The U.S. will not deny green cards based on a person’s use of Medicaid and most other government health programs under a regulation published Thursday that rescinds the Trump-era “public charge” policy designed to discourage immigration.
Medicaid and Children’s Health Insurance Program coverage will not be factored into assessments of whether an immigrant residing in the U.S. is likely to become dependent on government assistance, according to the new final rule. Support for long-term institutionalization can still be factored into determinations, however.
“Although the term ‘public charge’ does not have a single clear meaning, its basic thrust is clear: significant reliance on the government for support…. [The Department of Homeland Security] does not believe that the term is best understood to include a person who receives benefits from the government to help to meet some needs but is not primarily dependent on the government,” the rule reads. The department proposed the policy in February as a replacement for a controversial rule from President Donald Trump’s administration that allowed federal officials to consider a person’s potential use of public programs when evaluating permanent residency applications.
Studies show the Trump administration’s so-called public charge rule had a chilling effect on Medicaid enrollment among immigrants and their families.
President Joe Biden’s administration vacated the Trump rule last year and reapplied an interim guidance from 1999 in the meantime. The new regulation codifies a revised version of that guidance into law and takes effect Dec. 23.
“People who qualify for Medicaid, CHIP, and other health programs should receive the care they need without fear of jeopardizing their immigration status,” Health and Human Secretary Xavier Becerra said in a news release. “As we have experienced with COVID, it’s in the interest of all Americans when we utilize the healthcare and other services at our disposal to improve public health for everyone.”
The changes could make people more willing to access Medicaid and other public benefits, but long-term community efforts will be needed to reverse the Trump policy’s effects on Medicaid enrollment, according to a Kaiser Family Foundation report published in May.