for the 3.7 million disabled people who
The use of insidious representation of disabled people as benefit cheats
and mendicants without begging bowls has been widely deployed to discredit disabled
claimants (Briant, Watson, and Philo 2013) and to legitimate the swingeing cuts. A normative reconstruction of
disability is a priority for the neoliberal state. Repertoires of invalidation undermining the ‘deserving’ status of those who make claims on
the public purse have been mobilised. The privatisation and deregulation of the ethics and politics of care is
largely dependent on discrediting the character of disabled people; a task for which there are many historical examples,
live in the United Kingdom (Demos 2013).
for advocates of neoliberal policies, to draw upon (Hughes 2015). The beggar, w DISABILITY & SOCIETY 477 territory beyond. Folk devils congregate outside the virtuous circle of
citizenship, looking for opportunities to break through the walls and disturb its decency.
The moral calculi that keeps ‘them’ out focuses
on the ‘crookedness’ of disability (Briant, Watson, and Philo 2013; Garthwaite 2011) and the criminality of the incomer (see, for example, Banks
2008; Webber 2008). Meanwhile, the ‘virtuous citizen’ feels the economic pain; growing resentful at
having to dig deep into threadbare pockets to save foreigners from destitution and to subsidise
the idleness of disabled benefit fraudsters. The moral calculus that kept migrating disabled
bodies on the wrong side of the pearly gates is, in the Ellis Island and contemporary UK examples, repositioned as, primarily, a
matter of economic parsimony. Yet the same scripts of moral degeneracy – applied at the intersection between
disabled people and incoming foreigners – are used to legitimate the tightening of the purse strings to the
‘crippling’ material disadvantage of those least able to afford it. Michael Keith (2013, 27) calls the contemporary ‘campaign’
of nefarious representation against, and criminalisation of, asylum seekers and refugees a manifestation of the ‘bigot’s calculus at the cost of arrivals’. He strips back the antiimmigrant narrative to its locus in greed. On a parallel note one might speak of the ‘miser’s calculus’; the cost that ‘virtuous citizens’ feel they pay for ‘bogus incapacity’, for
people ‘pretending to be disabled’, ‘swinging-the-lead’, playing-up their impairments in order to dupe the custodians of the public purse into doling out billions to counterfeit
The bigot’s calculus epitomises the neoliberal mind-set. It equates not to the
hard currency costs of ‘looking after immigrants’ – a complaint that has never been translated into a believable bottom line – but to
the wrath, invective and hostility that it musters in press and population (Leudar et al. 2008). Likewise, the miser’s calculus,
claims for disability benefits.
mobilised by those who like to ‘bash’ disabled benefits claimants, is measured out in accusations of laziness and fraudulent conduct (Briant, Watson, and Philo 2013; Garthwaite
These repertoires of invalidation, focused on the so-called abuse of the welfare system by
the marginalised and disadvantaged, are strikingly commensurate, with the lynchpins of
neoliberal economics and social politics which has brought about the ‘triumph of the market
over citizenship ‘(Crouch, Eder, and Tambini 2001, 11) and the ‘the silent surrender of public responsibility’ (Gilbert
2004). Both the triumph and the surrender ensure that a politics of hospitality and care is delegitimated. The neoliberal hegemony is working hard to ensure that social need is
individualised, the moral economy privatised and national borders water-tight. ‘Brexit’ – a political
phenomenon that has invested heavily in cultural racism and ableism – is its latest manifestation. The migrant as foreign welfare burden is a theme that replays the emotional
and economic sentiments that shape the contemporary disability/non-disability relationship. It is a key test of tolerance and a quandary around which the social relations of
hospitality and care are stretched. The growth of intolerance to mass migration and multiculturalism in the United Kingdom and more widely in Europe and the Global North is
aligned – fittingly for neoliberals – with intolerance for 478 B. HUGHES home-grown ‘dependency’. The ranks of the deserving are redefined by administrative fiat. The shutters
Neoliberalism closes
down the social state to the detriment of disabled people. Simultaneously, it re-imagines
migration in terms of productivist priorities to the detriment of people trapped in situations of
violence and persecution. Both disabled people and immigrants are subjected to similar ‘scripts’ or repertoires of invalidation; to
the same sneering language of abjection. ‘They’ are the ubiquitous other. They take but do not give. The United Kingdom provides a case study of a society
at the borders are battened down. The ‘scroungers within’ have new allies in idleness who are at the gates and keen to swell their ranks.
witnessing not only the collapse of hospitality and compassion but worse; the stigmatisation of those very people – non-white, disabled, impoverished – who are the exemplary
products of ‘negative globalisation’ and the injustice it generates (Bauman 2007). The demonisation of disabled people and of ethnic immigrants, who make any kind of claim on
They are portrayed (interchangeably) as stalwarts of contemporary mendicancy;
part of the abject underclass of contemporary neoliberalism (Tyler 2013).
the community, has become commonplace.
The aff is necessary to challenge notions of citizenship and unravel the
government’s denial and exclusion that relegate those deemed disabled to
third-class citizenship
Hirschman and Linker 15 (Nancy - Professor of Politics at the University of Pennsylvania; her specialties are the
history of political thought, analytical philosophy, feminist theory, disability theory and Beth - Associate Professor at the University
of Pennsylvania in the Department of the History and Sociology of Science “Civil Disabilities” Disability, Citizenship, and Belonging: A
Critical Introduction pp. 4-5)mr
Similar variability characterizes the concept of citizenship. This might seem counterintuitive, for the
concept of citizenship
might seem to many, particularly from the United States and Western Eu rope, a fairly straightforward matter of
deciding who is and who is not one. Many of us think of citizenship as individual rights conferred
on us by a certain nation-state. Or, as sociologist T. H. Marshall put it, citizenship is “composed of the rights necessary for
individual freedom— liberty of the person, freedom of speech, thought and faith, the right to own property and to conclude valid
contracts, and the right to justice.”20 Because we
often take citizenship to be defined by a circumscribed
nation-state, the notion becomes almost indistinguishable from national identity. Citizenship thus
usually entails an attachment to a specific locality; we are citizens of something, generally a nation, but alternatively (or at the same
time) of states, cities, towns, or even organizations.21 But as Willem Maas observes, we
live a “multilevel citizenship”
on “nested and overlapping geographical levels: citizenship not only of the state but also of
substate, suprastate, or nonstate political communities.”22 Indeed, citizenship is often applied to
communities that are arguably apolitical. People who are considered “good citizens” include colleagues who are
conscientious about ser vice on university committees, neighbors involved in civic boosterism and civic pride in our local town or
borough, and parents who help out in the local public schools and coach local sports teams. Citizenship
implies belonging
to a group, society, and culture: our neighbors, the parents of our children’s classmates, the congregants of our
churches, or the residents of our towns, our counties, our states, and our nation. Such varieties of belonging already suggest that
citizenship is not as simple and straightforward as some might think. And even the mainstream definition is complicated by the fact
that people can be citizens of more than one state at a time, or of states and federations, such as the European Union or, indeed,
the United States, where we are citizens of states and of the nation. Legal theorist Linda Bosniak calls citizenship “multivalent,”
containing “a basic ethical ambiguity” between aspirations of inclusion and realities of exclusion.23 Lauren Berlant maintains that
“citizenship is a status whose definitions are always in process.”24 Legal theorists Linda McClain and Joanna Grossman similarly view
“citizenship as a non-unitary and evolving concept.”25 This can lead to a great deal of vagueness in how the term is used—
sometimes as a synonym for “human being,” sometimes as a stand- in for “local resident,” and sometimes as a more specific legal
category. Disability scholars Marcia Rioux and Fraser Valentine note that citizenship
is “a messy concept” that
“constructs a system of inclusion and exclusion, defining boundaries between who belongs and
who does not, who enjoys the privileges (and duties) associated with membership and who is
denied such privileges.”26 Hence “citizenship” as a term in both everyday language and scholarly
discourse often holds a much broader meaning than the narrow confines of voting, military
service, paying taxes, or even jury service. As philosopher Marilyn Friedman notes, “Citizenship is multiple and
various. It can be an identity; a set of rights, privileges, and duties; an elevated and exclusionary political status; a relationship
between individuals and their states; a set of practices that can unify— or divide— the members of a political community; and an
ideal of political agency.”27 Supreme Court justice Ruth Bader Ginsburg noted in United States v. Virginia that “full
stature” for all people entails “equal opportunity to aspire, achieve, participate in and
contribute to society based on their individual talents and capacities.”28 These views are echoed by
disability scholar Michael Prince, who maintains that “citizenship goes well beyond legal and governmental
conceptions to embrace economic and sociological notions of participation, reciprocity, and
autonomy”; it is constituted by “full membership in communities.”29 Indeed, community is vitally important
to citizenship, particularly from a disability perspective. As T. H. Marshall notes, “There is a kind of basic human equality associated
with the concept of full membership of a community— or . . . citizenship… Citizenship requires . . . a direct sense of community
membership based on loyalty to a civilization which is a common possession.”30 But citizenship
can also be a force that
marginalizes some members and thus damages a genuine sense of community, setting up a dichotomy
between a privileged class that grants citizenship and a subservient class on which this status
may or may not be conferred. In the United States, as in many Western nations, white, Anglo-Saxon,
property-owning men have often considered themselves the ones in charge of granting such
status. Men bearing full rights of citizenship have been generally nondisabled as well, with the ambiguous exception of disabled
war veterans, who are at once lauded as heroes and simultaneously pushed aside by an unaccommodating society.31 Even
under a purely legalistic definition of citizenship, however, many of these de facto exclusions
are not legitimate. Consider, for instance, that under the Fourteenth Amendment of the U.S.
