Legal immigrants have stopped using school programs, food subsidies, housing vouchers and health clinics for which they are eligible, the lawsuit says, hurting the city’s mission to welcome immigrants and creating long-term expenses as Baltimore deals with a sicker and less-educated community.

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“They’re giving up government-supported health care, they’re giving up free school lunches, they’re giving up food stamps, they’re not applying for housing,” said City Solicitor Andre M. Davis, a former federal judge. “It’s a noncash public benefit that people are abandoning so they don’t lose the opportunity for themselves or their family to get a visa.”

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The lawsuit, filed in U.S. District Court for the District of Maryland, challenges a change to the State Department’s Foreign Affairs Manual that took effect in January. The shift tells State Department workers evaluating visa applications abroad to consider whether applicants, their families or their sponsors have used a public benefit in the United States or might in the future.

Previous versions of the U.S. government’s “public charge” policy, which denies entry to people who are likely to become a charge on the government, explicitly excluded programs such as health care and food subsidies from consideration, the lawsuit says.

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The change in the manual is similar to but separate from a pending policy change announced in September by the Department of Homeland Security, which also would limit immigration visas on the basis of whether immigrants or the families who sponsor them have used public benefits. The DHS rule is open for public comment, and agency officials have said they expect it to be challenged in court.

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The Baltimore case, filed by the city with the help of the advocacy group Democracy Forward, alleges that the change in the State Department manual, along with Trump’s rhetoric, has already affected the city’s immigrant community. In the past few months, enrollment in Head Start early education programs by African immigrants has “virtually ceased,” the lawsuit says.

The Justice Department suggested in a statement that the change did not substantially alter U.S. immigration policies.

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“Since the founding, those who immigrate to this country have generally been expected to be self-sufficient,” spokesman Steven Stafford said in a statement issued after this story was posted online. “Baltimore’s problem is with the letter of our immigration laws, not with the Trump Administration’s policies.”

Liz Alexander, senior director of organizing for the immigrant rights group Casa, said any decision to forgo public benefits would have far-reaching consequences, since many state programs are funded according to enrollment.

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“It’s a snowball effect of generally poorer communities not getting access to the benefits they need,” she said.

The lawsuit does not offer a direct link between the change in the manual and the decline in enrollment, saying instead that the Trump administration’s words and actions have created a chilling effect.

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Davis, the city’s top lawyer, said the city hopes to prove a direct link through the discovery process and hopes that immigrants directly harmed by the change will come forward as plaintiffs.

“That lack of clarity discourages immigrants from taking necessary public benefits, frustrating Baltimore’s programs and, paradoxically, draining Baltimore’s budget as immigrants are forced off of more appropriate federal and state programs,” the lawsuit says. “Baltimore is left to sort through the mess Defendants have made.”

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A preliminary national study released this week found a nearly 10 percent drop in immigrant households using the federal Supplemental Nutrition Assistance Program in the first six months of the year.

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Trump won office on a platform that promised to aggressively address immigration, and a July analysis in The Washington Post said legal immigration was on pace to decline by 12 percent during Trump’s first two years in office.

Baltimore’s lawsuit cites more than 20 presidential tweets or comments that suggest immigrants are a drain on public resources. On Wednesday, Trump retweeted an erroneous claim that undocumented immigrants in the United States receive thousands of dollars a month in government assistance. The tweet was citing information from Canada.

The lawsuit cites anecdotal evidence of U.S. consulates using the expanded “public charges” definition in the State Department manual to deny visas to would-be immigrants. The American Immigration Lawyers Association, for example, says it has seen a surge since April in denials of visa applications on public-charge grounds at the U.S. Consulate in Juarez, Mexico.

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The lawsuit also cites the case of Michelle Nicoll Gutierrez, a Mexican business executive whose tourist visa was revoked in August as she was entering the United States to visit her mother and stepfather in Maryland. Nicoll Gutierrez was barred from the United States for five years.