A California woman whose son needs intensive medical care says she felt "like something blew up in my face" when she learned of a Trump administration rule that would make it tougher for legal residents like her to become citizens if they access the very services her son is eligible for — such as Medicaid.

“I have a son that has a serious medical condition,” said Aicha, a lawful permanent resident living in California who asked to be identified only by her first name to avoid government attention, speaking with NBC News. “Medicaid and food stamps … my son needs that, but it scares me that it might affect my chances of applying for my citizenship next year.”

Immigrants seeking to change their legal immigration status and who are enrolled in publicly funded programs such as food stamps and public health insurance could be deemed a “public charge” under the new rule starting on Oct. 15. Officials use the term to define someone who they consider may be likely to need public assistance in the future.

Aicha, who works three jobs to make ends meet, is one of roughly 45 million immigrants who pay billions of dollars in taxes to federal, state and local governments every year. But if immigration authorities label someone like her a “public charge,” they could deny their request for legal immigration status, putting them at risk of becoming undocumented in certain cases.

“We’re talking about restricting the path to citizenship to people who are here legally,” Kara Lynum, an immigration attorney in Minnesota, told NBC News.

The Department of Homeland Security previously defined “public charge” as someone who depended on cash assistance or government-funded long-term institutional care, but the new rule expands the definition to include additional benefits such as food stamps, nonemergency Medicaid, certain prescription drug subsidies and housing vouchers.

Lynum said, given the perceived effect of the ruling, many immigrants are asking themselves: "My family members are eligible for public benefits, but should I opt out because it might not look good in my citizenship application?”

This is the uncertainty facing the more than 16 million people living in mixed immigration status families, meaning that some in the family are U.S. citizens but some are not. It's estimated that one in four U.S. children have at least one immigrant parent, underscoring the impact immigration policies have on so many children.

“Most of the people we serve, they are part of mixed-status families,” Lisa David, president and CEO of the New York-based nonprofit Public Health Solutions, told NBC News. “They will not jeopardize breaking their family apart.”

For this reason, many families eligible to receive public benefits have dropped out of certain government programs or barred themselves from applying for assistance since a draft of the “public charge” rule was leaked last year.

Claudia Rodríguez, a U.S. citizen who is originally from the Dominican Republic, said she understands Aicha’s concerns, since she went through a similar situation before she became naturalized.

“When I arrived to the U.S., I started working. But during that time, I also lost my job and was dealing with certain health issues and had my daughter.”

Rodríguez recalled that when medical offices realized she was having a hard time affording health care, they informed her of public benefits she was eligible for.

“I felt a sense of equality,” Rodríguez said, adding that because she has paid taxes through her wages, which have helped others, she should be eligible for benefits when she needed them.

But now, more legal immigrants are afraid of accessing services like Rodríguez did.

Last fall, Public Health Solutions saw a 20 percent drop, or over 200 families, in participation in WIC, the government program that helps women and children with nutritional needs, David said.

People on low-incomes and retirees at the World Harvest Food Bank in Los Angeles in July. Mark Ralston / AFP - Getty Images

A recent study by the Urban Institute found that over 20 percent of the immigrants they surveyed considered not applying for federal aid programs for which they were eligible, out of fear that doing so would hinder their green card application status.

The latest “public charge” regulation can especially hit people who are U.S. citizens, or are in the U.S. legally, trying to sponsor their immigrant parents, Lynum said. She explained that many of them are elders who may be dependent on other family members or may be receiving public benefits. And under the rule, they are more likely to need public assistance in the future.

According to David, immigrants have a tendency to use public benefits at lower rates than native born Americans.

The new rule will not be applied retroactively, according to the Department of Homeland Security.

The Trump administration argues that expanding the meaning of “public charge” helps “protect American taxpayers” and ensures "that noncitizens in this country are self-sufficient and not a strain on public resources.”

But according to the New American Economy, a bipartisan research and advocacy organization, immigrants “contribute to the economy not only as consumers but also as taxpayers, helping fund social services and programs like Medicare and Social Security.”

The organization estimates that people like Aicha pay $405.4 billion in taxes annually. And yet, they have a hard time accessing much-needed taxpayer-funded assistance.

Rodríguez is one of over 175,000 members of 32BJ, the largest property services union in the country, with a majority immigrant membership. She takes issue with the idea that immigrants come to seek benefits. What she has seen, she said, are people “who come here already knowing that ‘I have to be self-sufficient.’”

“People come here to contribute,” Rodríguez said. “As citizens, what we should be doing is defending everyone who lives in this country, not turn against each other.”

"Harmful" for gender-based violence survivors

Aicha was born in West Africa and grew up in Niger with a father who had two wives and 28 children.

At 16, she was expected to take part in an arranged marriage and be subjected to female genital mutilation, a practice the World Health Organization recognizes as a form of “torture and cruel, inhuman or degrading treatment.”

“But I said no,” Aicha recalled.

She fled to the U.S. nearly 20 years ago to escape the gender-based violence, successfully sought asylum and eventually earned her green card.

When she first gained legal immigration status, she learned she was eligible up for benefits “to help me get back on my feet.”

“It included insurance and food stamps," said Aicha, who said most jobs that immigrants can first get are minimum wage. “That’s not enough to sustain your family and pay for health services, food, so this kind of additional help is critical. We need it to survive.”

Irena Sullivan, senior immigration policy counsel at Tahirih Justice Center, the largest national organization focused on helping immigrant women and girls fleeing violence, told NBC News the new rule is “especially harmful” for survivors of gender-based violence because “it strikes at efforts from a survivors trying to get independence.”

Sullivan explained that abusers commonly use threats of violence and deportation to keep survivors economically dependent on them. So in a way, she said, the rule rewards abusers by deterring survivors from accessing much needed benefits to help them escape and eventually become self-sufficient.

Certain immigrants are exempt from the “public charge” bar, including those serving in the military, those who have won asylum, and domestic violence survivors applying for permanent residence through the Violence Against Women Act (VAWA).

Survivors subjected to the rule will not be penalized for use of benefits by their U.S. citizen children, said Sullivan, who emphasized that “the rule is still meant to instill fear” among immigrants who are both exempted and subjected to the regulation.

“Survivors are witnessing a pattern of abuse happening simultaneously: one at home and one coming from this administration,” Sullivan said. “All survivors will most likely believe that they must choose between forgoing critical public services or getting their green card denied … especially when the administration has not created a climate of trust.”

David agrees.

“From the moment Trump was elected, we have seen a pattern: When anti-immigrant policies are put in place, we see fewer people enrolling and people unenrolling" from public benefits, she said, “I get people asking me, ‘Can you take my name off the list?’ And most of the people cutting back on these services are families with young children, seniors and people with disabilities.”

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