Constitution, “All persons born or naturalized in the United States, and subject to the
jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”32 Yet
as the history of women’s citizenship and the citizenship of racial minorities in the United States and Eu rope have shown, the legal
doctrine of citizenship is often not enough to secure rights, and being “born” within certain geographic boundaries also is often not
enough. (We set aside the naturalization clause because certain racial minorities were often excluded from naturalization, and
disabled persons have been denied the right even to enter the United States, much less
naturalize, as Douglas Baynton’s essay in this volume shows.) Scholars in women’s and African American studies have
demonstrated that the technical designation “citizen” has done little to protect minority groups from having certain privileges
inherent in their citizenship status denied. For instance, the Fourteenth Amendment legally designated women citizens as long as
they were born in the United States, but it was another sixty- one years before they could vote, and even longer before they could
universally serve on juries or in the military. They could even lose their citizenship by marrying non- American men, although men
marrying foreign women did not lose theirs.33 Similarly, although the Thirteenth and Fifteenth Amendments ended slavery and
granted black men the franchise, gross discrimination continued under Reconstruction, and “separate but equal” became the law of
the land in 1896, along with various pragmatic restrictions on black suffrage, such as “literacy tests,” which began in the 1890s and
continued through the 1960s, given disproportionately to blacks.34 Recent voter identification laws in various states similarly may
hinder racial minorities from voting. Scholars who
study the history and theory of citizenship among these
minority groups often refer to their status as that of “second-class citizenship,” a term that
refers to the discrepancy between theory and practice, as well as law and right. Women and African
Americans had long been citizens “on the books,” but for over a century they were not really treated as such. Their citizenship was—
and arguably still is— ineffectual, for their political power and action always paled in comparison with those of the ideal AngloSaxon, male citizen.35 Throughout
most of Western history, disabled people have also been treated as
second-class citizens. Going further, we might suggest that disabled persons are perhaps even
third-class citizens, for disability has historically served as a justification to deny the privileges
of citizenship to both African Americans and women. Helen Meekosha and Leanne Dowse maintain that “the
concept of a disabled citizen could be described as a contradiction in terms” because, as historian
Douglas Baynton writes, “the concept of disability has been used to justify discrimination against other
groups by attributing disability to them.”36 For example, antisuff ragists prohibited women from voting because of
the supposed innate “defects” of the female mind. Similarly, from slavery to Jim Crow laws to Hernstein and Murray’s infamous
book Th e Bell Curve, which was taken to suggest a possible genetic racial difference in intelligence, people have insisted that African
Americans were inferior to whites, and that by virtue of their race, blacks were intellectually and morally disabled.37 But
suffragists and abolitionists rarely “challenged the notion that disability justified political
inequality.”38 Instead, they put most of their political effort into disassociating themselves from the
disabled, those they termed “defective,” and “crippled.” For much of American history, both the socially
advantaged and the socially disadvantaged ostracized disabled people, making them the most
marginalized of all minority groups. 10 Nancy J. Hirschmann and Beth Linker This may be why disability was not covered
in the 1964 Civil Rights Act; as Michael Bérubé reminds us, disability rights were seen as a “dilution of civil rights,
on the grounds that people with disabilities were constitutively incompetent, whereas women
and [racial] minorities faced discrimination merely on the basis of social prejudice.”39 Anita Silvers
explains it the following way: “To make disability a category that activates a heightened legal shield against exclusion, it was argued,
would alter the purpose of legal protection for civil rights by transforming the goal from protecting opportunity for socially exploited
people to providing assistance to naturally unfit people.” 40 This
history of exclusion has meant that disability
has had a complicated and ambiguous status within the concept of citizenship. We seek an
enlarged conception of citizenship to address this. Citizenship is a matter of entitlement,
obligation, and belonging. Domenico Losurdo argues that the struggle to enlarge the notion of citizenship in the modern
era has been tied up with the struggle to recognize the humanity of property-less men, women, and racial minorities.41 We
share that aspiration for disabled persons and believe that this enlarged notion of citizenship
intertwines the political and the social, legal status and human status. A citizen is someone who
belongs to a particular group— whether a nation or other polity, organization, or community—
and has certain entitlements and obligations thereby. Th e entitlements, though, are both a function and a means of the
belonging. Thus denying those entitlements does more than take away an immediate good that the
entitlement provides, such as income, education, or suffrage; it also takes away the belonging
itself. Such denial is a signal of exclusion, an indication that you are not just different from
others but an outsider, inferior, less than a citizen, even less than human. It is this denial and
exclusion that disability scholars and activists seek to reject. We believe that this rejection
entails an enlarged understanding of citizenship.
Public charge determinations are endemic of attempts at capitalist
sustainability in the U.S- removing is is a step in the move to disassemble
capitalist logic in immigration and proves the perm
O’Brien, 11, (Mariana O’Brien, Proficient researcher in professional and academic
environments. Knowledgeable of planning policies and programs, as well as their regulations
and administrative procedures at federal and state level. As a private consultant, developed
plans for the Peruvian government and non-profit organizations. September 2011, “From
‘Welcome to America’ to ‘Public Enemy Number One’: The Evolution of Immigration Policy
Narrative and the Case of Legal Immigrants in America”, Florida Atlantic University,
Ineligible alien story lines. In substance, story lines about “ineligible aliens” aim to exclude the feeble-minded,
the pauper, the criminal, the contract-laborer and the defective (Speranza, 1914). Ideographs, such as
public charge, criminal alien, and anchor baby create story lines about those who are a danger for the
American culture and progress, originating a set of policies aimed to stop and punish those who
do differently. Public Charge. The public charge ideograph symbolizes societies burden from those not
entitled toward the good citizens. Liable to become a Public Charge (LPC) is the term used in the
United States to classify prospective immigrants who are denied entry due to their lack of
sustainable living means (Rogers, 2002) since the Immigration Act of 1882. After the first definition of public charge, subsequent
legislations have impinged on these ideographs negative characterizations such as convict,
lunatic, idiot, or any person unable to take care of himself or herself [themselves]. Act of 1917, section
3, adds to this definition: 'undesirables' from other countries, including "idiots, imbeciles,
epileptics, alcoholics, poor, criminals, beggars, any person suffering attacks of insanity, those
with tuberculosis, and those who have any form of dangerous contagious disease, aliens who
have a physical disability that will restrict them from earning a living in the United States...”. The
Personal Responsibility and Work Opportunity Reconciliation Act of 1996 constitutes that the policy response to prevent those ‘undesirables’ from landing or immigrating to America. It sets
income requirements for immigrant sponsors at 125 percent of federal poverty level; which is enforceable until the immigrant has worked 40 qualifying quarters of coverage as defined under
title II of the Social Security Act or until the date the alien is naturalized as a citizen of the United States. Criminal Alien. Illegal immigrants have, by definition, broken the law; however,
legislators have attributed criminal qualities and behaviors to groups of people that enter the country unlawfully. This ideograph criminal alien extends this element of criminality beyond their
immigration status (Newton, 2005). The Act of 1996 epitomizes the actions against criminal aliens. The Illegal Immigration Reform and Immigrant Responsibility Act, as indicated in its name,
targets the problems associated with the criminal alien and the public charge ideographs. This Act outlines provisions, such as the criminal alien identification system, and criminal alien tracking
center. It increases penalties against alien smuggling, employers of illegal aliens; outlines procedures for detention and removal of inadmissible aliens; and increases restrictions on benefits for
aliens and requirements for family sponsors. Anchor baby. This ideograph sets apart from the previous ideographs analyzed in previous sections, because it has not been incorporated in current
policies yet; however, it is already part of the immigration policy discourse. Based on the original term of “anchor children”, which referred to Southeast Asian teens who arrived in the United
States between the ages of 13 and 20 and have already formed an identity of themselves as wily and street-wise (Ima and Nidorf, 1987; Ima, Khommarath, and Nidorf, 1991). The anchor baby
ideograph, which shapes public motives as part of the immigration political rhetoric, will be studied through the analysis of newspapers. The sample data corresponds to The New York Times
issues from March 2006 to September 2011 (See Appendix I). The American Heritage Dictionary definition of anchor baby is: “offensive. Used as a disparaging term for a child born to a
noncitizen mother in a country that grants automatic citizenship to children born on its soil, especially when the child’s birthplace is thought to have been chosen in order to improve the
mother’s or other relatives’ chances of securing eventual citizenship”. In 2006, The New York Times acknowledged the existence of a new term: “Anchor baby: a derogatory term for a child born
in the United States to an immigrant. Since these children automatically qualify as American citizens, they can later act as a sponsor for other family members.” The anchor baby ideograph gains
powerful meaning through its association with other ideographs. The majority of stories reported by this mean, linked baby anchor with ideographs, such as illegal alien mother, illegal
immigrants, illegal alien invader, horde of devious Mexican mothers, and birth citizen abuse. The story lines as the result of this network of meanings are filled with negative connotations. Baby
anchors are used to cheat the system; they encourage illegal entry, and are blamed for America’s failure to write immigration laws that work. As a consequence, these story lines raise the ire of
anti-immigration advocates, who propose ‘amendments to the 14th Amendment’ to deprive these children of their citizenship. As observed, and based on the deconstruction of the dominant
narratives of the current immigration policy discourse, the ideographs are so powerful and negatively constructed, that the ineligible alien story lines shape the alien narrative in detriment of
the eligible one. As a result, legal immigrants suffer restrictions of their civil rights due to immigration policies that reflect the current policy discourse. Dominant narratives depict “[a]liens were
lazy, bloated welfare bums who worked so hard and for such modest wages that they crowded upstanding red-blooded Americans out of the workplace” (Bilderback, 1989). The dominant
narratives describe immigrants as freeloaders reaping the benefits of hardworking citizens who paid taxes. They constructed immigration as a problem and constructed immigrants as parasitic
and deviants (Newton, 2005). This situation causes the design and implementation of policies that focus more in punitive and restrictive measure. The alien narrative divides the public between
citizens and immigrants, where citizens are portrayed as victims of immigrants (Newton, 2005); therefore, the public sentiment towards immigration is increasingly negative. The Roper poll of
June 1980 found that 91 percent of Americans support an "all-out effort" to stop illegal immigration and 80 percent want to reduce the number of legal immigrants and refugees (Martin, 1982).
The next section explains the ways legal immigrants civil rights are affected by the current policy discourse. Following, this paper delineates a counternarrative, which will serve as a base for the
development of an immigration policy metanarrative. III. Circular Stories in the Immigration Policy Discourse that Restrict Legal Immigrants Rights Legal immigrants are referred to as people
who have entered and live in the United States following lawful procedures. This category considers both legal permanent residents (LPRs), and foreign-born citizens that have acquired
citizenship status through the process of naturalization. By definition, a LPR is a person who has been granted lawful permanent residence in the United States. He/she may live and work
permanently anywhere in the United States, own property, and attend public schools, colleges, and universities, and apply to become U.S. citizens if certain eligibility requirements are met. An
important eligibility requirement for naturalization is “good moral character”. The U.S. Citizenship and Immigration Services (USCIS) consider such things as honesty and criminal records to
determine applicants’ good moral character. Analyzing the immigration policy discourse through the deconstruction of its dominant policy narratives, it was observed that legal immigrants’
ideographic representation is so weak that is overwhelmed by those created under the ineligible alien story lines. As a result, immigration policies mainly targeted to combat illegal immigration,
also impact legal immigrants negatively. From this analysis some circular story lines were identified: 1. “Immigrants are welfare abusers that take away jobs from Americans”. Below, three story
lines are deconstructed in their arguments. A: “Legal immigrants are lazy and abuse welfare”. B: “Legal immigrants work hard and for low wages that take away jobs from Americans” Thus: They
are either lazy or hard workers, they cannot be both. 2. “Immigrants are a burden for society”. This story line has two characters, LPRs and native citizens and can be read as follows: A: “LPRs are
public charge” B: “LPRs are banned to access to welfare benefit for five years”. Thus: LPRs are not public charge and/or A: Naturalized citizens are public charge B: In order to become citizens,
LPRs have to prove they have not received welfare benefits. Thus: LPRs who become naturalized citizens are not public charge. 3. “Immigrants are criminals”. A: Legal immigrants are criminals B:
Legal immigrants have to exhibit good moral character in order to apply for citizenship. Thus: while being LPRs or naturalized citizens, legal immigrants are not criminals. Counter stories of
eligible aliens are not strong enough to prevent unequal participation in the democratic processes. Difference of Immigrants Treatment before the Law LPRs are impede from working for the
Federal government and have disadvantageous access to welfare . Immigrants who entered the United States after August 22, 1996, were prohibited from receiving most types of public
assistance. The ban is to be lifted once they become American citizens. Also, those who were in the country on August 22, 1996, were to be removed from the Social Security Income (SSI) and
food stamp rolls within a year (Borjas, 1999; Borjas and Hilton, 1996; Falcón, Bermudez, and Tucker, 1996; Primus, 1996). Taxation without representation was one of the major causes of the
American Revolution. LPRs pay taxes and are not allowed to vote. Naturalized citizens have limited political participation. When cultural characterizations of persons or groups depict them as
powerless and/or are negatively constructed, they fail to mobilize or to object to the distribution of benefits and burdens because they have been stigmatized and labeled by the policy process
(Schneider & Ingram, 1993). Conducting an analysis of the House of Representatives web pages, to study the level of participation of naturalized citizens, it was observed that only four (0.9%)
members are naturalized citizens. It is interesting to highlight the importance given to the place of birth in the American culture. Even native citizens serving a representatives of states where
In sum, despite
being legally admitted to live and work in the United States, LPRs and naturalized citizens have
different treatment than native-born citizens before the law. In case of political conflict between the United States
they were not born, omitted or disguised this information. On the other hand, those who were born in the state they represent expressed it as a badge of honor.
