The Public Charge policy significantly impacts health equity, especially for immigrants and their families who often fear that using public benefits will harm their immigration status. As a result, they may avoid seeking assistance and enrolling in health and nutrition programs even when they are eligible and have legal documentation. Although this policy has a narrow scope, confusion about it—particularly for families living in mixed-immigration status households—may still lead to fears of negative impacts on their immigration status and create barriers to accessing equitable health care and public benefits. From a health equity standpoint, the policy may disproportionately affect low-income immigrants; older adults (who may need long-term care); those with poor health, disability, or limited resources; and children in mixed-status families. The concern is not only direct denials of coverage but also indirect deterrence from using health, nutrition, and social services – widening existing health disparities and creating conditions of poorer health.
A written policy statement issued by a government agency or executive official that provides guidance, clarification, or direction on implementing laws or policies. Memos do not have the force of law but can influence policy interpretation and enforcement.
Who It Impacts: Federal agencies, policymakers, and sometimes regulated industries. Memos can shape how agencies enforce laws, impacting businesses, healthcare providers, and other stakeholders.
Who Is Not Impacted: Memos do not create binding legal requirements for the general public, though they can influence enforcement priorities that indirectly affect individuals and organizations.
Summary
The Public Charge Inadmissibility Memorandum, issued on September 4, 2025, reaffirms existing policy to follow the statutes, regulations, and current U.S. Citizenship and Immigration Services (USCIS) policy, which states that individuals seeking admission or adjustment of their immigration status may be denied if deemed “likely at any time to become a public charge” or, in policy terms, to become largely dependent on the U.S. government for support. The policy addresses cash assistance and public benefit programs (e.g., Social Security Income (SSI), Temporary Assistance for Needy Families (TANF), and state and local cash assistance programs), and support for long-term institutional care. Non-cash programs such as Medicaid, the Children’s Health Insurance Program (CHIP), and SNAP are generally excluded.
Impact Analysis
Legal Challenges
The reaffirmation of this policy memorandum may still be subject to scrutiny if it is applied inconsistently or if legal actions diverge from the regulation. Immigrant advocacy groups continue to monitor whether public charge determinations are fair, transparent, individualized, and free from disproportionate impacts on this community.
Take Institutional Action
Outreach and education to clarify the intent of the law and to ensure that immigrant communities are aware of the benefits available to support their health, well-being, and long-term care needs. Use trusted messengers that immigrant communities will be receptive to.
Educate public employees responsible for implementation, including U.S. Citizenship and Immigration Services (USCIS) staff, on the policy to reduce arbitrary or inconsistent actions that could exacerbate disparities, engender fear, and prevent access to critical public programs. Include explanations on potential impacts and why immigrant health matters for the country as a whole.
Research and assess how public charge determinations influence enrollment in health coverage and other programs for immigrant families.
Partner with community health centers, legal services, community health workers, care navigators, and immigrant-serving organizations to deliver accurate information and support to eligible individuals and families.
Support food pantries, food banks, clinics, and health centers that are willing and able to provide services without collecting identifying information to mitigate how this policy may deter eligible individuals from accessing services.
Associated or Derivative Policies
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