Update on Public Charge

Update on Public Charge

August 2021

The Center for Medicaid and CHIP Services (CMCS) released an Informational Bulletin informing states that the Trump Administration’s Public Charge Rule has been vacated and is no longer in effect. Effective March 9, 2021, the U.S. Department of Homeland Security (DHS) is applying the longstanding policy known as the 1999 Interim Field Guidance. Under this policy, participation in Medicaid (with the exception of Medicaid payment for long-term care in an institution such as a nursing home), the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) marketplaces are not negatively factored into public charge assessments that people undergo when they are applying for an immigration status. 

The Trump Administration’s Public Charge rule resulted in fear, and many people decided to go without benefits they were eligible for because of concerns that participation in public benefits would result in negative immigration-related consequences for themselves or a family member.

Substantial effort will be needed to raise awareness about the change in policy and to reduce fear so people feel safe in accessing benefits. Enrollment assisters can play an important role in raising awareness that participation in Medicaid (with the exception of long-term institutionalized care), CHIP, and the ACA’s premium tax credits and cost-sharing reductions are not negatively factored into public charge assessments. For more information regarding the application of public charge, please see resources published by the Protecting Immigrant Families campaign.

The bulletin also reminds states of their obligation to safeguard applicant and beneficiary information. Under federal law, states may not share information with DHS about an applicant or beneficiary’s coverage under Medicaid or CHIP for the purposes of a public charge assessment. Additionally, states generally may not provide information to DHS regarding medical assistance furnished to beneficiaries who are institutionalized.

Additional Resources

Immigrant Eligibility for Health Insurance Affordability Programs | View Resource

Helping Families That Include Immigrants Apply for Health Coverage | View Resource