and their country of origin (or heritage), history showed violation of liberty rights of foreign-born citizens and their descendants. LPRs, despite paying
taxes, are banned for five years from receiving federal and state aid. Additionally, they cannot apply for federal job positions. Naturalized citizens have
limited political participation. Through the narrative analysis of the Immigration policy discourse it has been shown that the
ideographs of
public charge, illegal alien, and anchor baby are stronger than the naturalized citizen and the almost
forgotten enemy alien. This fact causes the supremacy of ineligible alien story lines that
impinges the alien narrative of negative connotations. As a result, the convergence of the dominant narratives creates
an Immigration policy discourse loaded of regulations focus to restrict and penalize illegal immigration in detriment of legal immigrants’ rights.
Immigration laws have liberalized through legal action and the plan eliminates
a facet of ableist violence in immigration law
Picciuto 17 (Elizabeth – philosophy phD – writes for the LA Times, Daily Beast, and the Eastablishment “What We
Get Wrong When We Talk About the Value of Immigrants and Refugees” 31st January 2017 The Establishment
The sledgehammer of the White House’s executive order restricting immigration from majority-Muslim countries has fallen. Since
then, those opposed have been fighting hard to bring us out from under it. There have been rallies at airports, legal
challenges — and, of course, rightful and righteous outrage on social media. Many who oppose
the yes-it-totally-is-a-Muslim-ban have made strong arguments against it: It violates freedom of religion, a
cherished promise of the Constitution. America’s very identity is founded on it being a haven for refuge-seekers. Legal residents are
now forbidden from entering the country. I, too, am implacably opposed to the ban. However, I’ve repeatedly seen two
arguments against the ban that we shouldn’t be making. One lists financially successful immigrants and their
descendants. The other pines for the Canadian immigration system. Praise for the Canadian system swelled after Canadian Prime
Minister Justin Trudeau’s pointed tweet welcoming refugees. Listing successful immigrants and valorizing Canada’s open arms seem,
on the surface, entirely unrelated. They have one thing in common, though:
Both calculate the worthiness of
immigrants in terms of their skills and economic productivity. They not only prioritize the alreadyeducated or already-wealthy, they prioritize non-disabled people. They are classist and ableist. Of
course, disabled people do not necessarily lack skills and economic productivity. There are countless disabled people who are far more
skilled and economically productive than I could ever hope to be. But the desire to
exclude disabled people and
unskilled people spring from a similar source. It’s a ranking of people based on the expected
return on money invested in them. Unskilled people, it is presumed, are less likely to generate jobs and tax revenue.
Disabled people are less likely to have jobs and are more likely to consume expensive health care.
Yet an immigrant’s value to our country cannot solely be calculated in spreadsheet form. In the late19th and early 20th centuries, eugenics was widely popular. Eugenics is a pseudo-science that posits society should cultivate those
breeders who will supposedly improve the evolution of the human race. Simultaneously, “undesirables” thought to render future
generations less fit should be weeded. The presence of disabled people among the population meant that they might pass their
disability to future generations, thereby supposedly reducing the overall fitness of the human race. They were also believed to be
unbearable economic weights. As a result, immigration of disabled people to
the U.S. was severely restricted.
Eugenics as a guiding force reached a peak of terrifying and deadly power during the Holocaust,
when Nazis attempted to kill all those they considered genetically inferior, causing the genocide of 6 million Jews, as well as the
murder of Romany, LGBT, and disabled people. In succeeding decades, eugenics was, thankfully, gradually more discredited,
although certain shameful manifestations remained, such as forced sterilization of disabled people
and poor women of color. Currently, while ableism continues to be unquestionably rampant, and many people may privately
hold eugenic beliefs, bald statements supporting actual eugenics are rarer in the U.S. There are very notable exceptions — such as neoNazis and, well, Donald Trump himself. At least one famous neo-Nazi sees in the current Muslim ban a hope for the future when
eugenics may again be openly be part of U.S. immigration policy. Racism and eugenics have always been fellow-travelers. Since the
mid 20th century, ableist U.S. immigration laws slowly liberalized. A law that emphasized re-uniting families and to a
lesser degree skilled workers — as well as removing requirements regarding national origin — was enacted in 1965. Huge steps forward
occurred in 1986, when it was determined that disabled undocumented immigrants could legally remain in the country, and 1990,
when specific disabilities were no longer named as justification to bar entry. The
American immigration system is not
free from ableism. It still bars people who are likely to be “a public charge,” that is, require
government benefits (a clause which doesn’t specifically target disabled people, but a higher percentage of whom are likely to
be disabled). People with certain mental illnesses thought to predispose people to criminality and certain communicable diseases are
also denied entry. These are not to be waved away — but overall, the U.S. has undeniably made strides in its immigration policies.
During the recent senate hearings on his nomination to the office of Attorney General, Jeff Sessions commented, “Immigration flow
from almost all of our countries is based on family connections and other visas rather than a skill-based program more like Canada has
today.” He later reiterated, “Looking at the Canadian system, some of those policies ought to be considered by the United States.”
(See from 2:43:10 and 3:05:26.) This is the same Jeff Sessions who is believed to be one of the architects of the Muslim ban. Why
would he be in concert with so many decrying the ban, calling for a system more like Canada’s? Since November 2015, Canada has
indeed permitted more than twice as many refugees from Syria to enter their country as the U.S. What Sessions admires about the
Canadian system, aside from its refugee policy, is its relative de-emphasis on family unity. Instead, Canada emphasizes skilled
immigrants likely to generate more tax revenue than they cost. Canada restricts immigration by those who are likely to cause
“excessive demand” on public services. This sounds like the U.S. restriction on those likely to be a “public charge,” but it functions
quite differently. Though there’s no explicit restriction on immigration by disabled people, Canada factors in the cost of special
education and health care as part of public services. So in practice, almost all disabled people cannot immigrate to Canada, unless they
are wealthy enough to cover the costs of the services they require. Importantly, though, exceptions are made for disabled refugees.
Here is an insightful blog post on the topic by disabled scholar Kim Sauder. In the U.S., health care is of course not publicly funded.
Requiring special education doesn’t render an immigrant a public charge. People residing in the U.S. may have disabled family
members, who would then receive priority for immigration. It is in fact significantly easier (for now) for disabled people to immigrate
to the U.S. than to Canada. This fact gained some brief notoriety recently when a professor in Canada was denied residency because
his son has Down syndrome (I wrote about the caseat the time). Canada prioritizes immigrants who already have education and skills.
This immigration system is what Sessions wants to import to the U.S. When we enact laws that
prioritize skills, that discourage disabled people from immigrating, we are stating a collective
value: What makes a human being worthwhile is a low cost/benefit ratio. It’s not surprising that Trump, a
businessman who campaigned on a promise to run the country like a business, might view citizens in terms of their effect on the
bottom line. Similarly, when we argue that we should permit Syrian refugees because Steve Jobs’s father was Syrian, or when we list
all the economically successful people who are immigrants or children of immigrants, we are suggesting that we should permit
immigrants because one of them is likely to be successful too. What does this say about the immigrants who don’t found a disruptive
tech startup? Who are dishwashers and cab drivers and janitors? Who may not earn much money, but are valued members of their
families and their communities, and who no less lack the dignity and worth we all share? The words of The New Colossus have been
much quoted these past few days: There is no caveat here that we welcome only those yearning to breathe free if they already know
how to code C#. Let’s welcome refugees as Canada does, without making all our immigration priorities more like Canada’s immigration
priorities. Let’s recognize that the
value inherent in each person is not reducible to dollar signs. Let’s
provide refuge for those in danger no matter their religion, bring families together, and ensure
opportunity for all — including disabled people. Those are the values I hope America may one day embody.
And - addressing disability policy at every turn is a prerequisite to
understanding and combating the pathologization of certain identities
Taylor 17 (Sunaura - American activist for disability and animal rights. She has taught classes at the University of
California, Berkeley. “Beasts of Burden: Animal and Disability Liberation” 2017 ch. 2)mr
The profound systemic prejudice and discrimination faced by disabled people pervades nearly
all aspects of society. Yet this prejudice changes with location, race, gender, class, and the nature of a person’s specific
disability. My own privilege as a white, middle-class, physically disabled American woman with no communication impairments and
the means to live in my own home with assistants whom I choose and hire has often shielded me from the reality of many of these
oppressions—realities that are inescapable for other people with disabilities. Disability oppression and disability activism play out
differently depending on place and experience. Individual populations face specific challenges particular to them. Further
complicating matters is the fact that, as is becoming evident, the barrier between able- bodiedness and disability is far from clearcut or permanent. Disability
can be an identity one embraces, a condition one struggles with, a space
one finds liberation in, or a concept that can be leveraged to marginalize and oppress. It can also
be all of these things at once. It becomes increasingly clear that disability is not only a lived experience
that shapes individual human lives—it is also an ideology that plays a central role in forming our
histories, politics, and cultures. Disability doesn’t belong simply to the margins, or to medicine, or to a few specific
historical events; instead, disability—like gender, class, and race—is a social force that affects the world in a pervasive manner.30 As
historian Douglas C. Baynton notes, “Disability is everywhere in history, once you begin looking for it, but conspicuously absent in
the history we write.”31 This
becomes starkly evident when we consider that ideologies of disability
have been central to the development of the modern world. For example, scholars have exposed the role of
disability in the creation of capitalism and labor relations, particularly in contributing to definitions of a “work-based” system versus
a “needs-based” system of distribution, as well as in definitions of concepts such as independence, efficiency, and productivity.32
Others have shown how ideologies
of disability have been key to formulating US. immigration policies,
as justifications for the exclusion of various racialized and classed populations have often
stereotyped certain populations as “likely to become a public charge" or pose a public health
threat.33 Such examples of the importance of disability in shaping our society abound. Perhaps
most telling, though, is the role concepts of disability have historically played in reinforcing and
defining categories or difference.” Ideologies of disability have contributed to the pathologization of various populations
by infantilizing them, declaring them weak, vulnerable, unintelligent, prone to disease, less advanced, in need of care, and so forth.
