Effective December 23, noncitizens requesting admission to the United States or applying for legal permanent residence can access government health benefits for which they qualify—including Medicaid and the Children's Health Insurance Program (CHIP)—without jeopardizing their immigration status. The rule, issued by the U.S. Department of Homeland Security (DHS), rescinds a 2019 Trump administration policy that allowed immigration officials to deny permanent resident status to applicants who utilized any form of government assistance.
The 2019 rule overturned two decades of federal policy barring immigration officials from factoring in applicants' receipt of noncash benefits—such as health and nutrition programs—when deciding whether to approve applications for immigration or legal permanent residence, also referred to as “green card” status. In addition to protecting Medicaid and CHIP access, the new rule stipulates that other benefit programs such as the Supplemental Nutrition Assistance Program (SNAP), disaster assistance, and pandemic assistance, among others, won't be considered in immigration application decisions. However, use of cash support from programs such as Supplemental Security Income and Temporary Assistance for Needy Families can be factored in as a basis for denying applicants deemed likely to become “public charges,” meaning they would be primarily dependent on government assistance.
“As we have experienced with COVID, it's in the interest of all Americans when we utilize the health care and other services at our disposal to improve public health for everyone,” U.S. Department of Health and Human Services Secretary Xavier Becerra said in a statement announcing the Biden administration's new policy, which essentially restores past practice. In support of the policy change, DHS cited research showing that the Trump-era rule discouraged noncitizens from applying for any government programs, even when doing so had consequences for U.S. public health.
To resolve the lingering confusion in immigrant communities about which benefits are permissible, groups like the Migration Policy Institute and the Brookings Institution have called for outreach campaigns to spread the word about the new rule; a policy analyst from Brookings urged “a coordinated outreach effort led by the federal government that leverages the large health and social service infrastructure of state and local governments.” Nurses and other health care providers, especially those who work in the community setting, can help by explaining the new policy to immigrant patients and community groups, thereby easing concerns about accessing needed benefits.—Diane Szulecki, editor