Rules that could give immigrants reason to avoid enrolling in health safety-net programs would deliver a blow to California’s economy, costing the state thousands of jobs and billions of dollars in economic output, a new study concluded.

Under the rules proposed by the U.S. Homeland Security Department, immigrants who enroll themselves or their children in Medicaid (the half-century-old government health insurance program for the poor), nutrition assistance programs such as CalFresh or federal housing assistance could jeopardize their chances of getting green cards.

The rules would likely cost the California economy more than 17,000 jobs and $2.8 billion in lost economic output if just 35 percent of the Californians in immigrant families currently making use of these programs disenroll, said the study, which was done by the UCLA Center for Health Policy Research, UC Berkeley Labor Center and a nonprofit group, California Food Policy Advocates. At that rate of disenrollment, the study said 6,200 of those lost jobs and $992 million of that lost output would be in the Los Angeles area.

California’s health care industry, food-related industries, as well as real estate would be hardest hit by the resulting job losses, authors of the study said. Forty-seven percent of jobs lost would be in health care,10 percent would be food-related, and 4 percent of total jobs expected to be eliminated would be in real estate.

“Every industry could be affected though to a lesser degree than the top three industries we listed,” said Laurel Lucia, an author of the study and director of healthcare at the UC Berkeley Labor Center.

The proposal is an expansion of existing “public charge policies” that make it harder for immigrants who receive certain forms of public assistance - such as income assistance or long-term care at federally funded institutions - to apply to enter the U.S. or to become a permanent resident.

“Under the harsher ‘public charge’ test proposed, participation in public programs is one of a number of factors that would be considered to determine whether a person is likely to use public benefits in the future,” said She also said prior enrollment in the expanded list of programs would not be considered unless the immigrant is still in one of the programs when the rule change takes effect.

For more than two centuries, the United States has placed restrictions on immigrants deemed to be a “public charge.” But the government officials long viewed health programs as important tools for protecting the well-being of citizens and noncitizens alike.

If the proposed changes are implemented, about 765,000 immigrants in California may choose to disenroll from nutrition assistance and healthcare programs, according to the study. It said that level of disenrollment could in turn lead to California losing $1.46 billion in federal benefits.

“Immigrants make crucial contributions to California’s workforce, economy and tax base,” Ninez Ponce, director of the UCLA center and an author of the study, said in a statement. “The proposed changes to the ‘public charge’ test would significantly reduce the use of much-needed public programs among those who are eligible, and the economic ripple effect would hurt communities statewide.”

The public can still comment on the proposed rules through Monday. The rules are expected to be finalized and published in February.

In a joint statement in September, health officials, physician groups, hospitals and patient advocates across the country condemned the proposed changes and urged President Trump’s administration to withdraw the proposal.

“The order puts a governmental barrier between healthcare providers and patients and stands in stark contrast to the mission each of our organizations shares: ensuring meaningful access to healthcare for patients in need,” they said.

When announcing the proposed ruling in September, Homeland Security Secretary Kirstjen Nielsen said in a statement that immigrants must show that they can support themselves financially.

“This proposed rule will implement a law passed by Congress intended to promote immigrant self-sufficiency and protect finite resources by ensuring that they are not likely to become burdens on American taxpayers,” said Secretary Kirstjen Nielsen.

The California Health Care Foundation and the California Endowment funded the new study.