Policy

Explaining Public Charge, and Its Impact on Immigrants Living in the US

Public charge is a law that determines ineligibility for lawful permanent residency and inadmissibility to the United States, based on an individual’s ability to provide for themselves and their families. Generally, this rule ensures that a person is able to provide for themselves currently and in the future, and will not become a ward – or charge – of the government. Current public charge rules for immigrants seeking to adjust status only apply to those who extensively participate in programs such as Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), or state cash assistance programs. Immigration officials also determine whether someone is a public charge based on a host of other factors, based on their current and future ability to provide for themselves.   

In October 2018, the Director of the United States Citizenship and Immigration Services (USCIS), Lee Cissna, proposed new changes to the current public charge ruling and requirements. At present, the proposed changes to the public charge ruling redefines the programs used to determine if someone is a public charge. This means, that if anyone were to rely on additional public benefits programs, such as SNAP, Medicaid, and Medicare Part D, they are subject to ineligibility due to their status as a public charge. The proposed changes also subject immigrants and their family members to a “public charge test” which determines how well an immigrant applicant can speak, read, and write in English.

However, the proposed rule is not current law in the United States. Before the government can finalize the proposed changes, they must review the more than 266,000 comments submitted on the ruling, as well as a congressional review. While the proposed rules have not been written into law, the announcement of the ruling has already created significant changes in how immigrants access and use their benefits. 

(Photo:  LA Opinion )

(Photo: LA Opinion)

Immigrant advocacy groups have seen how this ruling affects their clients and communities; the Urban Institute reported 13.7% immigrant adults did not participate in their noncash benefits programs, because they are afraid they will be deported or denied their green cards. This means that these individuals did not apply for benefits, or they elected to drop out of their Medicaid, SNAP, or Medicare Part D programs. By not participating in these programs, immigrants are denying themselves preventative healthcare and access to healthy and nutritional foods. 

The proposed changes in public charge do not only affect immigrant adults. Immigrant families, elderly immigrants, and immigrants with U.S. citizen children are also impacted by these proposed changes. In fact, researchers have seen a 20% decline in WIC enrollments; this program is designed to help low-income mothers provide food for their babies and infants. By dropping out of this program, immigrant families cannot provide nutritious and healthy foods for their infants and children, who are often U.S. Citizens. These children and infants will be more likely to experience malnutrition, which will have long-term effects on their physical and mental growth. However, the immigrant parents do not want to risk their family’s ability to stay in the country due to fears of deportation.  

The government asserts that these changes in the rule will encourage immigrants and their families to become self-sufficient; through hard work, they will not need to rely on public benefits. However, this rule perpetuates systemic discriminatory practices on low-income immigrant families. By passing this rule into law, the government ensures that immigrant communities, especially those from countries in Latin America, Asia, and Africa, will forgo the aid that they need in order to receive their green-cards. 

In doing this, immigrant families will struggle socioeconomically, relying only on minimum wage income to pay for doctors’ visits, food, and their housing, along with other utilities and costs associated with daily living. If the rule passes, immigrant families will be stuck in a cycle of poverty, since they will have to work multiple jobs to support their families, since they do not have access to benefits. Public benefit programs are specifically designed to help working families without forcing them to decide if between rent, medicine or food, regardless of immigration status. However, with the proposed changes, immigrants must now decide between their immigration status or a healthy life. 

Immigrant families should not be vilified for dropping out of public benefit programs. Their actions are perpetuated by confusion – while many non-profits and community based organizations continuously provide education to immigrants – other factors contribute to the confusion. Misinformation in the community, the news, and distress from the current political climate propels immigrants into dropping out of their public benefits programs. However, since this rule has not been passed into law, immigrants can and should continue their benefits. Only if the ruling goes into effect, they will have up to a year to participate in programs such as Medicaid and SNAP before they are deemed a public charge. Regardless, the proposed changes to public charge are drastic, damaging, and harmful, and if they are passed, the ramifications will be worse. We have an obligation to provide basic human services to legal immigrants. 

In the 1880s, Emma Lazarus, a New York poet and refugee activist, wrote: “give me your tired, your poor, your huddled masses yearning to breathe free.” This was later inscribed on the Statue of Liberty, which has greeted millions of immigrants and refugees over the decades. Immigrants come to this country seeking a better life; the government should not prevent the nation’s most vulnerable immigrants by forcing them to choose between immigrant status or their health and wellbeing. 

