Proposed 'public charge' rule could cause confusion for immigrants
This week, the Department of Homeland Security unveiled a proposed rule on “public charge” that could subject legal immigrants to arbitrary and unfair decisions when trying to become lawful permanent residents, or “green card” holders.
Public charge is a long-standing part of federal immigration law. The public charge inadmissibility test is designed to identify people who may be relying on the government as their primary source of support. If the government finds that a person is “likely to become a public charge,” it can deny that person entry into the United States or lawful permanent resident status.
Historically, the test has not been available to other plans, including health insurance.
Under this policy, the government assesses whether a person will be dependent or “primarily dependent” on the government in the future. It takes into account a number of factors – use of specific public benefits, age, income, education and skills, health and family size – to make a final decision based on the “total totality of the circumstances.” Historically, public benefits included in the test have been limited to cash plans or whether the person was admitted to a long-term care facility. It does not apply to other plans, including health insurance.
Expanding the definition of harmful again
In 2019, the first Trump administration changed that, enacting a new rule that expanded the definition of public charge and considered a broader range of services when making public charge determinations. This includes whether the individual or a member of his or her family does or may need help purchasing prescription drugs, food and housing assistance, or Medicaid services under Medicare, as well as penalties for being over 61 or having a disability.
The Biden administration has rescinded Trump-era rules and limited public benefit considerations to cash assistance and long-term institutionalization, returning to 1999 guidelines.
This could leave future immigrants subject to inconsistent and unpredictable decisions.
Now, the second Trump administration is proposing to repeal the Biden-era rules. Instead of spelling out new standards like the first Trump administration did, the proposed rule includes discussion of the agency’s new interpretation of public charge — a significant expansion of the current definition — but allows immigration officials to decide for themselves what should be included. This could leave future immigrants subject to inconsistent and unpredictable decisions.
A system that pushes families further away from care
An expanded and erratically enforced system could have an alarming chilling effect on immigrants and families, causing many to avoid seeking health care or benefits for their citizen children for fear it would harm their future immigration status.
This new system will build on the damage caused by HR 1, the 2025 budget bill, which disqualified most immigrants from most health insurance, including Medicare.
Why Medicare Rights Oppose the Proposal
At Medicare Rights, we oppose this proposal. While some officials may administer the test fairly, increased discretion could put potential immigrants at risk of unfair and unfair applications. As the recent COVID-19 pandemic has revealed, we must do everything we can to give everyone within our borders access to the care they need to protect their personal and public health.
further reading
Read the proposed rule.
Learn more about the proposed rule.
