Trump Continues Assault on Immigrant Communities and Medicaid: Changes to “Public Charge” Intended to Intimidate Immigrant Families and Slash Enrollment in Medicaid, Other Social Services

Trump Continues Assault on Immigrant Communities and Medicaid: Changes to “Public Charge” Intended to Intimidate Immigrant Families and Slash Enrollment in Medicaid, Other Social Services

August 13, 2019                                                                          CONTACT: Andy DiAntonio

Washington, D.C. – The Trump administration’s Department of Homeland Security (DHS) finalized on Monday a rule that seeks to intimidate immigrants from using public programs aimed at combatting illness, hunger, and poverty. The final rule furthers two of the administration’s callous policy goals: to make life increasingly difficult for immigrants and their families and to shrink the rolls of social safety-net programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP). 

Public charge is an immigration law term used to assess whether individuals applying for entry to the U.S. or lawful permanent residency status (commonly known as a “green card”) are likely to become dependent on the government as their primary source of support. While the term “public charge” is rooted in late 19th century xenophobic ideas to prevent certain “undesirable” immigrants from entering the country, Trump’s final rule vastly broadens the “public charge” evaluation to consider enrollment in Medicaid, the Supplemental Nutrition Assistance Program, and specified housing benefits. This radical re-write of “public charge” is contrary to the statute, goes against decades of policy, and targets immigrants of color.  

National Health Law Program Executive Director Elizabeth G. Taylor expressed dismay at the finalized rule. “This rule change fits squarely in this administration’s pattern of sustained attacks on immigrants, particularly immigrants of color. This rule is designed to cause families to back away from accessing vital health, food, and housing benefits to which they remain legally entitled by stoking fear and creating confusion.”

The impact of the rule will be to reduce enrollment in Medicaid and other public programs, which has been a longstanding goal of conservatives and the Trump administration.

”This new rule will have a chilling effect such that many immigrants and their family members will avoid accessing vital health care and other social services. Even families not subject to a public charge determination will be caught up in the chaos. The programs affected by the proposed rule are essential, not only for immigrants and their family members, but for the health and well-being of all people,” said Senior Attorney Priscilla Huang.

These realities, however, have not moved the Trump administration’s policy. For the last two years, Trump and his officials have shown that facts and sound public policy mean little when it comes to advancing an agenda that includes walling off lawfully present immigrants from health care services to which they are legally entitled.

For more information or comment about the “public charge” rule change, please contact the National Health Law Program Director of Health Policy, Leo Cuello at To learn more about public charge, visit

National Health Law Program, founded in 1969, advocates for the rights of low-income and underserved people to access quality health care.


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