Colorado Just Capped the Price of Insulin at $100/mo

Colorado has become the first state in the United States to pass legislation to limit the out of pocket price of insulin sold in their state. Starting in January 2020, the law states that those paying co-payments for the lifesaving drug under private insurance plans will only have to pay up to $100 for a 30-day supply. This is a substantial cut from the 2016 national average of a person with type 1 diabetes paying annual insulin costs of $5,705, or $475.41 a month— which is double the national average from 2012.

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While signing the bill into law Governor Jared Polis said, “today we will finally declare that the days of insulin price-gouging are over in Colorado,” as reported by the local Denver CBS affiliate. He later described how some residents were paying as much as $600-$900 a month for their prescriptions to be refilled.

The reduction in costs will be welcome to those who get their insulin through private insurance. According to the Colorado Health Institute, “the state’s insurance rate is 93.5 percent, essentially unchanged from the all-time high of 93.3 percent set in 2015.“ This means that the legislation going into effect next year will cover the vast majority of Colorado citizens, which will hopefully begin to set a precedent for other states to follow.

Since the legislation only affects the out of pocket price of insulin, covered by private insurance, unfortunately those who are uninsured will not be covered by the new law, exemplifying a need for a more equal healthcare system where medically necessary drugs like insulin don’t get caught up in politics or drug company price gouging.

While this legislation doesn’t fully address the main issue at large, which is everyone should have access to healthcare and not get priced out from medicine that they need, it does go a long way in the state of Colorado by guaranteeing that the majority of those in Colorado will be affected by the law, and will hopefully spread to other states.

Universal Health Coverage Should Be a Fundamental Human Right

Although the United States is currently classified by the Human Development Index (HDI) as the 13th most developed nation on Earth, it still lacks one of the most fundamental human rights: a system for assuring that all of its residents are able to afford and receive healthcare. In fact, out of the HDI’s top 15 most developed nations, the United States is the only one that does not currently implement some sort of functioning universal healthcare system. The debate surrounding universal healthcare in the US is definitely nuanced, but ultimately, the argument for universal healthcare boils down to the notion that health is a basic human right. 

This is by no means a new concept — the constitution of the World Health Organization, which was written in 1948, declared universal health coverage to be a fundamental human right. There are three crucial objectives to universal health coverage: first, that everyone receives health services, not just those who can pay for them; second, that these health services effectively improve the wellbeing of those who receive them; third, that receiving these health services does not negatively impact the financial situations of patients. In short, universal health coverage seeks to ensure that no one forgoes receiving necessary healthcare because they can’t afford it. Healthcare is a right, not a privilege. 

Although universal health coverage, sometimes referred to as ‘Medicaid for All,’ might seem like a lofty goal, it is possible. According to the Organization for Economic Cooperation and Development, 18 countries have fully achieved universal health coverage, which means that 100% of their population is covered by adequate health insurance. Many other nations, including Austria, Japan, and Spain, have achieved near-universal health coverage, which means that over 98% of their population is covered by adequate health insurance. In comparison to these nations, the US is actually lagging behind — as of late 2017, less than 88% of Americans reported being covered by adequate health insurance. Although the United States prides itself on being one of the most developed and prosperous countries in the world, it cannot claim to be a frontrunner when it comes to ensuring the health of its populace. 

Most Americans with health insurance are covered by employer-sponsored private coverage. Other Americans receive health insurance by qualifying for Medicare or Medicaid. Finally, a small percentage of Americans receive health insurance through the US military or Veterans Administration. However, this still leaves almost 30 million Americans who are not covered by any kind of health insurance. 

For people who are just starting to research the arguments behind universal healthcare in the United States, trying to make sense of the different kinds of health insurance systems can be incredibly confusing. There are three major ways that countries can achieve the goal of universal health coverage: a single-payer system, a two-tier system, and an insurance mandate. Of the 32 nations that offer universal health coverage, 16 utilize a single-payer system, 9 utilize a two-tier system, and 7 utilize an insurance mandate. 

In single-payer systems, the federal government is singlehandedly responsible for providing health insurance, which is funded by taxes. However, the actual healthcare services can either be government-run or contracted from private organizations. Nations with single-payer systems include the UK, Canada, and Norway. The US actually does have a modified single-payer healthcare system, Medicare, but not all US residents qualify for it. Most people who qualify for Medicare are retirees over the age of 65. However, you can also qualify for Medicare if you receive Social Security Disability Insurance or have been diagnosed with chronic kidney failure. If you don’t fall under any of these categories, then you cannot benefit from a single-payer health insurance system in the US. 