This pathologization is intricately tied up with ableism, which asserts that markers of disability,
such as vulnerability, weakness, physical and mental abnormality, and dependency are undesirable. Consequently, any physical or
mental attributes that can then be associated (falsely or accurately) with these conditions are seen as biological, natural deficiencies
that need to be regulated and controlled.
Policy feedback can spill over and is a first step in dismantling current restrictive
immigration policy that justifies the perm on the k
Pedraza et al 17, Pedraza's research was supported by the RWJF, Scholars in Health Policy
Research Program. LeBrón's research was supported by University of Michigan National Center
for Institutional Diversity. (Franciso I. Pedraza, Vanessa Cruz Nichols, Alana M. W. Lebrón,
“Cautious Citizenship: The Deterring Effect of Immigration Issue Salience on Health Care Use and
Bureaucratic Interactions among Latino [Latinx] US Citizens”, 10-1-2017, The Politics and
Challenges of Achieving Health Equity, [edited for language]
Research shows that health care use among Latino [Latinx] immigrants is adversely affected by restrictive immigration policy. A core concern is that immigrants shy away from sharing personal information in response to policies that expand bureaucratic monitoring
of citizenship status across service-providing organizations. This investigation addresses the concern that immigration politics also negatively influences health care utilization among Latino [Latinx] US citizens. One implication is that health insurance expansions may
not reduce health care inequities among Latinos [Latinxs] due to concern about exposure to immigration law enforcement authorities. Using data from the 2015 Latino [Latinx] National Health and Immigration Survey, we examine the extent to which the politics of
immigration deters individuals from going to health care providers and service-providing institutions. Results indicate that Latino [Latinx] US citizens are less likely to make an appointment to see a health care provider when the issue of immigration is mentioned.
Additionally, Latino [Latinx] US citizens who know someone who has been deported are more inclined to perceive that information shared with health care providers is not secure. We discuss how cautious citizenship, or risk-avoidance behaviors toward public
institutions in order to avoid scrutiny of citizenship status, informs debates about reducing health care inequities. Introduction A major challenge to reducing health care inequities is that the costs of health insurance and health care deter people from using health
Policy designed to subsidize coverage and expand eligibility, such as the 2010
Patient Protection and Affordable Care Act (ACA), helps address this challenge.
care services for which they are eligible.
For example, by September 2015, two years
since key coverage provisions of ACA were implemented, Karpman and Long (2015) report a 41 percent decrease in uninsured rates among non-elderly adults. However, they also report that inequities in uninsurance rates remain disproportionately high for Latino
[Latinx] s [Latinxs] (23 percent) relative to non-Latino [Latinx] s [Latinxs] (7 percent), even in Medicaid expansion states (Karpman and Long 2015). Expansions and subsidies may fall short if implemented without adequately accounting for various social, economic,
and political forces (Chin et al. 2007; Kilbourne et al. 2008; Minkler 2010). One line of research that attends to such complexity focuses on the relationship between immigration policy and health (Hacker et al. 2011; Rhodes et al. 2015).
paths of research addressing inequities in health care
coverage (Castañeda and Melo 2014; DeRose, Escarce, and Lurie 2007; Joseph 2016), health care access and
utilization (Beniflah et al. 2013; DeRose, Escarce, and Lurie 2007; Donelson 2015; Toomey et al. 2014), and health outcomes (Cavazos-Rehg, Zayas, and Spitznagel 2007; Miranda et al. 2011; Rhodes et al. 2015)
immigration policy is health care policy.
conclude that
Studies pointing to this conclusion begin by noting that immigration politics structures health-related outcomes because nativity and citizenship criteria
determine program eligibility (Gee and Ford 2011; Zimmermann and Fix 1998). A related claim is that policy exclusions lead immigrants to worry that using welfare programs, including public programs related to health, increases the risk that they or those they are
immigration and
immigrant policies reinforce definitions of national belonging that conflate citizenship status and
ethnicity, which then transfers stigma associated with unauthorized immigration to entire
groups of people, regardless of their citizenship status
close to will be detected or classified as an unauthorized immigrant, which may spoil efforts to adjust citizenship status, or result in deportation (Fix and Passel 1999; Park 2011). Scholars also contend that
(Chavez 2008; Fox 2016; Viruell-Fuentes, Miranda, and Abdulrahim 2012). These studies highlight the salience of
immigration issues and suggest why some people might be cautious about sharing personal identifying information, even with health care providers. These strands of research corroborate a narrative that immigrant advocates use in describing
withdrawal from full engagement in public life among immigrants and their United States-born
co-ethnics in response to anti-immigrant policies
(Kalet 2009; National Council of La Raza 2014; Vallejo 2010). However, evidence is sparse on the extent to which restrictive
immigrant policy spills over to US citizens and their propensity to access health care services. The presumption has been that US citizens are not personally at risk in an environment of more exclusionary immigrant policies; therefore, their behavior surrounding
health care services that they are eligible for should not be shaped by such policies. We also know very little about whether the concerns outlined above extend broadly to other service-providing bureaucracies, or deeply to the perceptions that citizens have about
the integrity of health care professionals to guard their personal information. Reducing health care inequities may require the trust of patients at various steps in the provision of services, including the collection of basic demographic information that helps
determine appropriate diagnosis, treatment, and access to needed social and health care resources. To what extent does the salience of immigration issues deter US citizens from using health care services? Who expresses skepticism about sharing personal
identifying information in health care settings? In the sections that follow, we answer these questions theoretically and empirically. We argue that one consequence of contemporary restrictive immigrant policies is that it psychologically conditions Latino [Latinx]s to
navigate daily life around considerations of immigration policy for themselves, for those they are close to, and for members of their social networks. The growth in immigration enforcement bureaucracies charged with identifying and detaining people in the interior
of the United States (Koulish 2010; Meissner et al. 2013), as well as efforts to police citizenship by officials outside of law enforcement (Sampaio 2015), facilitates a psychological aversion to immigration-related issues. We contend that the rise of a restrictive
immigrant climate has taught even Latino [Latinx] US citizens to adopt strategies that minimize their risk of experiencing harassment associated with questions about their citizenship status. Using a population-based survey experiment, we test the claim that
immigration issue concerns structure one's willingness to seek medical attention. By priming concerns over “immigration issues,” as opposed to “health insurance” policy concerns, we expect respondents to be less willing to engage with health care providers. When
we refer to priming, we refer to raising the relevance and recency with which certain considerations become activated in one's working memory (Fiske and Taylor 1991; Taylor and Fiske 1978). As a broader analysis, we also compare the effects of priming
“immigration issues” to other facets of quotidian life. Despite their US citizenship, we find Latino [Latinx] s exposed to the “immigration issues” cue shy away from engaging with doctors, police, and, to a lesser extent, educators. We also find that a personal
connection to someone who has been deported is associated with the belief that personal information shared with health care providers is not secure. In the final section, we discuss implications of our study for addressing health care inequities. Issue Publics, Policy
the issue of immigration guides the way
Latinx]s think
about and engage with health care resources
Latinx health care inequities and
evaluation efforts aimed at addressing such inequities require an understanding of how
immigration and health care policy overlap.
Latinx] s that
are unwelcome in America this connection is sustained by a decades-long protracted salience
of immigration politics
Feedback, and the Immigration-to-Health-Care Link Our core theoretical argument is that
that many Latino [
. We contend that both Latino [
Connections between restrictive immigration and health care policy in the US relay messages to Latino [
, and
for Latino [Latinx] s. In this section, we draw on the concept of issue publics, priming, and the framework of policy feedback to motivate hypotheses about the relationship between immigration and
engagement with health care providers. Immigration Issue Salience and Latino [Latinx]s Rather than one public that is highly informed about politics in general, societies consist of smaller issue publics (Converse 1964; Key 1966). Demands on our time from other
aspects of life are too onerous to afford attention to a wide range of politics (Rosenstone and Hansen 1993; Verba, Schlozman, and Brady 1995). But most people pay attention to one or two issues. Groups of individuals who pay close attention to an issue, such as
health care or immigration, are attentive to these political issues because of their salience in day-to-day life. Compared to nonmembers, members of issue publics form strong attitudes about their issue and use that issue to orient their political behavior (Krosnick
1990). Moreover, information in the political environment that raises the salience and accessibility of particular considerations—what social psychologists call priming (Fiske and Taylor 1991; Taylor and Fiske 1978)—can stimulate information collection for those with
intense interest in that issue (Hutchings 2003). Priming effects can also influence political judgments broadly. For example, Nicholson (2005) found that issues primed by statewide ballot initiatives frame the way people think about and choose candidates for federal
offices, even when those issues are not featured in those contests or extend beyond the scope of responsibilities associated with those offices. These studies uncover the power of priming effects to transcend institutional boundaries, and suggest that members of
issue publics may use their issue priorities to guide how they think about other issue areas. For Latino [Latinx] s, the link between matters of immigration and matters of health care begins with the importance of immigration as an issue. Gallup's famed question that
asks what is the “most important problem” facing the country indicates that from 1994 to 2016, a multiracial nationally representative sample of Americans infrequently mention “immigration” as the most challenging issue, with most years registering less than 10
percent.1 Unlike the perennial worry over jobs and the economy, only at key moments such as the 2006 immigration rallies (19 percent), the 2007 congressional debates over national immigration reform (15 percent), and the 2014 surge in refugees from Central
America seeking asylum in the United States (17 percent), did more than one in ten Americans point to immigration as most important. In contrast, at six different points from 2004 to 2012, the Pew Hispanic Center observed no fewer than 27 percent of US Latino
[Latinx] s citing immigration as the top issue, with peaks of 37 percent in 2007 and 34 percent in 2012.2 For about one in three Latino [Latinx] s, or three times as many compared to the general public, immigration is a chronically salient policy issue. Latino [Latinx] s
are a key constituency of the immigration issue public for a more basic reason. Fifty-two percent of Latino [Latinx] adults are foreign born, and 85 percent of all Latino [Latinx] s have at least one immigrant grandparent (Fraga et al. 2011). Migration into Latino
[Latinx] communities in the United States has been sustained over a century, replenishing Latino [Latinx] ethnic identity and reviving anti-Latino [Latinx] nativist impulses (Gratton and Merchant 2015; Jiménez 2008). Unlike immigrants from various European
countries, Latino [Latinx] incorporation traces through conquest in the 1800s, through migration preceding the Great Depression, to newcomers sponsored through the Bracero guest-worker program that operated from 1942 to 1964, and to present-day workers
from Mexico and other Latin American countries responding to the demand for cheap labor in the United States since the 1970s (Gutiérrez 2004; Massey 2002). The salience of immigration for Latino [Latinx] US citizens today also stems from their personal proximity
to undocumented immigrants, who are the focus of the most intense debates in immigration politics. A 2014 survey of Latino [Latinx] s (Lopez, Gonzalez-Barrera, and Krogstad 2014) by the Pew Hispanic Center found that 23 percent of US-born Latino [Latinx] s, and
31 percent of US-born children of at least one immigrant parent, reported personally knowing someone who had been detained for immigration-related reasons or deported in the past year. Responses collected one year later in the 2015 Latino [Latinx] National
Health and Immigration Survey (LNHIS), a survey that the authors of this study helped to design and field, suggest a similar figure: 39 percent of Latino [Latinx] US citizens, inclusive of immigrants who are naturalized citizens, personally know someone who has been
deported. A major implication of deep and widespread personal connections to the immigration experience is that Latino [Latinx] US citizens are chronically primed by immigration matters in everyday life, including matters related to health care. The concepts of
issue priming and issue publics help clarify the salience of immigration issues to Latino [Latinx] s and the potential connection to other issues. The key to understanding why immigration politics is an obstacle to reducing health care inequities is the historical overlap
between immigration and welfare-state policies. The overlap between immigration and welfare policies reveals crucial lessons to Latino [Latinx] s about their place in America, both as suspect clients of the welfare-state, as well as default targets of immigration
enforcement. Next, we draw on the concept of policy feedback to explain why immigration provokes a psychological aversion to engagement with health care-providing resources among Latino [Latinx] s. Policy Feedback and Deterred Engagement with Health Care
The policy feedback framework posits that policy creates new politics by influencing mass
publics through “resource” and “interpretive” effects
Policy also has interpretive effects that can reshape later rounds
of policy processes by empowering some voices and discouraging others. Interpretive policy
effects begin simply with policy that classifies people and codifies criteria, such as nativity and
citizenship, that determines who receives benefits and who receives burdens
(Pierson 1993). Policy investments in senior citizens (Campbell 2002) and veterans (Mettler 2005), for example,
redistribute resources such as money and time, which facilitate political participation.
