Immigrants living in Hawaii legally could be denied future visas and permanent residency if they rely on government assistance such as food stamps and Medicaid under a Trump administration rule that is set to take effect Oct. 15.

Trump officials have said their “public charge” rule aims to promote self-reliance and personal responsibility among immigrants. But the policy has outraged Democrats, including top officials in Hawaii where 1 in 5 Hawaii residents is an immigrant.

On Tuesday, U.S. Sen. Mazie Hirono and 26 fellow Democrats introduced the Protect American Values Act, which seeks to prohibit the Trump administration from using federal funding to implement the rule.

“The true effect and, therefore, the true intent behind the administration’s public-charge rule is to create a climate of fear among immigrant families, and it’s working,” said Hirono during a taped news conference in Washington, D.C., announcing the bill. “I’ve heard from a number of hardworking, taxpaying immigrants in Hawaii, many not even subject to the rule, who are afraid to see their doctor or access essential services.”

Earlier this month state Attorney General Clare Connors also joined the national fight to halt the rule, signing onto a multistate lawsuit against the U.S. Department of Homeland Security that argues the rule violates federal immigration and welfare laws.

The public-charge rule has been a lightning rod in the national debate over immigration with critics accusing Trump of pushing racist policies that discriminate against immigrants from poorer regions of Asia, Latin America and Africa while giving preference to Europeans.

The rule, part of President Donald Trump’s America First immigration policy, identifies “negative” factors that immigration officials are to take into account in reviewing applications of immigrants seeking to enter or remain in the country. Not having a college education, speaking limited English, suffering from medical conditions that could require extensive treatment not covered by private means and limited income can count on an application.

Immigrants also can be penalized for using public benefits such as Temporary Assistance for Needy Families; Section 8 housing; SNAP, commonly known as food stamps; and Medicaid if they rely on the public health insurance for more than a year.

By contrast, the rule identifies English fluency, advanced educational degrees and wealth among “positive” factors to be taken into account.

The rule is not retroactive, but it’s already been shown to have a chilling effect among immigrants, even if they wouldn’t be effected by it.

One in 7 adults in immigrant families reported that they or a family member decided to forgo benefit programs in 2018 out of fear that they would risk future green card status, according to a national study by the Urban Institute. This rate increased to 1 in 5 adults in low-income families.

In Hawaii this “chilling effect” could affect about 110,000 Hawaii residents, according to the Fiscal Policy Institute, a calculation that includes households that have received government support for food, health or housing and where at least one member of the family is a noncitizen.

The rule also specifies that citizens from Micronesia, Palau and the Marshall Islands, many of whom come to live and work in Hawaii, would need to pass the new public-charge test. However, it’s not clear how this would be implemented. Citizens of those countries can freely enter and the leave the United States under the Compacts of Free Association and don’t require a visa. They also aren’t eligible for most government benefit programs, including SNAP, Medicaid and Medicare.

“We don’t know if Customs is going to start pulling them over because they have passports from those countries,” said Nicole Woo, a senior policy analyst at the Hawaii Appleseed Center for Law and Economic Justice. “I think that is still ambiguous.”

Hawaii Republican Party Chairwoman Shirlene Ostrov said that the spirit of the Trump policy isn’t novel. For instance, former Democratic President Bill Clinton in 1996 signed into law the Personal Responsibility and Work Opportunity Reconciliation Act, which restricted immigrants access to public benefits.

“It’s not something new. In this day and age, anything that President Trump does is horrible even though it may have been something that happened 20 years ago and passed 20 years ago by a Democratic president,” said Ostrov.

Ostrov, whose parents were Filipino immigrants, said she understands the concern from critics that immigrant families, including children, could suffer under Trump’s rule, but said it’s a sound policy.

“I, of course, have sympathy for that. I’m raising my own family, and I come from a family of eight children to immigrant parents. So I totally get it,” she said. “But I think in the world of finite resources, who are you going to give the help to?

“What they are saying is if you can’t stand on your own, then we can’t let people in who are going to be a drain on our public resources.”

However, the rule doesn’t sit well with everyone in Hawaii’s Republican Party.

State Rep. Bob McDermott (R, Ewa Beach-Iroquois Point), who married an immigrant, said he didn’t believe in restricting benefits for immigrants here legally.

“If you are here legally, then you are here legally, and you are entitled to everything everyone else is,” he said.