In two-tier systems, a basic government health insurance plan is mandatory for all residents. This plan is funded using taxes and covers basic services, including hospital services and general practitioners. However, additional services that are not covered by the basic government health insurance plan are offered privately, and can be paid for out-of-pocket, or by purchasing a supplementary private insurance plan. That being said, the nuances of individual two-tier systems vary from country to country. Nations with two-tier health insurance systems include France, Australia, and Singapore.

Finally, insurance mandates require that all the residents of a country are covered by some form of health insurance, with the bare minimum policies covering hospitalizations and outpatient medical treatment. Nations with insurance mandates include Germany, South Korea, and Switzerland. The Affordable Care Act (ACA), also known as ObamaCare, is a form of insurance mandate, with the goal of ensuring that all American residents are covered by some kind of health insurance. 

Many people are confused about what the ACA is actually supposed to do. One of the biggest ACA reforms is the establishment of public health insurance exchanges, which are like marketplaces that allow individuals and families to seek out and buy affordable and comprehensive health insurance plans. The ACA also provides increased government subsidies to help low and middle-income families afford health insurance. Additionally, it prohibits insurance companies from refusing service or charging higher rates to people with pre-existing conditions, making health insurance more affordable and accessible to all. The ACA also prohibits insurance companies from placing an annual or lifetime cap on how much money they’re willing to pay for an individual’s healthcare. Finally, the ACA requires all companies with at least 50 employees to offer affordable, comprehensive health insurance to all of their full-time employees. 

Although the ACA has made considerable strides towards the goal of achieving universal health coverage for all Americans, it’s not a perfect system, and has faced considerable pushback, especially from Republican politicians. One of the ACA’s major flaws involves Medicaid, a program established in the 1980s to provide affordable healthcare for low-income Americans. When the ACA was first established, one of its main goals was to expand Medicaid to all 50 states in the hopes that more low-income individuals could gain access to affordable health insurance. However, in 2012, the Supreme Court declared the expansion of Medicaid unconstitutional, which means that individual states are still allowed to opt out of providing expanded Medicaid coverage to their residents. As of 2019, 37 states (including Washington DC) have adopted the ACA’s Medicaid expansion, but 14 states have chosen not to. This has created a coverage gap for low-income individuals in these 14 states, which means that about 2 million Americans still do not have affordable or accessible health coverage. Until all Americans, including those who live at or under the poverty line, are given access to affordable healthcare, we cannot claim to be a nation that values the fundamental human right of health. 

In March of 2019, the Trump Administration announced that it wanted to overthrow the entire Affordable Care Act, nullifying advances in healthcare coverage for over 30 million Americans. To do this, the Trump Administration is banking on a lawsuit against the ACA, Texas v. Azar, which seeks to declare the entirety of the ACA unconstitutional. Legal scholars are divided on whether or not this lawsuit poses a serious threat to the ACA, so in the coming months, the Texas v. Azar suit is definitely something to keep your eye on if you’re interested in following the debate surrounding the ACA. To combat the Trump Administration, House Democrats recently introduced a bill to strengthen the Affordable Care Act. Provisions in this bill include increasing subsidies for low-income individuals, expanding federal assistance to include individuals at higher income levels, and fixing the ACA’s notorious “family glitch,” which currently makes it difficult for employed individuals to afford insurance plans that include their spouses and children. However, because of rampant partisanship in Congress, it’s still unclear whether this bill will make any ground. 

Universal healthcare and ‘Medicaid for All’ has become the battleground of a fierce partisan debate, with Republicans and Democrats vying for political power by trying to repeal or strengthen the ACA. Although the debate swirling around universal health coverage and the ACA can be incredibly tense and confusing, it’s important to always keep in mind the core tenet of human rights that serves as the foundation of the argument for universal healthcare. Regardless of what form it ends up taking, access to quality healthcare is a fundamental human right, and every attempt to deny this healthcare is a degradation of the United States’ commitment to upholding human rights. 

The Algorithmic Accountability Act Is Designed to Remove Bias From Big Data

How does your Netflix account always seem to know just what cheesy rom-com or gory slasher flick you’re in the mood for? How is an iPhone X able to recognize your face as easily as a person does? How can Google Maps calculate routes that circumvent traffic jams and get you where you need to be in as little time as possible? These, and many other technological innovations, are possible due to algorithms. 

