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  • Washington Highlights

    AAMC Comments on Considerations for Defining “Public Charge”


    Phoebe Ramsey, Director, Physician Payment & Quality

    The AAMC submitted comments on Oct. 22 to the Department of Homeland Security (DHS) regarding its advance notice of proposed rulemaking, “Public Charge Ground of Inadmissibility.” This notice is the first step to identify key policy considerations for revising the public charge regulations through future rulemaking since the DHS vacated the broadened definition of public charge finalized under the previous administration, which was challenged in court [refer to Washington Highlights, Sep. 13, 2019].

    The DHS solicited information on a variety of topics through the notice, including on the definition of public charge and public benefits considered part of the public charge grounds of inadmissibility. The AAMC’s comments urge the DHS to limit review of lawful use of medical and health-related public benefit programs when considering whether immigrants seeking to enter the United States or change their status are likely to become a public charge.

    Specifically, consistent with congressional intent and legal precedent, the AAMC recommends the DHS define someone likely to become a public charge as a person who is “likely to become primarily and permanently reliant on the federal government to avoid destitution.” Following that narrow definition, the AAMC believes that appropriate use of any type of Medicaid benefit, including the Children’s Health Insurance Program, should not be considered by immigration officials when determining public charge grounds of inadmissibility. Adopting a limited definition that clearly excludes lawful use of these critical public benefit programs will remove confusion and help to reverse the “chilling” effects of the vacated rule.

    In addition, the AAMC asked the DHS to acknowledge that incoming international students, medical residents, physicians, scientists, and researchers are unlikely to become a public charge in part by making it clear that letters from sponsoring institutions documenting an individual’s ability to meet federal income and insurance requirements are sufficient proof for admittance into the United States without delay.