New CMCS Informational Bulletin on Public Charge

Yesterday, CMCS released a new Informational Bulletin reminding states that the public charge rules have changed and emphasizing that Medicaid and CHIP benefits will not be considered when immigrants apply for a green card.

The Trump Administration sought to change the public charge rules – rules that are used as part of an immigrant’s application for lawful permanent status, or a green card – moving away from longstanding policy to impose a much harsher test that emphasized wealth above all else. The proposed rule changes were finalized despite widespread public opposition, and after a temporary pause imposed by the courts, the Trump-era rules went into effect very briefly in February 2020. In early March 2020, the Biden Administration began the process to unwind the Trump-era rules, and the public charge rules reverted to what is known as the 1999 field guidance.

Under the 1999 field guidance, using public benefits such as Medicaid and CHIP do not count in a public charge determination. There is one exception for Medicaid – if Medicaid pays for a person’s long-term care in an institution, that can count as part of a multi-factor, public charge determination. But for the vast majority of Medicaid and CHIP enrollees, including children, parents, caretakers, and other adults who use Medicaid and CHIP for preventive care, treatment of illnesses, prescription drug coverage, hospital says, etc., such benefit use will not be a factor in a public charge determination for the individual or their family members who may also be applying for a green card.

The Informational Bulletin reminds states and the public about the current public charge rules and emphasizes that it is safe to continue using Medicaid/CHIP without fear of immigration consequences. The Informational Bulletin also reminds states that they may only share information about a beneficiary or an applicant when it is necessary to administer Medicaid/CHIP – meaning that states cannot share beneficiary information with the Department of Homeland Security (DHS).

New CMS Administrator Chiquita Brooks-LaSure first announced the upcoming Informational Bulletin in her keynote address for CCF’s annual conference, and in her remarks, she emphasized that Medicaid benefits are safe, protected, and will have no bearing on a person’s immigration status – DHS will not consider the receipt of Medicaid benefits against someone pursuing a legal path to citizenship.

Hopefully, the Informational Bulletin and ongoing work of the Biden Administration will succeed in stopping the chilling effect that the Trump-era public charge rule and other anti-immigration policy changes brought about. Researchers at the Urban Institute have continued to document the harmful impact of anti-immigrant policies and rhetoric: 1 in 5 adults in immigrant families with children reported that they or a family member avoided public benefits or other help with basic needs in 2020 because of immigration-related concerns, despite facing significant hardships, financial concerns, and health needs during the COVID-19 pandemic and economic fallout.

More work needs to be done – including issuing new public charge regulations (the 1999 field guidance is sub-regulatory, and therefore easier to undo and/or challenge in court) that reflect the values President Biden outlined in one of his early executive orders. That is, rules that are, “consistent with our character as a Nation of opportunity and welcome.” Each step, including the Informational Bulletin, is important as we eagerly await the next step in the path to a more fair and just immigration system.

Kelly Whitener is an Associate Professor of the Practice at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.