(Schneider and Ingram 1993). Policy also imparts
lessons through participation in public programs that signal who is a deserving member of the polity (Soss 2002). Programs such as the GI Bill (Mettler 2005), Social Security (Campbell 2007), and Head Start (Soss 2002), teach people that government is responsive,
and empower participants to engage in civic life. By contrast, “stop-and-frisk” policies and “show-me-your-papers” laws that disproportionately target blacks and Latino [Latinx] s communicate to members in those groups that government is not responsive to their
needs and they are second-class members of society. Studies show that such laws nudge Latino [Latinx] s and blacks to distrust and avoid government (Burch 2013; Rocha, Knoll, and Wrinkle 2015; Walker 2014; Weaver and L erman 2010). Here, we are interested in
the interpretative lessons Latino [Latinx] s might glean from immigration policies and policies related to the provision of health care. The social construction of immigrants and Latino [Latinx] s as less deserving stems from nineteenth-century public charge laws used
to regulate entry into the United States. The United States is a nation that welcomes immigrants, the reasoning goes, but the United States must secure its own welfare before aiding the less fortunate of other nations. Public charge laws also exclude persons alleged
to have committed or convicted of a crime, a provision lawmakers connected to Mexican immigrants in the debates that produced the 1924 Johnson-Reed Act (Ngai 2004). Importantly, Johnson-Reed introduced the concept of illegal alien (Ngai 2004: 58), which
“Europeans and Canadians tended to be disassociated from,” but “became constitutive of a racialized Mexican identity and of Mexicans' exclusion from the national community and polity.”3 From the perspective of policy feedback, overlap between immigration and
welfare-state policies reifies nativity and citizenship as markers that distinguish more from less “deserving” groups (Myers 2007). Policy feedback theory anticipates that products of past policy, such as the designation of illegal immigrant and public charge rules, can
have long-lasting influence on future policy outcomes and how subsets of the population view government. The
policing citizenship and nativity
policy roots of health care inequities grow from
remain with us today. For example, the ACA continues to invoke citizenship and nativity as boundaries of our social obligations (Joseph 2016). Specifically, the health care
exchanges created through the ACA call for local bureaucrats and computer systems to flag the citizenship status of applicants. The ACA systems are extensions of exclusions codified in the 1996 Personal Responsibility, Work Opportunity and Reconciliation Act
(PRWORA), which reinforced citizenship and nativity-based privilege by barring immigrants with authorized US presence who arrived after the law passed from accessing public benefits for five years or until attaining proper status. Although numerous states
countered the five-year residency ban by legislating immigrants back into the fold within their jurisdiction, the 1996 federal bar initially excluded authorized immigrants from Medicaid, the Supplemental Nutrition Assistance Program, and Supplemental Security
Income. States have implemented similar exemptions to cover excluded populations under the ACA. Still, contemporaneous to PRWORA are policies such as the 1996 Illegal Immigration Reform and Immigration Responsibility Act (IIRIRA), and the Anti-Terrorism and
Effective Death Penalty Act (ATEDPA), which expanded US immigration enforcement powers by removing key components of due process for noncitizens, increasing the set of deportable crimes, and allowing retroactive application of deportation proceedings for
crimes previously adjudicated (Welch 2002). Like PRWORA, IIRIRA and ATEDPA widen the gap in rights between noncitizen and citizen, setting the stage for the federal immigration enforcement of the 1990s that Watson (2014) and Vargas (2015) identify as deterring
eligible people from using various welfare programs, including Medicaid. More explicit ties between law enforcement officials and public health bureaucrats stretch back over a century. According to Molina (2006), rather than pointing to the unsanitary living
conditions of labor camps provided by railroad companies, public health workers advanced racist claims of Mexicans' aversion to bathing to explain the spread of typhus in Los Angeles in 1916. After blaming Mexican immigrant railroad workers for typhus outbreaks,
public health workers enacted policy that required railroad companies to quarantine new workers from Mexico and report the names of all new hires to the Los Angeles Board of Health. As Molina (2006: 66) explains, “[q]uarantine guards, invested with the same
legal power as deputy sheriffs, policed the quarantine observation facilities to prevent anyone from leaving,” and “the expanding information exchange between public agencies and private companies placed Mexicans under an unprecedented level of surveillance.”
Through their authority to implement health policy, public health officials associated themselves with immigration authorities. Ironically, by redirecting public health politics into immigration policy debates, health officials sowed the seeds of aversion toward their
services, and potentially generated future Latino [Latinx] health care inequities. Working with immigration authorities, relief bureaucrats divulged client information that guided mass deportation operations during the Great Depression. According to Fox (2012),
Depression-era social workers ensured that poor European migrants settled into a world of relief and inclusion, while blacks in the S outh and Latino [Latinx] s in the Southwest, by contrast, faced exclusion from relief. For Mexicans and United States-born Mexican
Americans, stakes mounted when charity workers passed applicant information to immigration officials that led to expulsion from the United States. As a strategy to thin welfare rolls, some relief agents like “the head of the Arizona Board of Public Welfare had no
objections to letting immigration officers have access to the personal histories of all aliens applying for relief,” while others like “the county board's lawyer advised against it, ‘on the ground that many deserving aliens would be afraid to ask for help’” (Fox 2012: 151).
As targets of
and immigration policies Latinx] s are likely to have understood the stakes of turning to
relief programs in this context, and gleaned a lesson to avoid public program participation.
citizenship-based exclusions from public program benefits are not limited
cooperation between local welfare bureaucrats and federal immigration authorities
mandated that public workers report to officials
As policy implementers, relief bureaucrats were aware of the “interpretive” effects—that is, the impact on public clients—of their choice to coordinate (or not) with immigration authorities.
, Latino [
Nativity- and
to the Depression-era past; nor is
. In 1994, California voters enacted
Proposition 187, an initiative restricting undocumented immigrants from using public schools and public hospitals. The measure
person they suspected of being undocumented. By interpreting “a discrete act of violating immigration law” as “a criminal tendency in Mexicans” (Jacobson 2008: 47), supporters of Proposition 187 reinforced the conflation of ethnicity with citizenship status, and
proponents left a
legacy of arguments to justify policy prescriptions for public program exclusion and expulsion
from the country, as well as reasoning to condone racial profiling as the means to achieve such
policy logic that conflates citizenship status with Latinx] identity motivated a health
insurance fraud detection program targeting
revived the Depression-era practice of using local welfare bureaucrats as extensions of federal immigration enforcement authorities. The courts deemed California's Proposition 187 unconstitutional. But,
. For instance,
Latino [
Latina {Latinx}women of child-bearing age at airports (Park 2011: 2). The California Department of Health Services initiated this fraud
detection program, but it was discontinued in the early 2000s, according to Park (2011: 2), after investigators found program implementers “legally liable for overstepping the scope of their aut hority by attempting to influence federal [Immigration and Naturalization
Services] decisions on whether to admit or deport immigrants as well as sharing confidential medical information in the process.” Similarly, Proposition 187 replica legislation such as Arizona's S. B. 1070 (2010), Alabama's H. B. 56 (2011), and Georgia's H. B. 87 (2011)
invoke the term “illegal alien” as justification for service-providing bureaucrats to identify suspected undocumented immigrants, sustaining the specter of racial profiling. Historically, policing citizenship happens at airports, welfare offices, and on the streets when
encountering police—all contexts where personal information must be divulged. Sensitivity to racial profiling and policing citizenship is particularly acute for Latino [Latinx] s following post-9/11 public investments in operations that focus on deporting people from
the interior. According to the US Department of Homeland Security, the number of deportations from 2000 to 2015 exceeded the total number of deportations in the twentieth century.4 Record-level deportations are possible, in part, because programs such as
Secure Communities expand the geographic reach of immigration enforcement across and within each US state by coordinating federal and local law enforcement resources (Cox and Miles 2013; Meissner et al. 2013; Pedroza 2013). As evidence that Latino [Latinx] s
have internalized policy lessons from Secure Communities operations—as predicted by policy feedback theory—Rocha, Knoll, and Wrinkle (2015) find that deportations increase distrust in federal and local government among both immigrant and US-born Latino
[Latinx] s. Fueling criticism of interior-oriented immigration enforcement programs is evidence of racial profiling by local police, who identify and detain both Latino [Latinx] US citizens and persons without criminal records (Kohli and Chavez 2013; PBS 2011). In
addition to bringing immigration authorities closer to their day-to-day life, interior operations are salient to Latino [Latinx] s because immigrants from Latin American countries represent 96 percent of all deportations from the United States since 2010 (TRAC 2014).