In the world of computer science, algorithms can be defined as lists of instructions that tell computers what to do. In this increasingly digital age, algorithms are a part of almost everything we do. Amazon uses algorithms to suggest items that you might want to browse. Online dating sites like eHarmony and OkCupid use algorithms to match up potential couples. Financial analysts and traders train algorithms to predict and react to fluctuations in the stock market at speeds that no human being could ever accomplish. Modern society has grown reliant on algorithms for a lot of the tasks we take for granted, and this reliance shows no signs of stopping. Although these increasingly complex algorithms present new and exciting opportunities to harness the power of computers to better modern life, they still have flaws. 

The Algorithmic Accountability Act, sponsored by (2020 presidential candidate) Senator Cory Booker from New Jersey and Senator Ron Wyden from Oregon, seeks to address some of these flaws. Algorithms are essentially just lines and lines of code, and as such, they cannot think for themselves. However, algorithms often have the unintended effect of reflecting the unconscious biases of their creators. For example, a facial recognition algorithm called Rekognition, championed by computer engineers at Amazon, was recently accused of racism. In a study conducted at MIT, Rekognition could successfully identify the genders of lighter-skinned individuals, but misidentified the gender of darker-skinned individuals at a 20-30% rate. This isn’t because the algorithm itself harbors prejudice against people of color, but because its coders originally only trained it on white subjects. This major oversight could have dangerous implications in the real world — a recent Georgia Tech study concluded that the algorithms behind self-driving vehicles were consistently unable to identify dark-skinned people as pedestrians. In practice, that would make dark-skinned people more likely to get hit by self-driving cars than white people. Driverless cars aren’t the only technology accused of potentially dangerous bias — Amazon, Facebook, and Google have all been accused of algorithmic bias in the past five years. 

The Algorithmic Accountability Act would be a huge stride forward for ethics in tech. Under the act, large tech company and data broker algorithms would be held accountable to a greater degree — they would have to evaluate any algorithm involving behavior prediction, sensitive data, or the monitoring of publicly accessible spaces for discrimination and potential privacy breaches. If any concerns arose in these evaluations, tech companies would need to address them in a timely manner. This way, we can reap all the technological benefits that algorithms have to offer, but without suffering the discriminatory, hurtful, and even physically harmful consequences of race, gender, or class-based algorithmic bias. 

 

Why We Need a $15 Minimum Wage

By Caroline Hsu

Though many of us don’t notice it, there’s a crisis brewing surrounding minimum wage and near-minimum wage jobs in the United States. Retail workers, food service employees, janitors, delivery drivers, and caregivers are among the lowest-paid employees in the United States, despite the fact that their work forms the backbone of modern American society. Because their jobs don’t necessarily require very much training or prior education, their labor is both undervalued and underpaid. The fight to raise the minimum wage is borne out of the idea that all employees should earn enough to support themselves and their dependents, regardless of their age, education level, or amount of job training. The work that minimum wage employees do ensures that society as we know it functions smoothly, and the least we can do as American citizens is to fight for business owners and corporations to compensate them fairly for their labor. 

In 2017, about 23.2 million people earned minimum or near-minimum wages, which fall anywhere between the federal minimum of $7.25 an hour and $10.10 an hour. Another 1.8 million people earned less than the federal minimum wage per hour. (This is possible for employees who earn tips, full-time students enrolled in work-study programs, and certain workers with disabilities.) The food service industry employs the most minimum wage, below-minimum wage, and near-minimum wage employees, but industries like sales, caregiving, administrative support, janitorial services, and transportation also employ hundreds of thousands of minimum wage employees. 

What are the overall demographics of minimum wage employees? About half of minimum wage employees in the US are aged 16 to 24. Over three-quarters of minimum wage employees are white. 20% have not finished high school. 36% have earned a high school diploma or GED. 37% have some form of college education, but have not earned a bachelor’s degree. From these statistics, we can surmise that the average minimum wage employee in the US is relatively young, white, and has not pursued any form of higher education after high school. 

The federal minimum wage in the United States has been set at $7.25 an hour since 2009. This current rate actually has less purchasing power than previous federal minimum wages. Adjusted for inflation, the minimum wage’s purchasing power was highest in 1968, when it was equivalent to about $8.68 per hour in 2016 dollars. Most states and territories have established legislation that sets their own minimum wages, which means that many minimum wage workers in the US are able to earn slightly more than the federal rate, ranging anywhere from $7.50 to $11.50 per hour. At first glance, this sounds like good news, but the actual state of minimum wage in the US is not quite that simple. Among countries with a comparable GDP per capita, the United States pays its minimum wage employees abnormally poorly. According to the Economist, if the federal minimum wage in the US were proportional to the federal minimum wages in similarly wealthy countries, all American minimum wage employees could expect to earn about $12 per hour. 

