What is Public Charge?

From Eve Krief MD

A new proposal from DHHS expands the definition of what it means to be a “public charge,” making it harder for immigrants to enter the United States and advance through the immigration process. The proposal was officially published on October 10, 2018.
“Public charge” has long been a part of our country’s immigration laws. Currently, a “public charge” is defined as someone who is primarily dependent on the government for subsistence. A public charge determination is made when a person applies for a visa to enter the United States or to adjust status to obtain a green card (but not when applying for citizenship). In other words, someone who is found to be a public charge under this definition can be denied a visa or green card.

Under the new public charge proposal, an immigrant’s use, or likely use, of certain public benefits can now be considered to deny entry or permanent legal status in the United States. For the first time, the government will look at an immigrant’s use of Medicaid, the Supplemental Nutrition Assistance Program (SNAP), housing assistance, and Medicare Part D low income subsidy. The administration is also contemplating adding use of the Children’s Health Insurance Program (CHIP) to the list of programs that would count toward a public charge determination.

Additionally, the proposal would consider family income as a factor in determining whether an immigrant is a public charge, putting low-income parents with children at a disadvantage compared to adults without children. To avoid scrutiny under the public charge test, a family of four would need to earn nearly $63,000 annually. And, the proposal would discriminate against people with preexisting conditions. Specifically, a low-income immigrant with a medical condition that may require extensive treatment who is unable to cover the cost of such treatment could be determined to be a public charge.

This is your last chance to raise your voice for the hundreds of thousands of children and families who are currently afraid to access public benefits like Medicaid, WIC (Women, Infants, and Children Food and Nutrition Service) & SNAP, even though they are eligible.

Documented and undocumented children and families across the country are terrified that new rules, even though they are not yet implemented, will impact their ability to get citizenship, green cards, and to bring their family members to join them.

They are even afraid that they may be deported if the new rules are put in place, or if they apply for benefits today before the new rules take effect.

Although none of these fears are based on current facts, they are, right now, causing families to avoid vital public benefits like Medicaid, WIC & SNAP.

The changes to public charge will make the lives of children and families, whether documented or undocumented, more difficult, frightening, and stressful. This debate and the final outcome has enormous implications for the health and well-being of children and families across the country. Like all children, children in immigrant families benefit when they have access to programs and services that promote their health and development. The new public charge rule could restrict their access and harm their health. #ProtectFamilies, oppose public charge.

Please submit your public comments above by December 10th.

Here is what you can do immediately:

(1) The most urgent is to submit public comment against changes to public charge as this is due by 12/10. Here is a FB link explaining what the changes are and how they will impact immigrants: Under the new public charge proposal, an immigrant’s use, or likely use, of certain public benefits can now be considered to deny entry or permanent legal status”


(2) for those interested in helping more directly with migrants at the border I would refer them to a new sanctuary where they can donate money or services or get trained to help


(3) Call members of Congress to

  • express objection to holding unprecedented numbers of children in detention . Now that the Flores Agreement has been overturned despite tremendous public comment, children will be allowed to be held in detention indefinitely with no guarantees to their human rights . This is unacceptable
  • tell them we need to offer asylum hearings to people legally seeking it who are escaping life threatening situations for them and their children . We have to get more staffing at the border for those who oversee such proceedings because people are not getting the hearings they are entitled to and the back up of migrants has led to a humanitarian crisis at the border that is only going to get worse if we don’t intervene .


Nonprofits struggle to house migrants in San Diego


About D. Posnett MD

Emeritus Prof. of Medicine, Weill Cornell Medical College
This entry was posted in Health Care, immigration/deportation, medicare, Trump, Trump atrocities, Uncategorized and tagged , , , . Bookmark the permalink.

1 Response to What is Public Charge?

  1. Hi nice reading yyour blog

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