In fact, after Arizona lawmakers passed a law mandating that local police officers inquire about immigration status during routine traffic stops (S. B. 1070), a 2010 survey of Latino [Latinx] voters in Arizona found that 72 percent said they believe that police primarily
inequities are shaped by histories of institutional and interpersonal
racism from medical institutions toward racial minorities,
studies indicate medical abuse
and the forced sterilization
abuses serve to widen the structural space betwee [Latinx] s and health care
systems, which shapes patient mistrust of providers and public health institutions
target Latino [Latinx] s (Barreto and Segura 2010). Subsequently4
as well as racialized power imbalances between predominantly white health care providers and racial
minority patients (Sewell 2015; Smedley, Stith, and Nelson 2003). In addition to the racializing role of public health instit utions described above,
intentionally infected with syphilis and other infectious conditions in the 1940s (Reverby 2011),
medical and public health
of Guatemalans who were
of Californians in the early- to mid-twentieth century (Stern et al. 2017).
n Latino
. Indeed, Sewell (2015) reports that
Latino [Latinx] adults are more likely than non-Latino [Latinx] white adults to express mistrust in their health care providers' medical decision making and interpersonal competence. Similarly, qualitative research suggests that some undocumented immigrant youth
perceive that physicians prioritize health care finances over medical decision making, contributing to mistrust in providers (Raymond-Flesch et al. 2014). This evidence base suggests that racial inequities in the mistrust of health care providers may contribute to
health care inequities. The arc from historical to contemporary accounts shows that immigration and public health policy streams compound one another to “position [Latino [Latinx] s] as a stigmatized out-group in American social cognition” (Massey 2013: 267).
Past policy patterns that connect welfare stigma and social program deterrence give historical
to the 22 percent of Latino [Latinx] s in 2007 who indicated that they were less likely to use government services because of increased public attention to immigration issues (Pew Hispanic Center 2007: 18). Importantly, this figure is the same for
immigrant and US-born Latino [Latinx] s, and was collected prior to the major expansions in interior-oriented immigration enforcement operations noted above (Golash-Boza 2012; Koulish 2010; Meissner et al. 2013). From the perspective of persons who are likely to
be profiled, or who personally know someone who is likely to be profiled or has been deported, the interpretive lessons from contemporary immigration and welfare policy are that local law enforcement is not worthy of their trust, nor are the people and
organizations who keep personal information that might be turned over to law enforcement officials. As Zayas (2015: 81) notes, in response to restrictive immigration policy, Latino [Latinx] communities “devise new ways of coping and techniques to evade the new
restrictions and harsher penalties for immigration violations.” Yet, as a source of factors that deter people from using health care services, we know very little about the extent to which the politics of immigration spills over to influence US citizens.
Perm do the alt
Perm do the alt – public charge is a neoliberal justification to exclude and
render immigrants as disposable labor
Park 11 (Lisa, Assistant Professor in the Ethnic Studies Department and the Urban Studies and
Planning Program at the University of California, San Diego. She is co-author of The Silicon Valley
of Dreams: Environmental Injustice, Immigrant Workers, and the High-tech Global Economy
(2002). International Journal of Sociology of the Family Vol. 37, No. 1, POLICING MOTHERHOOD
(Spring 2011), pp. 27-47. “CRIMINALIZING IMMIGRANT MOTHERS: Public Charge, Health Care,
and Welfare Reform”, JSTOR) NREM/Lil’ GBN
Public charge is a federal immigration law to describe an "alien who has become (for deportation
purposes) or is likely to become (for admission or adjustment of status purposes) primarily dependent on the
government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance, or
institutionalization for long-term care at government expense" (USCIS 1999.) It is used as an administrative tool to
exclude or deport those immigrants perceived to be or to have the possibility of becoming a
burden on the state. Pregnancy has long been categorized as a public burden with respect to low-income immigrant women.
Scholars consider this designation as part of a continuing tradition of "selective immigration" that began in 1875
(Luibheid, 2002: 9). This was solidified with the Immigration Law of 1891, which provided the institutional mechanism
for federal officials to inspect and exclude immigrants on the basis of public charge. At this time,
Public Health Service agents were required to inspect and issue a medical certificate to all incoming immigrants
for "loathsome or a dangerous contagious disease," including pregnancy (Fairchild, 2003: 14). According to
historian Martha Gardner (2005: 89), "Between 1880 and 1924, 'likely to become public charge' (LPC) provided a catch-all category
of exclusion through which vast numbers of women found themselves deported as potential paupers for moral, marital, physical,
and economic deficiencies." Gardner points out that while laws against poverty were usually applied to both men and women
immigrants, LPC singled out women as the social mores of the early 20th century linked immorality to indigence and, subsequently,
poverty alleviation policies increasingly focused on women's morality and their "proper" role within the family. From 1895 to 1915,
LPC designations accounted for two-thirds of all exclusions from entry to the U.S. (Gardner, 2005: 91). By the end of
the Great Depression, public charge designations largely disappeared from the federal immigration agency's exclusionary
repertoire. Then, in the mid-1990s, it reappeared with new health care fraud detection programs in
California (Park, 2001). In particular, prenatal care access and utilization by low-income immigrant women was
targeted. This paper addresses how and why public charge resurfaced to criminate low-income immigrant mothers in the 1990s.
As part of a larger project on the impact of immigration and welfare policies on prenatal care access for low-income immigrant
women in California, I began this research in 1998. In addition to analyzing the local, state, and federal policies, my research team
This content downloaded from on Fri, 06 Jul 2018 18:33:57 UTC All use subject to 30
International Journal of Sociology of the Family and I interviewed 196 safety-net health care providers, immigrant health advocates,
government officials and low-income immigrant women in San Diego County, the San Francisco Bay Area, Los Angeles, and the
Central Valley. For this paper, I will first discuss the significance of neoliberalism, as a specific historical moment, which set the
conditions for the resurgence of public charge. I next outline in greater detail a lawsuit brought by Mrs. R. against the Medicaid
Fraud Detection program, which exposed the illegal actions of this government program. I then place this program in the larger
political context of public charge and the Welfare Reform of 1996. Here, I show how immigrant mothers are affected by this
federal legislation and delineate the new institutional linkages formed between issues of
immigration and health care. Finally, I discuss the implications of public charge on the criminalization of
immigrant motherhood. Policing Immigrant Motherhood in Neoliberalism. While the notion of immigrants as public burdens is
not new, re-assertions of formal, state designations of public charge policy are critical political moments that
highlight the role of immigrants during crucial, historic shifts in national ideology. In this latest iteration in
the 1990s, public charge enters the scene once again, teasing the rights of migrants within transnational free
market governmental practices.3 In many respects, the timing appeared perfect. As immigrant women s labor
becomes more central to everyday life, their presence is increasingly destabilized and marginalized as
burdensome. Sanford Schram (1995: 61) observed, even before the passage of major welfare and immigration reforms in 1996,
. .an ongoing 'privatization of public assistance' - a retrenchment of public welfare programs and the corresponding elaboration of a
network of substitute services, often in the form of private aid." Unlike entitlements or rights, publicly
funded programs
including welfare and health care were
increasingly stripped of dignity and privatized into a humiliating form of
individual charity. The consequences are extensive. Schram correctly predicted greater fragmentation and
less accessibility, visibility, and effectiveness in the provision of social services, which diminished what litde protection existed
from structural issues that cause poverty including declining wages and eroding worker protections,
racism and the dismantling of civil rights, unaffordable and inadequate childcare, underfunded
public schools, and diminished access to higher education (Marchevsky and Theoharis, 2006: 10). Instead,
poverty is individualized as personal moral failings so that the solution centers on disciplining non-normative bodies to perform in
certain ways. This content downloaded from on Fri, 06 Jul 2018 18:33:57 UTC All use subject to Criminalizing Immigrant Mothers: Public Charge, Health Care... This logic allowed for the justification of
policing poor women by defining dependency as a pathological disease indicative of those with such weak moral constitution that
they are unable to self-regulate and make the "right" choices. In their analysis, Marchesvky and Theoharis (2006: vii) assess, "To
confess one's dependencies is to forfeit one's individuality and rights in the American state."
Dependency, then, becomes intertwined with whether or not one is deserving of rights indicative of social citizenship and
almost entirely separate from actual need. In fact, a decade after key western nations enacted neoliberal policies, Ricky
Solinger (2002: 62) argues that in the 1980s the "core, essential attribute of a person in the state of
dependency" was solidified as "the absence of the capacity to make sensible choices." She writes
that dependency and choice become fixed in an antithetical relationship with each other,
creating the necessary justification for greater restrictions on women's behavior (Solinger, 2002: 65). By the
1990s, low-income immigrant women are firmly circumscribed as dependent public burdens. For Asian and Latino immigrants, their
purported dependency as a public charge is used to criminalize particular legal behavior as "illegal," regardless of their actual
citizenship status. The formal re-surfacing of public charge was achieved by simultaneously capitalizing on the modes of racialization
and gendering that already existed within state institutions while at the same time utilizing new
forms of fear and anxiety
associated with immigrants in the "War on Terror" (See Fernandes, 2007; Maira, 2009; Nguyen, 2005). The purpose of this
manufactured and enforced dependency is to preserve the political and economic vulnerability of
immigrants during a time of unimpeded demand for their labor. Public charge policy is a
technology4 of what Nicholas De Genova calls "deportability." Writing on Mexican immigrants specifically, De Genova (2005: 8)
states, "It is deportability, and not deportation as such, that has historically rendered Mexican labor to be a distinctly
disposable commodity." He argues that U.S. immigration authorities do not actually intend to deport all undocumented
migrants. On the contrary, it is deportability, not deportation that ensures that some are deported in order that most may remain as
workers, whose pronounced and protracted legal vulnerability may be sustained indefinitely. Similarly, the possibility of deportation
through public charge maintains the vulnerable social location of immigrants (regardless of their legal citizenship status) and stricdy
polices their behavior. In the end, neoliberalism promises that less
government and more privatization will
lead to greater individual freedom. This assertion raises a crucial question: "For whom?" In the
case of many immigrants who are part This content downloaded from on Fri, 06 Jul 2018 18:33:57 UTC
All use subject to International Journal of Sociology of the Family of the growing working poor,
less government in the form of state services has led instead to greater state surveillance (a
different but continued government presence) and a diminishment of individual rights and freedoms (Schram
2000). In his astute analysis, Matthew Sparke (2006) points out that as much as neoliberalism trumpets ^-regulation, in
practice, it is a form of re regulation. He writes that whether at the macro level of government policy (in the form
of free trade, financial deregulation, welfare reform, etc) or at the micro level of governmentality (audits, performance assessments,
cultural cultivation of self-policing entrepreneurial individualism), these governmental
practices are all forms of
statecraft (see also Jayasuriya, 2006). This re-configured governance produces a multi-tiered state in
which the freedoms and rights of some are maintained by the reciprocal restriction on those
same freedoms and rights of others. Rather than greater rights in return for greater "personal responsibility," low-
income immigrants must allow increased government policing of their movements as proof that they are in fact making the right
"choices" and taking "personal responsibility”.
