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.
In 2022, the Biden Administration proposed a new public charge rule that would improve upon the rule that was in place for more than 20 years prior to when the Trump Administration enacted its harmful rule. Justice in Aging submitted comments in support of the Biden Administration’s efforts to enact a more humane and clear public charge immigration rule, and offered recommendations to further limit the policy’s discriminatory impact on older adults, including that long-term institutionalization be excluded from the public charge test.
We are preparing for the issuance of a final public charge regulation and will update our network when the rule is published.
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
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.