Trump’s News Green Card Policy Shocks Everyone

The Trump administration on Monday formally began the process of expanding how immigration officials evaluate applications for permanent residency, allowing greater consideration of whether immigrants have used public assistance programs such as Medicaid, the Children’s Health Insurance Program (CHIP) or SNAP benefits.

The Department of Homeland Security released a revised “public charge” rule that revives a broader approach first introduced during President Trump’s first term before being rolled back under the Biden administration.

Under the updated policy, immigration officers will have greater discretion to determine on a case-by-case basis whether applicants for green cards are likely to become dependent on government assistance. The rule states that receiving means-tested public benefits, including Medicaid, CHIP and SNAP, may be considered as part of that evaluation.

According to the Department of Homeland Security, the new rule restores broader authority for immigration officers to review “all pertinent facts” while reinforcing the long-standing principle that immigrants should be self-reliant and that government benefits should not encourage immigration.

The policy has drawn criticism from public health organizations and immigrant advocacy groups, which argue it could discourage eligible families from enrolling in health coverage or other assistance programs out of fear that doing so could jeopardize their immigration status.

Andrew Racine, president of the American Academy of Pediatrics, said the rule would increase fear and uncertainty among immigrant families and could result in children, including U.S. citizens, missing out on healthcare services and benefits for which they qualify.

Research has already suggested immigration concerns influence participation in public benefit programs. A survey conducted by KFF and The New York Times found that 11 percent of immigrant adults said they stopped using public assistance programs last year because of immigration-related fears. The share rose to 42 percent among respondents believed to be undocumented and 17 percent among immigrant parents.

Health policy experts warn the change could reduce access to preventive care, increase reliance on emergency rooms and leave hospitals with higher levels of uncompensated care while widening health disparities.

The Department of Homeland Security estimates the policy could reduce federal and state transfer payments by more than $13 billion annually. At the same time, the department acknowledged the rule may reduce revenue for hospitals participating in Medicaid, as well as companies that manufacture pharmaceuticals and medical supplies.

Federal immigration law has long allowed officials to consider whether someone seeking permanent residency is likely to become a public charge, although certain groups, including refugees and asylum seekers, remain exempt from those determinations.

During Trump’s first administration, the public charge rule was expanded to include most Medicaid benefits. The Biden administration later narrowed the policy, largely limiting public charge determinations to cash welfare assistance.

Even after those changes, concerns persisted among immigrant families. According to the Urban Institute, roughly one-quarter of adults in households containing both undocumented and legally present family members avoided public benefit programs in 2022 because they feared it could affect future green card applications.

The revised policy is scheduled to take effect for permanent residency applications submitted on or after Sept. 18.