AT: Alt – Communist Horizon
The “communist horizon” doesn’t solve ableism—the institutionalization and
stigmatization of people with disabilities still exist
Vann and Siska 6 (Barbara H. Vann and Jan Siska, Barbara H. Vann is a professor at Loyola College and Jan Siska Is
a professor at Charles University, Taylor & Francis, Disability & Society, Vol. 21, No.5, “From ‘cage beds’ to inclusion:
the long road for indivduals with intellectual disability in the Czech Republic,” pg. 425-426)//jy
The Czech Republic, as other Central and East European (CEE)
countries, has a long history of placing people with
disabilities in large institutions, often located in remote parts of the country. People with intellectual
disabilities have been particularly likely to be placed in such settings. Reports by international organizations on conditions of institutions in the CEE
region highlight exclusionary practices and human rights abuses (Mental Disability Rights International (MDRI), 1997; Amnesty International, 2002). The
prevalence of appalling conditions in long-term institutions is by no means unique to CEE countries. Reports
of abuse were a factor
in – perhaps a driving force behind – de-institutionalization in the UK and the USA. However, ‘barriers to effecting
positive change are more complex in the countries of CEE’ (Klein & Parker, 2003, p. 16) due at least partly to the transition from state-domination to
more open societies. Official
government policy of placing people with intellectual disability (ID) into institutions
was premised on the discipline of defectology coming out of Russia’s Institute of Defectology, established in 1929.
Socialist educational philosophy insisted on a State where as many children as possible could
be brought up to standards based on ‘normal’ development. Children with any form of
‘deficiency’ were to be separated from normal children and, in many cases, from their families. By
maintaining children with disabilities in separate, segregated facilities, Soviet society was able
to exist as if there were no people with disabilities. People with disabilities were invisible (MDRI,
1999). These ideas prevailed throughout much of Central and Eastern Europe during most of the 20th century. Individuals with ID who
were not institutionalized were often isolated in their own homes due to lack of available
community-based services, as well as family members’ wishes to protect them from potential
abuse or to avoid bringing shame on the family. Under communism, decades of emphasis on
inpatient acute care facilities, biomedical specialties and institutionalized care occurred at the
expense of prevention, behavioral healthcare and community-based services (Ensor, 1993). Few public
resources for disability services were directed toward re-entering the community and independent living. On the other hand, large and often
elaborate institutions were constructed, staffed and funded by the state. While many of these health and
rehabilitation facilities provided adequate inpatient care, services were highly centralized and institutionalized (Holland, 2003). In many, if not most,
CEE countries today, a centralized, heavily biomedical and institutional health care sector remains in place. According to one author, ‘The
of institutionalized care for people with disabilities or chronic illness has not changed
significantly … since the fall of communism in 1989’ (Holland, 2003, p. 133). A void remains with regard to communitybased services. Individuals with disabilities and their families who resist institutionalized care often
are left to navigate many of their needs on their own. According to Klein and Parker: Promotion of the rights
of people with mental disabilities and the development of policies and practices for their care
and support is rarely high on the governmental agenda. Furthermore, the current fiscal crises threaten to make the
already unacceptable conditions in these institutions much worse. Nor has the gradual advent of market economies automatically brought any relief.
The networks of community-based services that are essential to the social inclusion of people
with mental disabilities remain drastically underdeveloped, particularly in rural areas. These factors
illustrate the urgent need for change. (Klein & Parker, 2003, p. 16)
AT: Cybernetics
Link Turn
Challenging ableism goes against technoscience’s re-conception of humanness
Campbell 9 (Fiona Kumari Campbell, Senior Lecturer In the School of Education and Social
Work at the University of Dundee (Scotland), Adjunct Professor in Disability Studies with the
Faculty of Medicine at the University of Kelaniya (Sri Lanka), PhD in Sociology, Humanities, and
Law from Queensland University of Technology (Australia), Certificate in Higher Research
Degree Supervision in 2005 from Griffith University (Australia), author of #Ableism: An
Interdisciplinary Introduction to Studies in Ableism and Textures of Ableism: Essays on
Ablement, Silence and Voice, contributor to the International Advisory Board of the Socio-Legal
Review, Journal of Literary and Cultural Disability Studies (England), Ethnographica: Journal of
Disability and Culture (Belgium), the International Review of Disability Studies, and Associate
Editor, Journal of Social Inclusion (Australia), the Scientific Board of the Italian Journal of
Disability Studies (Italy), 2009, “Contours of Ableism: The Production of Disability and
Abledness”, Palgrave MacMillan,
The processes and practices of translation cannot be separated from the creation of that ordering category termed ‘disability’. For
many people deemed disabled, in the world of technoscience their relationship with non-human
actants has been profoundly cyborgical and hybridisable (e.g. the use of communication and
adaptive devices, implants and transplants). As such the networks of association between
human and non-human (sentient beings and machines) have always been and increasingly are
pushing the boundaries of the practices of purification. The disabled body induces a fear as
being a body out of control because of its appearance of uncontainability. The practices of
purification insist on this being the case. Ableism’s constitutional divide posits two distinct and
entirely clear ontological zones: disabled and abled (normate). Latour (1993, p. 11) explains, Without the first
set, the practices of purification would be fruitless or pointless. Without the second, the work of translation would be slowed down,
limited, or even ruled out. ... So long as we consider these two practices of translation and purification separately, we are truly
modern – that is willingly subscribe to the critical project, even though that project is developed only through the proliferation of
hybrids down below. As soon as we direct our attention simultaneously to the work of purification and the work of hybridization
[translation], we immediately stop being wholly modern, and our future begins to change. The
challenge then is to look
beyond social context, at the interactivity between the processes and techniques of purification
and translation, in particular to investigate what this interactivity clarifies and obfuscates. Even
though Latour claims that purification is not an ideology in disguise, I would assert that the existence of processes of purification
creates a simulation, if you like, of the conditions of naturalism. Latour’s discussion of whether relations are conscious and
unconscious or are illusion and reality is an important one. He concludes that moderns are not unaware of what they do; rather it is
the holding steadfast to dichotomies, the divides, which makes possible the processes of translation. We can, by analogy, argue that
matters of intentionality or discourse and so forth are not critical to the emerging technologies
of ableism, but rather it is the act of holding stoically to the distinction between abledness and
disabledness. In contemporary developments in high-tech and biotechnologies, it is occasionally
possible to witness the glitches in the purview of purification, whether that is in the debates over transhumanism,
xenotransplantation or the emergent of new ‘life’ in the form of artificial intelligences (A.I’s). The
confusion about where human life begins and ends harks back to the Enlightenment era where philosopher’s like Locke inquired
‘What is It?’ in trying to make sense of the humanness
of changelings (Campbell, 1999; Locke, 1979). The fortunes of
technoscience continue to disrupt the fixity of defining disability and normalcy especially within
the arenas of law and bioethics. Whilst anomalous bodies are undecidable in being open to
endless and differing interpretations, an essentialised disabled body is subject to constant
deferral – standing in reserve, awaiting and escaping able(edness) through morphing
technologies and as such exists in an ontologically tentative or provisional state. Latour points
out the ultimate paradox of this modern constitutional divide is that whilst the proliferation of
hybrids is allowed for, at the same time this constitution continues to deny the very existence of
hybrid entities within its formulation (Latour, 1993). Contemporary conditions suggest that it is not the event of denial
that is operational; rather it is the ‘place’ or significance given to such ambiguous entities that disrupt the rather neat demarcation
AT: Biopolitics
Immigration restrictions and health care promotes inclusion of the disabledcounters biopower
Mitchell 15 (David T. Mitchell, faculty member in the Department of Disability and Human
Development at the University of Illinois at Chicago, coeditor of Corporealities: Discourses of
Disability, author of Precarity, Geopolitics, and the Matter of Disability, Ed. Sharon L. Snyder,
2015, “The Biopolitics of Disability neoliberalism, ablenationalism, and peripheral embodiment”,
University of Michigan Press,
In referring to the biopolitics of disability we identify a marked historical shift in practices evolving initially
during the primary eugenics period wherein lives with disabilities found their existences increasingly immobilized within the nation.
Institutionalization (chronic human warehousing), marriage prohibitions, involuntary sterilization, confinement within one’s
home, inaccessibility of shared public space, segregated education, and intensified immigration
restrictions are all tactics employed by liberal governance practices not just to physically
control, but to statistically graph and determine in minute detail the cultural parameters of
life within which disabled people find themselves enfolded. We want to demonstrate throughout this book
that control of the coordinates of what Georgio Agamben refers to as “bare biological life” among citizens
in market capitalism has been fashioned on the basis of systems of oversight specific to disability
and others occupying peripheral embodiments (Homo Sacer 1). This approach allows us to situate disability
as a primary case of social justice rather than an exception to the rules of human governance. As
Martha Nussbaum points out, “issues that seem extremely important for social justice—issues about the
allocation of care, the labor involved in caring, and the social costs of promoting the fuller
inclusion of disabled citizens—fail to come into focus or are explicitly deferred for later
consideration” (431–32). Nussbaum exposes how neoliberalism, by treating disability as an exceptional
case to be put off until later, involves national strategies of deferral as part of its efforts to
“seize hold of life in order to suppress it” (Foucault, History of Sexuality 136).
Public charge is a key vector of biopower—the regulation of the movement of
immigrants through the constant fear of deportation traps them in a system of
poverty and violence—the plan solves this by removing public charge
Park 1 (Lisa Sun-Hee Park, Assistant Professor in the Ethnic Studies Department and the Urban Studies and Planning
Program at the University of California, Hein Online, EBSCO Host, 2001, “Perpetuation of Poverty Through ‘Public
Charge,’” The perpetuation of poverty, Denver University Law Review)//jy
In the final version of the
1996 Welfare Reform, restrictions on immigrant welfare accounted for almost half of the total
federal savings.(FN37) This is despite the fact that only about eight percent of the U.S. population are foreign-born as of 1990, and undocumented immigrants
comprise about one percent of the U.S. population, or thirteen percent of the foreign born population . Ostensibly a budgetary measure, all the
savings from eliminating almost all of the safety nets for immigrants come from denying
benefits to legal -- not "illegal" -- immigrants. Undocumented immigrants are already ineligible
for most major means-tested entitlement benefits. Federal welfare and immigration reform legislation of 1996 added restrictions to
the use of Medicaid by legal immigrants. The Personal Responsibility and Work Opportunity Reform Act of 1996
restricted immigrants' access to health care by more narrowly defining which immigrant
populations were eligible for federal Medicaid funding. The Illegal Immigration Reform and
Immigrant Responsibility Act of 1996 made it harder for more recent immigrants to establish
income eligibility for Medicaid. The PRWORA created two categories of immigrants with respect to Medicaid eligibility: pre-and post-enactment
immigrants.(FN38) The distinction was based on the relationship of an immigrant's date of entry to the date of the legislative change; those entering after August 22, 1996, were
classified as post-enactment immigrants. States had the option of providing Medicaid coverage for pre-enactment qualified immigrants. Coverage of non-emergency services for
legal post-enactment immigrants would have to be state-funded for the first five years of the immigrant's stay in the country. California opted to continue Medi-Cal coverage to
state and local government agencies continued to
require documentation of immigration status from applicants for means-tested programs. The passage
legal immigrants irrespective of their date of entry to the U.S. However,
of these two laws facilitated the exchange of information regarding immigration status and the receipt of Medicaid-funded services between states and the INS. PRWORA
Therefore, unless they
have a specified immigration status, immigrants are allowed only coverage for emergency care. In
the past, a Social Security card or birth certificate was sufficient to establish legal immigration status. Moreover, state and local governments are
prohibited from restricting communication between state and local agencies and the INS
regarding the immigration status of benefits applicants. This information link between the INS and DHS can occur through local
explicitly prohibits the use of federal funds for Medicaid benefits other than emergency care for specific groups of immigrants.
