What is the public charge rule and how will it impact me?

Individuals with no coverage | Navigating Health Insurance Marketplace Options

In October 2018, the Trump Administration proposed an expansion to the current policy that determines whether certain immigrants would be considered a “public charge.” A public charge is a determination made by the Department of Homeland Security of whether an immigrant applying for admittance the US, renewal of certain visas, and/or permanent resident status would become primarily dependent on the government upon approval.

If the rule is finalized, immigrants subject to the public charge determination test may place their immigration status at elevated risk if using certain public benefits like Medicaid (CHIP beneficiaries and applicants are not included in the proposed rule). Public charge determinations affect individuals seeking admission to the U.S. or seeking to adjust status to lawful permanent residence (green card).

Under the current and proposed rules, application and enrollment in marketplace coverage and the application and use of premium tax credits and cost-sharing reductions are exempted from the public charge determination test, and undocumented immigrants are not affected due to ineligibility for the marketplace and Medicaid. The current and proposed rules do not take into account an immigrant’s citizen family members’ use of public benefits.

The proposed rule does not apply to immigrants going through the naturalization process or undocumented immigrants. Other immigrants who do not have a pathway to adjustment of status, like people with Temporary Protected Status (TPS), are also exempt. Further, many immigrants are exempt from a public charge determination (e.g. refugees and asylees are not subject to a public charge determination).

If the rule is finalized, you will have time to act before the rule goes into effect, and thus can still apply for and use public benefits including Medicaid in the interim. Under the draft proposal, benefits previously excluded from the public charge determination (such as Medicaid) will be considered only if those benefits are received after the final rule is published. For more information on the proposed rule and possible effects, please see these talking points from the National Immigration Law Center and this brief from the National Health Law Program.

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