Even if the US were to raise the federal minimum wage to $12 an hour, which is highly unlikely due to current Republican control of Congress, those wages still would not be enough to allow many employees to support themselves and their families. MIT economics professor Amy Glasmeier runs a US living wage calculator, which estimates the minimum income that a family with two working parents and two children would need to survive in the US without relying on public assistance or holding multiple jobs. This calculation takes into account housing, food, medical care, childcare, and transportation. As of 2015, the living wage in the United States for a family of four is $15.12 per hour, which is significantly higher than even the most generous of state minimum wages. In order for a single parent with two children working a federal minimum wage job to survive without public assistance, they would have to work 139 hours per week. Just for comparison, the standard for full-time employment in the United States is 40 hours per week. 

Because many hourly-wage jobs just don’t pay enough to support families, a significant number of hourly employees are forced to take on multiple jobs. In September of 2018, the US Bureau of Labor Statistics reported that approximately 7.7 million workers held multiple jobs, an alarmingly high rate that hasn’t been seen since the mid-1990s. However, the actual number of multiple job-holders is likely even higher than the statistics reported by the Department of Labor. Though they may not realize it, wage or salary employees who also run a part-time, self-employed business also count as multiple job holders. An indeterminate number of multiple job holders may be withholding that information from the federal government so that their secondary income remains untaxed. 

Clearly, the state of the American minimum wage is so dire that many hourly employees are forced to rely on public assistance or additional jobs just to make ends meet. However, there is progress being made on state, local, and corporate levels. In early 2018, 18 different states began to increase minimum wage rates by about $1 per hour, including Maine, Colorado, Hawaii, and Washington state. Additionally, the state of California and New York City have both announced that they will be raising their minimum wages to $15 over the next 5 years. Finally, companies like Amazon, Walmart, and Target have recently announced increases in their corporate minimum wage regulations for part-time, full-time, and seasonal employees. Important progress is definitely being made in the fight for a higher minimum wage on both the political and corporate level, but many skeptics still oppose the raising of wage floors. 

Although the debate surrounding minimum wage is incredibly multifaceted, with factors including national employment rates, commodity prices, economic vitality, inflation, racial and gender equality, and tax rates, the heart of the argument for a higher minimum wage is empathy. There is an intense stigma against minimum wage jobs and the people who work them. For many people, entry-level, minimum wage jobs are generally considered to have little societal value. Minimum wage jobs are often characterized as temporary summer work for young high school or college students looking to earn a little spending money. Otherwise, they’re considered to be bottom-of-the-barrel employment for the lazy, unintelligent, and unmotivated. These generalizations do a disservice to the vast majority of minimum wage employees, who are just as diligent and hardworking as any salary-earner. 

Anyone who has ever worked a minimum wage job, even temporarily, can tell you that the daily demands of the food service, retail, caregiving, janitorial, and transportation industries are just as demanding, if not more taxing, than a 9-to-5 office job. Minimum wage employees are often asked to work 6 to 14-hour shifts every day of the week, with little or no opportunities for a break. For the duration of their shifts, cashiers, food service workers, and retail associates are frequently forbidden from sitting down, which means that they must remain on their feet for hours on end. Minimum wage workers endure verbal abuse and harassment from entitled customers, physically uncomfortable working environments with insufficient heating or air conditioning, and exposure to unclean or unsanitary substances on a day-to-day basis. Their work is the foundation for the fast food industry, the movie business, the brick-and-mortar retail industry. Minimum wage workers clean up after our messes, deliver our packages, care for our children and elders, and prepare our food. And yet, despite the fact these jobs form the backbone of our society, the people who hold them are not even paid a living wage.  

If you’re interested in joining the fight for a $15 minimum wage, even if you’re not a minimum wage employee yourself, there are several ways you can get involved. First, do your research into political candidates at the local, state, and federal levels who support increasing the minimum wage. If you’re able, donate or volunteer for their campaigns. At the very least, do your civic duty and vote! Additionally, try to support small businesses and larger companies that have demonstrated a sustained commitment to paying their employees fairly. Look into the wage policies of the businesses you frequent. If possible, try to support as many businesses that pay a living wage as you can. Although these steps might seem small and ineffectual, they can make a huge difference in convincing corporations and legislators to start paying hourly employees fairly!