Medi-Cal eligibility offices. When immigrants apply for Medi-Cal, the information they provide about their income and assets, as well as the information in documents they used
to establish their California residency, can now be turned over legally to the INS. Currently in California, legal challenges to the implementation of welfare and immigration
reforms and the use of state general funds have ensured the eligibility of low-income immigrants for Medi-Cal coverage of prenatal care and other pregnancy-related services.
the policy implementations of the welfare and immigration reforms have
created a chilling effect that has discouraged use of Medicaid by immigrants who are legally
eligible in California. There is concern that a decline in Medi-Cal enrollment, and consequently prenatal care utilization, is occurring among low-income
pregnant immigrant women. Studies have shown that uninsured women are less likely to make the recommended
number of prenatal care visits, and they experience poorer birth outcomes than women with
Medicaid.(FN39) Furthermore', foreign-born women are more likely than U.S.-born women to be
uninsured for prenatal care and are less likely to follow the recommended schedule of prenatal
care visits.(FN40) A minimum standard of fourteen visits starting no later than the third month of pregnancy is recommended by the American College of Obstetricians
The problem, however, is that
and Gynecologists.(FN41) During these visits, women are screened for potential pregnancy complications, which can require additional visits, especially in the latter months of
Medicaid coverage for prenatal care is important in ensuring early and continuous use of
prenatal care by women who would otherwise be uninsured for the care. B. IMPACT OF PUBLIC CHARGE Among the
various forms of collaboration between the state DHS agency and the federal INS agency , the issue of public charge is perhaps the most
alarming to immigrant communities and those who serve them. The issue at stake is whether Medicaid, a non-cash public
benefit, falls within the public charge domain since the benefit is not cash assistance, but health care coverage. The INS can prevent an immigrant
they judge likely to become a public charge from obtaining legal permanent residency. In addition, the
INS can refuse readmission to the United States to immigrants who leave the country for more than 180 days, whom, when they attempt to reenter, are judged likely to become
a public charge.
The MS can also deport a person found to be a public charge, though this is rarely done. Since the 1996
enactments, information concerning people who apply for and receive Medi-Cal has been provided continuously to the state DHS office by local Medi-Cal eligibility agencies. In
May of 1999, after pressure from immigrant health advocates, the federal government further clarified public charge criterion to exclude non-cash benefits, such as Medicaid
the failure of the federal government to
provide clarification on the potential impact of the use of non-cash benefits on future
immigration status, almost three years after the passage of the legislation, had a significant impact on immigrant
communities. Since 1994, the INS and state DHS officials have made public charge determinations based solely on the use of Medi-Cal.(FN43) This practice was in
and special-purpose cash benefits that are not intended for income maintenance.(FN42) However,
conflict with a written policy stating' that public charge determinations should be made on the basis of the individual's total circumstances, including age, health, family status,
assets, resources, financial status, education, and skills. One community health care clinic director told us of an incident in which she received a phone call from a family member
of someone who was having a heart attack. They had called to ask how much an ambulance would cost for a full fee, cash paying patient. Despite the fact that they were
an immigrant
woman in the Bay Area scalded herself badly in the bathtub. The clinic director described the situation: [H]er family
were all documented citizens and working in one of the suburbs. And she was so afraid of... getting her family in
trouble, or getting herself in jeopardy that she didn't show up in the emergency room for 30
days after having scalded herself, and by then she was so infected that she was not able to
survive. She died.(FN44) C. PORT OF ENTRY DETECTION PROGRAMS In California, the sharing of information between Medi-Cal
and the INS around issues of public charge became institutionalized through the Port of Entry
Fraud Detection programs. There were two such programs: the first was the Port of Entry Detection (PED) at the border of Mexico, and the second one
documented immigrants, they expressed fear of a public charge determination for using an ambulance as a public benefit. In another case,
expanded this program to include the Los Angeles International Airport and the San Francisco International Airport. This later program was called the California Airport
Under this program, INS officials shared
information with DHS staff regarding non-citizen entrants they suspected might have illegally
received Medi-Cal benefits. DHS staff used the INS assistance to identify potential cases of Medi-Cal fraud, especially with regard to California residency.
Residency Program (CARR). The first Port of Entry Detection Program started in 1994.
The second program, the California Airport Residency Program began at the Los Angeles International Airport in 1994 and expanded to the San Francisco International Airport in
1996. Under this program, nonresidents returning to the country through the Los Angeles and San Francisco Airports were asked about their use of Medi-Cal.(FN45) In many
immigrants who had received coverage legally in the past five years were required to
repay the benefits before reentering the country. These demands for repayment were illegal,
and in response to lawsuits and advocate pressures, a court injunction stopped this practice.(FN46) However, despite the
injunction against forced repayments, the inspection process continued under stricter legal guidelines. DHS
officials, unable to legally demand repayment for benefits consequently informed immigrants
that they may "wish" to pay back claims paid by Medi-Cal for past health services. During an interview, an
official of the DHS office of Audits and Investigations explained that INS initially contacted DHS regarding beneficiary fraud by individuals entering the United States. DHS then
created a pilot program in the San Diego Port. The INS officials first identified potential fraudulent beneficiaries and referred them to DHS for further investigation. In a separate
office, DHS officials asked for proof of California residency and determined if the individuals had or were receiving AFDC or Medi-Cal. If they suspected residency fraud, then they
referred them back to the INS with information about the results of their initial review and wrote a "notice of action" to the DHS field office to determine residency status and
money owed for medical care or AFDC. This additional measure of referral to the field office was a procedural change from the past when DHS used to determine fraud solely on
the initial meeting at the airport or port of entry. More recently, DHS referred cases to their field offices for independent review. At this point, DHS and the MS conducted
separate investigations. The DHS official explained that most of the people detained at these points of entry were not undocumented immigrants. They had a temporary border
pass, a U.S. tourist visa, or a U.S. temporary visa. One possible outcome of the DHS referral was the collection of repayments of potentially fraudulent claims paid by Medi-Cal in
the past. Most of the cases were referred back to the INS with the understanding that no fraud was suspected. However
, in some cases, immigrants
were denied re-entry into the United States. A hotline was created for complaints of inappropriate treatment within the DHS investigation
process. This was in response to past problems with DHS officials demonstrating a lack of respect toward immigrants in this program. The DHS official we interviewed
acknowledged this problem and stated that these issues had been resolved. In April 1999, the state Health and Human Services Agency terminated the two programs. A few
days later, both the state assembly and senate budget subcommittees defunded the programs. These actions followed a particularly negative review of the programs by the
Bureau of State Audits, declaring both Port of Entry Medi-Cal fraud detection programs "unjustified."(FN47) The audit cited operational and administrative deficiencies and
found that the department was no longer recovering enough fraudulent Medi-Cal payments to justify its investment in these programs. In part, this was due to a class action
challenging the California Department of Health Services' practice of colluding with the INS to demand repayment of Medicaid benefits received.(FN48) The settlement required
the state DHS to return at least $3 million to immigrants who were improperly ordered to return Medi-Cal benefits at the port of entry fraud detection programs.(FN49) State
auditors documented intimidation by way of threatened imprisonment or reduced chances for citizenship, and by demands for repayments higher than the actual cost of the
Medi-Cal benefits received. About 1,500 families were eligible for refunds under this settlement. DHS contends that these programs were a separate issue from public charge,
since they were concerned with benefit fraud and not whether an immigrant is or will become dependent on public benefits. However, public charge is a concern for the INS. It
appears that, in effect, immigrants were screened for both issues of benefit fraud and public charge by two different governmental agencies within the same program. For
immigrants in general, the differences between the two are subtle, if not insignificant. For them, the message is clear: using Medi-Cal is dangerous. According to the Auditor's
using Medi-Cal was especially dangerous for immigrant women. After reviewing 440 case files, the audit team found
that ninety-seven percent of all the individuals investigated by the Port of Entry Programs were
women. Eighty-six percent were between twenty-one and forty years old, and eighty-nine percent of cases involved families
with children. The report went on to add: The profiles of people investigated by the PED and CARR programs contrasted sharply with the general profile of people
eligible for Medi-Cal benefits. For example, just under 20 percent of people eligible for Medi-Cal in July 1998 were between the ages of 21 and 40, yet this age group represented
over 80 percent of the individuals investigated by both programs. In addition, women accounted for 50 percent of the people eligible for Medi-Cal benefits but comprised over
97 percent of the PED and CARR program investigations. Finally, in 1997, nonimmigrants and undocumented aliens living in California represented just 7 percent of the eligible
Medi-Cal population. However, they accounted for at least 80 percent of the investigations for the programs.(FN50) A key informant, a Bay Area community clinic director, had
an opportunity to visit the California Airport Residency site in San Francisco in November 1997. She became concerned about the program after half a dozen of her clients
reported having problems trying to re-enter the country. The director was able to set up a meeting with DHS and INS officials to find out how the program operated (it was not
When asked how they chose particular people to
interview, she learned that flights from Asian and Latin America, principally Mexico, and women
of childbearing age were targeted. She described the extra screening conducted near the customs checkpoint: They are looking at women of Asian
stated whether she spoke to the DHS and the INS together or separately).
and Latino origin, not who looked pregnant, but if they had little children with them or they were somewhere between the ages of 20 and 45, then (they were) asked a series of
light interview questions. And in those light interview questions, [if] either determined that they had children within a certain period, then they would ask, who paid for it? What
kind of insurance did you have? Who was your health care provider? And if someone ended up showing their Medi-Cal card, then they were totally in the next realm of
interview.(FN51) According to the clinic director
, the process of determination appeared "purely arbitrary." She went on to
explain the complicated interplay between the federal TNS official and the state DHS representative. The exchanges played on the fact that there were parallel but conflicting
agendas, laws, and interpretations of regulations. With the DHS official sitting quietly beside him, the INS agent would question the woman until she described applying for
At that point, the INS agent would raise questions as to
whether she was truly eligible and advise her to consider paying back the benefits to avoid being
sent to court for an eligibility determination, or the even more severe penalty of being deported
and permanently deni