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Public Benefits and
Immigrant Seniors

Public Charge Rule

The “public charge” test has been part of federal immigration law for decades and is designed to identify people who are “primarily dependent” on certain government benefits, namely Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF) and comparable state and local cash assistance programs, and government-funded institutional long-term care (including through Medicaid). The government can deny admission to the U.S. or refuse an application for lawful permanent residency (green card) to an applicant whom it determines is likely to become a public charge. This determination looks at the “totality of circumstances,” including the applicant’s age, health, family status, income and resources, education and skills.

In 2019, the Trump Administration made sweeping changes to the public charge rule that discriminated against older immigrants and resulted in immigrant families being unable to access or fearful of accessing a variety of government programs and services, including Medicaid. This rule was challenged in court and the Biden Administration ended the Trump public charge policy in March 2021. However, this chilling effect persists and was especially harmful during the pandemic when access to health care and economic security resources was particularly critical.

On December 23, 2022, new US Citizenship and Immigration Services’ (USCIS) regulations on public charge issued by the Biden Administration went into effect. The final USCIS public charge rule is similar to the longstanding policy and clarifies that the only benefits considered in the public charge test are public cash assistance for income maintenance and long-term institutionalization paid for by the government. The new rule also clarifies that long-term institutionalization does not include home and community-based services or short-term institutionalization for rehabilitation purposes, and that Medicaid and other health programs are not considered unless they are paying for long-term institutionalization. Similarly, the new rule excludes food and nutrition programs, housing programs, and utility assistance.


Older Immigrants & Medicare

Enrolling in the Medicare program and accessing its benefits can be complex and challenging for older immigrants, some of whom do not have a significant work history in the United States, are not citizens, or have limited English proficiency. Almost 7 million U.S. residents age 65 and older are immigrants, and 4 million Medicare beneficiaries are limited English proficient.


Read our Issue Brief about Older Immigrants and Medicare to assist advocates working with older immigrants with understanding Medicare policies and practices most relevant to older immigrants.

“Medicare & You” Handbook Now Available in Chinese, Korean, and Vietnamese

Expanding Older Immigrants’ Access to Public Benefits

Federal public benefits provide critical support to older immigrants. But the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) greatly restricted immigrants’ access to federal public benefits, including programs that are critical to ensuring older adults can meet their basic needs. One of the restrictions is the “five-year bar,” which makes older immigrants ineligible for SSI, SNAP, Medicaid, and other programs for the first five years after attaining a “qualified” immigration status.

The LIFT the BAR Act, which has been introduced in Congress, would restore access to programs like Medicaid, SSI, and SNAP by removing the five-year bar and other barriers so that older immigrants and their families can get the support they need to keep a roof over their heads, access health care, and put food on the table.


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