Impact of New Public Charge Rule on Medicaid Enrollment in Immigrant Families

The Kaiser Family Foundation (KFF) is renowned for its in-depth research and surveys on U.S. health policy and public programs. By examining public opinions on healthcare systems, KFF aims to enhance public understanding in significant national debates. Their KFF Health News division produces detailed journalism focusing on pressing health-related issues.

On July 20, 2026, the U.S. Department of Homeland Security enacted final regulations concerning the public charge rule, providing significant discretion to immigration officers. This rule now allows the inclusion of programs such as Medicaid and the Children’s Health Insurance Program (CHIP) in evaluations for lawful permanent residency. As a result, immigrant families might opt out of health coverage driven by concerns and misconceptions about regulatory compliance and the implications of the rule.

A recent KFF analysis reveals that around 13.5 million Medicaid or CHIP enrollees live in households with at least one noncitizen, including 5.6 million citizen children. Misunderstandings about the rule may decrease enrollment rates, with potential disenrollment affecting 1.4 million to 4.1 million individuals, including 560,000 to 1.7 million citizen children. Additionally, the analysis indicates that between 166,000 and 498,000 eligible individuals living in mixed-status households might choose not to enroll in Medicaid or CHIP, affecting thousands of citizen children.