Posted Sep 15, 2026
Effective September 18, 2026
A printable PDF is available here.
In August 2026, the U.S. Citizenship and Immigration Services (USCIS) updated guidance in the USCIS Policy manual regarding Public Charge Inadmissibility Determinations. As a result, the 2026 Public Charge Rule gives immigration officials broader discretion to make case-by-case determinations on their immigration status based on the totality of individual’s circumstances (age, health, family status, finances, education, and skills).
At Healthfirst, we support immigrants’ access to high-quality, comprehensive health insurance. We understand this is a very confusing topic, and that there is a lot of concern about how this may impact members’ immigration status. We encourage members to seek help to get their questions answered, but do not give up your or your children’s health coverage without understanding the details about your particular circumstances.
Below is a list of frequently asked questions to help providers understand these changes and how it affects their Healthfirst members.
1. What is Public Charge?
“Public charge” is the term used when U.S. Citizenship and Immigration Services considers whether a person is likely to become dependent on the federal government for support when they apply to enter the U.S. or apply to change their immigration status once here; for example, an application for a green card (legal permanent resident). Public charge does not apply to green card holders who are applying for U.S. citizenship.
2. What has changed about Public Charge?
The 2026 Public Charge Rule gives immigration officials broader discretion to make case-by-case determinations based on the totality of individual’s circumstances (age, health, family status, finances, education, and skills). Officials may now consider an applicant’s receipt of any means-tested public benefit including Medicaid, CHIP/Child Health Plus, SNAP, and housing assistance. No single benefit automatically makes you a public charge; it is one factor among many.
3. When does the Public Charge go into effect?
The Public Charge goes into effect on September 18, 2026*. The new rule applies to applications for admission or change in immigration status or a green card on or after that date. Benefits received before September 18, 2026 are evaluated under the prior (2022) protections.**
* Unless it is delayed by lawsuits or other reasons.
** Benefits received before September 18, 2026 are evaluated under prior 2022 protections and will not be considered under the 2026 rule.
1. How does this impact Healthfirst members?
Certain Medicaid and CHPlus enrollees may be affected by this change. However, the following Medicaid/CHPlus members will not be affected:
Additionally, individuals enrolled in any of the following Healthfirst plans are also not affected:
2. What actions do providers need to take?
1. What if my family members use healthcare, nutrition, or other programs?
Generally, it is benefits received by you, the applicant for a visa or green card—not benefits received by your family members—that are to be considered in the Public Charge Rule. However, if a family member the applicant is legally obligated to support receives such benefits because the applicant’s income is too low, that can reflect on the applicant’s own financial status and be considered in the totality of the circumstances.
2. What do I need to know about my sponsor’s liability?
For questions about whether your sponsor may have liability or other obligations, you should contact an immigration attorney.
3. Who is NOT IMPACTED by the Public Charge Rule?
Healthfirst cannot advise members on whether or not it affects individuals personally, but below is a table of general guidelines.
| Status | Definition |
|---|---|
| Lawful permanent residents (LPRs) seeking to obtain U.S. citizenship | A lawful permanent resident is a person who has been given this status by the U.S. Citizenship and Immigration Services. If you are an LPR, you should have an I-551 card with your photo on it, and your immigration case number, to use to prove your LPR status. |
| Green card holders | Public charge and any changes under this rule WILL NOT impact green card holders. However, if you plan to leave the country for more than six months, it is a good idea to talk with an immigration attorney. Current green card holders who are receiving Medicaid will only be subject to a public charge determination if they leave the country either (a) for more than six months, or (b) with certain criminal convictions, and then want to come back to the United States. |
Individuals who have or who are applying for any one of the following:
|
If you already have or are in the process of applying for one of these immigration statuses, you can continue to use any government programs that you qualify for. Benefits received while you are in this status will not be counted against you in the future, even if you apply for a green card on another basis. |
4. What is the most important thing individuals need to know?
The Public Charge Rule is extremely complicated and may not affect you or your family members. It is important to get information and legal advice for your individual situation.
If you have any questions, please contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am-5:30pm
Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).
Released September 2026
