September 18, 2026

The New “Public Charge Ground of Inadmissibility” Rule 

WASHINGTON, D.C. –Doctors for America strongly condemns the new Public Charge Ground of Inadmissibility Rule (new Public Charge Rule), which went into effect today. Legally, a public charge is an individual who is “primarily dependent on the government for long-term subsistence.”  In practice, a public charge determination can block an individual’s pathway to citizenship. Until today, the definition of public charge narrowly included only individuals who use cash assistance for income maintenance or undergo long-term institutionalization at government expense. Essential non-cash benefits, such as food assistance or health insurance, were not counted against an applicant.

Rather than maintaining the clear, established list of services included in the public charge definition, the new Public Charge Rule gives immigration officials unfettered discretion to determine who can be excluded on public charge grounds. Under the new rule, immigration officials are encouraged to consider any means-tested assistance as evidence to exclude a green card applicant. This means that families could face immigration penalties for using the Women, Infants, and Children (WIC) food assistance while pregnant, enrolling a citizen child in the Children’s Health Insurance Program (CHIP), or accepting needs-based higher education grants. 

The health consequences of the new rule will be widespread. In 2020, the first Trump administration enacted a similar but less severe rule that was soon blocked by the courts. As physicians, we witnessed a “chilling effect”, where patients from immigrant families and communities refused all services in fear of being deemed a public charge, even if they themselves were citizens, even after the rule was blocked, and even at the height of the COVID-19 emergency. Many of these patients ended up sick in our emergency rooms and hospitals. The new rule will only make things worse.

For this reason, a coalition of 6 cities and counties, 22 states, and the District of Columbia have filed immediate lawsuits to block the new Public Charge Rule from going into effect on the grounds that it is “arbitrary and capricious, exceeds DHS’s statutory authority, and departs from the longstanding meaning of the public charge provision established by Congress.”

In the current landscape, 30% of immigrant adults say they or a family member have limited their participation in activities outside the home since January due to concerns about drawing attention to someone’s immigration status, with 29% skipping or postponing health care in the past 12 months. Implementation of the new rule could drive up to 4.1 million eligible people on Medicaid and CHIP to refuse their benefits, including up to 1.7 million citizen children. Doctors for America calls on the Department of Homeland Security to put the health of our patients and families over politics and stop the implementation of this rule and similarly dangerous policies that discourage people from seeking essential healthcare resources.

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About Doctors for America:

Doctors for America (DFA) is a national nonprofit that mobilizes over 40,000 physicians and medical trainees to advocate for policies that improve the health of patients and communities. Through advocacy training and action at the state and federal levels, DFA works to expand access to affordable care, strengthen community health and prevention, and advance health justice and equity. We do not accept funding from pharmaceutical, insurance, or for-profit health care entities, ensuring our work remains fiercely independent and patient-centered. DFA puts patients over politics–and over profits. Find out more at doctorsforamerica.org and on X @drsforamerica or Bluesky drsforamerica.bsky.social.

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