Public Charge Task Force

Last Updated: June 29, 2018

Come back often as we update this page with the latest information and resources. If you have questions or would like more information related to the content on this page, contact us at




Federal Proposal to Expand the “Public Charge” Definition to Include Health Care, Nutrition and Education

The Department of Homeland Security’s U.S. Citizenship and Immigration Services (USCIS) requires that immigrants seeking permanent residency in the U.S. (a green card) must first prove that they will not be a “public charge,” i.e. likely to become dependent on cash assistance or long-term care “at government expense.” Those determined to be a “public charge” may be denied legal permanent residency in the U.S. or even deported (as was the case in the 1990s).

Refugees, asylees and certain other groups are exempt altogether from the “public charge” definition. For a full list of groups who are exempt, see the USCIS’ Public Charge web page.

How Does this Affect Community Health Center Patients?

AAPCHO health centers are already reporting that proposed changes to “public charge” policy are having a chilling effect on patients’ willingness to seek medical care.

Draft language by USCIS to expand the definition of “public charge” was leaked to the public via:

The draft regulation, if finalized, would categorize use of all government programs as a “public charge,” including:

  • Health coverage programs, e.g. Medicaid, CHIP, ACA exchange subsidies
  • Food programs, e.g. WIC, SNAP
Education programs
  • Federal, state, and locally-funded programs
  • U.S.-born children who use services could jeopardize their families’ legal permanent residency

The leaked draft from the media is not official. We expect that the Administration will release the official version anytime between now and July 2018. At that time, the public will have at least 60 days to submit comments. The Administration must review the comments before revising and finalizing the draft.

This proposal has a disproportionate impact on children and families. Members of the public, especially health care providers, need to get ready to submit public comments. Families who are directly affected will be reluctant to speak out so it is important for health care providers to submit specific comments that help policymakers and the public understand the devastating effects of the proposed policy on children, the elderly, and families.


Public Charge Resources


Recent Articles on the Trump Administration’s Leaked Public Charge Draft Rule

What to Say to Patients About Public Charge

Preparing to Talk with the Media About Public Charge

Public Charge: Estimate of Patients Impacted and Potential Loss of Revenue

Medicaid and Federal Community Health Center Funding is why community health centers in the U.S. serve 27 million people each year.

  • Jeffrey B. Caballero, MPH, executive director of AAPCHO, delivered remarks in a meeting with the Office of Management and Budget in Washington, D.C. on June 29, 2018 discussing the potential impact of the administration’s draft proposed rule. See a transcript of Mr. Caballero’s remarks here:Remarks to OMB on Impact Of Proposed Public Charge Rule (June 29, 2018).
  • Here’s a calculator to (1) estimate the number of patients impacted and (2) potential loss of revenue if they disenroll from Medicaid and other health coverage: Public Charge Impact Calculator (Asian Health Services – last updated March 12, 2018)

When the Draft Rule on Public Charge is Officially Released: Tips on Submitting Public Comments

Right now, the Trump Administration is preparing an official draft rule that proposes to expand the definition of who is considered a “public charge.” After the official draft is released, the public will have 60 days to submit comments (so far we’ve only seen a leaked unofficial version).

AAPCHO will alert members to submit as many comments as possible. Numbers count, and so does the quality of the comments. Here are tips to help prepare:

Know Your Rights: Operational Readiness for Health Centers


About this Task Force


The AAPCHO Public Charge Task Force is a joint national initiative led by AAPCHO and it’s member health centers and clinics located in communities with high concentrations of medically underserved Asian Americans (AAs) and Native Hawaiians and Pacific Islanders (NHPIs).

The Task Force works to respond to any proposed changes to public charge guidance or regulations—including advocating against any threats to the health access and status of AA, NHPI, and other vulnerable communities that would be disproportionately impacted by any detrimental changes to public charge policy.

We coordinate our efforts with our member health centers and other partners including but not limited to the Protecting Immigrant Families coalition and the National Association of Community Health Centers.


« back to Current Projects