USCIS Public Charge Rule Allows Medicaid and CHIP Use in Immigration Status Decisions
A new USCIS rule effective September 18, 2026, permits immigration officers to consider applicants' enrollment in Medicaid, CHIP, and SNAP when evaluating green card and visa applications, reversing Biden-era restrictions. The policy applies to immigrants seeking lawful permanent residency but exempts refugees, asylees, VAWA self-petitioners, and certain other groups. The Department of Homeland Security estimates the rule could reduce federal and state spending by nearly $9 billion annually due to disenrollment or forgone enrollment by U.S. citizens and eligible household members in mixed-status families. KFF projects between 1.4 million and 4.1 million Medicaid and CHIP enrollees in households with noncitizens could disenroll due to immigration-related concerns.
State Medicaid agencies will likely see enrollment declines among eligible citizen children and pregnant women in mixed-status households, reducing federal match revenue while facing potential downstream impacts to MCO capitation rates, provider networks, and uncompensated care costs.
CHIP · Managed Care · Maternal
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