Public Charge (March 2021)

On Tuesday, March 9, 2021, there were some major updates to the Public Charge policy. In short: the 2019 Trump administration public charge rule is no longer in effect! The public charge policy is still in effect today. However, it will now be based on the 1999 iteration, which is much more narrow (see below for details). The 2020 application of the public charge rule by the Trump Administration is no longer being enforced by the Department of Homeland Security (DHS).  

Why does public charge still matter now?  

  1. We need to inform those who were affected by the rule about this change. 

  1. There is still intense fear from Trump’s public charge rule and it will not immediately go away.  

  1. The rule has had significant, long-lasting negative health consequences in immigrant communities, including preventing families from seeking essential public benefits such as SNAP, types of Medicaid, and federal housing assistance. Supporting families from accessing these resources again will be important.  

  1. Immigrant communities continue to be disproportionately affected during the pandemic and could benefit greatly from this new change. 

 

What are the 1999 guidelines for making public charge determinations?  

Resources included in public charge determinations: 

  • “The receipt of public cash assistance for income maintenance” (e.g. Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF)/CalWorks, General Assistance) 
  • “Institutionalization for long-term care at government expense”  

What is NOT included anymore:  

  • Medicaid/Medi-Cal (except for long-term institutionalized care) 
  • Supplemental Nutrition Assistance Program (SNAP, CalFresh or Food Stamps) 
  • Federal Public Housing and Section 8 assistance 
  • Earned cash benefits: social security, disability, unemployment, workers compensation  

The Bottom Line messages for your patients:  

  • The public charge inadmissibility test does not apply to all immigrants - many immigrants are exempt from a public charge test.  
  • Many immigrants who are subject to public charge are not eligible for the benefits that count under the test, and many benefits are not considered in the public charge assessment. 

Let us go through some practice cases! 

Case #1: 

Judy is getting ready to apply for a green card.

She is concerned that some of the benefits she uses could put her at risk for being considered a public charge.

She uses WIC, Rental Assistance, and Medi-cal for her children. She also recently had a COVID-19 test. What can you tell her?  

Consider the following:  

  • Informing her of the recent changes in the policy: “Judy, there is some news that I would love to share with you. The public charge rule under the Trump Administration is no longer in effect! Though the public charge policy is technically still in effect, it now takes less resources under consideration than before.  
  • WIC, Covid-19 testing and treatment, and Medi-cal for children are NOT included: “Judy, even before the recent changes last week, WIC, medi-cal for children less than 26, and COVID-19 testing and treatment  were not included in the public charge test.” 
  • Rental assistance may be included: “Judy, rental assistance may be considered in the public charge rule. However, the rule looks at more than just benefit use and also includes other factors such as age, income, education, skills, health and sponsor’s statement of support.” 
  • Seek legal advice before disenrolling in benefits: “You should speak with a legal advisor before making any decisions about unenrolling from benefits. Let me give you a list of free or low cost legal resources in the area that may be able to help your specific case.” 

 

Refresher: 

Which Public Benefits are Included?  

As of March 2021, Trump’s changes to the public charge rule were reversed. The ONLY benefits included in the public charge rule are:  

  1. Cash assistance programs for income maintenance  (like Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF)/CalWorks, General Assistance) 

  1. Institutionalization for long-term care at government expense.  

Which benefits are Not Included?  

  1. Medicaid/Medi-Cal (except for long-term institutionalized care) 

  1. Supplemental Nutrition Assistance Program (SNAP, CalFresh or Food Stamps) 

  1. Federal Public Housing and Section 8 assistance 

  1. Earned Cash benefits (unemployment/disability, workers compensation, social security)  

  1. Medicare 

  1. Covid-19 testing and treatment 

  1. WIC (Special supplemental nutrition program for women, infants and children) 

  1. CHIP (Children’s health insurance program) 

  1. School Lunches 

  1. Shelters  

  1. Food banks 

Case #2:

Maya is a legal permanent resident (LPR) and she is ready to naturalize (to become a U.S. citizen).

She is worried because she uses CalFresh. What can you tell Maya? 

Consider the following:  

  • There is no public charge test to naturalize: “Maya, the public charge test affects people applying for admission to the country or for lawful permanent resident (LPR) status.” 

 

Resources for providers:  

Smartphrases to give to patients: 

@Mission Bay, @ZSFG, @Kaiser 

.AVSpubliccharge (updated) 

.AVSpublicchargespanish (updated) 

.AVSpublicchargechinese  (updated in next few days-look at date on the top)  

 

Smartphrases for providers with basic information: 

@Mission Bay, @ZSFG, @Kaiser 

 .publicchargeprovider (updated) 

 

Please reach out to Ali Valdrighi, Greta Peng, Ali Lai or Priya Pathak if you have any additional questions or comments. We are open to any suggestions.  

Thank you! 

Public Charge Healthy Steps Grant Leadership