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在美國經常有一些人會申請Medicaid / WIC。因為在美國生孩子需要一大筆開銷。要是如果沒有保險COVER，在美國從懷孕例行檢查到生產，順產一般要兩萬美金左右，剖腹產大概要兩萬多到三萬美金了。不過基本都會有保險來替你付絕大部分啦。那么在美國申請Medicaid / WIC是會影響綠卡的申請嗎？

Short answer：以前不影響；以后很可能會導致綠卡申請被拒。

Trump 政府日益收緊合法移民政策

Trump 上臺后，美國政府日益收緊了合法移民的政策。最直觀的一些重要變化包括：

• 移民局處理速度更慢了。我2016年給岳母申請延期，提交52天之后批準，而現在 USCIS 處理時間越來越久，很多讀者反映：提交延期申請之后，過了半年，申請人已經按計劃如期回國了，還沒收到批復。
• 以前職業移民不需要面試，現在所有職業移民都需要面試（職業移民也更慢了）。
• 綠卡排期也比以前更緊張了。以 EB-1 為例：2016 年之前全年有名額、不用排期，2016 財年 H2 首次出現排期，2017 財年排期更早出現，而進入 2018 財年，第1個月就有排期，「EB-1 排期進入常態化」。
• 2018年10月，Trump 在接受采訪時表示，計劃通過行政命令來取消出生公民權。

我9月底和 New Jersey 的一位移民律師聊天，她說，根據她最近一段時間的經驗，“They are looking for every reason to deny an application.”

Public Assistance 以前不影響綠卡申請

根據 Medicaid 官網 2014 年的說明，申請 Medicaid/CHIP  “will not affect someone's chances of becoming an LPR or US citizen; the one exception is for individuals receiving long-term care in an institution at government expense”，它還同時表示，申請 Medicaid/CHIP 不屬于會影響綠卡申請的“Public Charge”。

截至2018年9月25日我更新本文時，USCIS 的 “Public Charge Fact Sheet” 依然明確表示以下項目不屬于 public charge，包括 Medicaid（除非用于長期看護如精神病院、養老院等）、CHIP、SNAP/Food Stamp、WIC、住房福利、non-cash benefits 等：

• Medicaid and other health insurance and health services (including public assistance for immunizations and for testing and treatment of symptoms of communicable diseases, use of health clinics, short-term rehabilitation services, prenatal care and emergency medical services) other than support for long-term institutional care
• Children's Health Insurance Program (CHIP)
• Nutrition programs, including the Supplemental Nutrition Assistance Program (SNAP)- commonly referred to as Food Stamps, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the National School Lunch and School Breakfast Program, and other supplementary and emergency food assistance programs
• Housing benefits
• Child care services
• Energy assistance, such as the Low Income Home Energy Assistance Program (LIHEAP)
• Emergency disaster relief
• Foster care and adoption assistance
• Educational assistance (such as attending public school), including benefits under the Head Start Act and aid for elementary, secondary or higher education
• Job training programs
• In-kind, community-based programs, services or assistance (such as soup kitchens, crisis counseling and intervention, and short-term shelter)
• Non-cash benefits under TANF such as subsidized child care or transit subsidies
• Cash payments that have been earned, such as Title II Social Security benefits, government pensions, and veterans' benefits, and other forms of earned benefits
• Unemployment compensation

Public Assistance 以后可能導致綠卡被拒

2018年9月22日，Trump 政府提議進一步收緊移民限制，合法使用 public assistance 和 non-cash benefit 亦會導致綠卡被拒。

In making this determination, DHS is proposing to consider current and past receipt of designated public benefits above certain thresholds as a heavily weighed negative factor.  The rule would also make nonimmigrants who receive or are likely to receive designated public benefits above the designated threshold generally ineligible for change of status and extension of stay.

The public benefits proposed to be designated in this rule are federal, state, local, or tribal cash assistance for income maintenance, Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), Medicaid (with limited exceptions for Medicaid benefits paid for an "emergency medical condition," and for certain disability services related to education), Medicare Part D Low Income Subsidy, the Supplemental Nutrition Assistance Program (SNAP, or food stamps), institutionalization for long-term care at government expense, Section 8 Housing Choice Voucher Program, Section 8 Project-Based Rental Assistance, and Public Housing.

Medicaid、SNAP/Food Stamp 以及 Public Housing 等項目，以前明確規定不屬于 public charge，今后都會成為綠卡被拒的原因。雖然現在該提案還在公示、尚未正式實行，但是根據 Trump 上臺后美國政府的政策風向來看，該提案極大可能很快會正式實施。

誰不受此提案影響？

新聞稿說：“By statute, asylees, refugees, and other categories of vulnerable individuals are not subject to the public charge ground of inadmissibility and as such are not impacted by this rule. When considering receipt of public benefits in the public charge inadmissibility determination, DHS would also not consider any public benefits received by aliens serving in active duty or in the Ready Reserve component of the U.S. Armed Forces, or the spouse or child of the service member. Additionally, DHS would not consider disaster relief, emergency medical assistance, benefits received by an alien’s U.S. citizen children, and Medicaid benefits received by children of U.S. citizens and potential adoptive children of U.S. citizens.”

也就是說，以下幾類情形暫不受影響：

• 政治避難者、難民。
• 美國軍人、預備役及其配偶和子女。
• 災難救援、緊急醫療服務不屬于 public charge。
• 外國人的公民子女接受的美國福利不屬于 public charge。
• 美國公民的子女或欲領養的兒童接受的 Medicaid 不屬于 public charge。

延期和身份轉換也會受影響

“Extension of Stay and Change of Status”：

Pursuant to section 214(a)(1) of the Act, 8 U.S.C. 1184(a)(1), DHS permits certain nonimmigrants to remain in the United States beyond their current period of authorized stay to continue engaging in activities permitted under their current nonimmigrant status. The extension of stay regulations require a nonimmigrant applying for an extension of stay to demonstrate that he or she is admissible to the United States. For some extension of stay applications, the applicant’s financial status is an element of the eligibility determination.DHS has the authority to set conditions in determining whether to grant the extension of stay request. The decision to grant an extension of stay application, with certain limited exceptions, is discretionary.

Under section 248 of the Act, 8 U.S.C. 1258, DHS may permit an alien to change his or her status from one nonimmigrant status to another nonimmigrant status, with certain exceptions, as long as the nonimmigrant is continuing to maintain his or her current nonimmigrant status and is not inadmissible under section 212(a)(9)(B)(i) of the Act, 8 U.S.C. 1182(a)(9)(B)(i). An applicant’s financial status is currently part of the determination for changes to certain nonimmigrant classifications. Like extensions of stay, change of status adjudications are discretionary determinations, and DHS has the authority to set conditions that apply for a nonimmigrant to change his or her status.

就是說：延期和身份轉換以后都會更加注重申請人的財務狀況，若申請過政府福利，除了申請綠卡會被拒絕以外，延期、轉換身份都可能會受影響。建議申請人加強財力證明文件。

所以說在以前，申請Medicaid / WIC是不影響綠卡的申請的。但是現在美國移民政策日益收緊。所以說在未來若申請過政府福利，除了申請綠卡會被拒絕以外，延期、轉換身份都可能會受影響。