Kat Gruschow, Policy Fellow

On September 22, 2023, the Biden Administration issued a rule that finally codified a longstanding definition of “public charge,” a sub-regulatory facet of immigration policy, which the Trump Administration tried to harshen in 2018. Then, on May 17, 2023, the U.S. Senate passed a resolution attempting to reverse the Biden Administration ruling. The House is expected to vote on the resolution–and many foresee easy passage through the second chamber.

While the Biden administration has vowed to veto the measure, the back-and-forth rulings on public charge, the rhetoric used to propel the reversal resolution’s success, and debates over immigration more broadly speak to a pivotal question at the heart of much public policy: who is, and who is not, deserving of help? 

The “deservingness” question, as applied to public charge, revolves around the second, perhaps more contentious question of what it means to be “American” and who has the right to enjoy the privileges of that title. Under the veneer of rhetoric about budget concerns and national debt, the fight over public charge follows the narrative that “Americans” deserve government help, while everyone else is just a burden. And, using policy to shift the boundaries of “Americanness” and, thus, “deservingness” has longstanding racist, xenophobic, and ableist roots—and significant ramifications for the health and well-being of millions of people in the country.

Despite Lady Liberty and the image we like to project, the United States–a nation forged through colonization and genocide by European settlers–is not, and never has been, open and accepting to all. Immigration policy has served as a mechanism to construct American identity through the purposeful inclusion and exclusion of specific groups. 

One of the first uses of “public charge” emerged during the pre-Civil War years as Northern whites confronted the disconnect between their stance against slavery and aversion to living alongside freed black people. Several states erected barriers to entry for freedpersons looking to migrate north, including an attestation directly from migrants that they would not become a “public charge” and some requiring those bringing emancipated slaves north to post bond against the freedperson “becoming a public charge.” Opaque language around what exactly constituted a “public charge,” coupled with the ability to deport those deemed one, enabled states to perpetuate white supremacy culture in the guise of immigration law and rhetoric of self-sufficiency. 

That example is notably Black; other exclusionary policies skirted race by relying on class: Massachusetts required shipowners to ensure passengers would not become reliant upon the Commonwealth to “prevent the introduction of paupers.” Later, this was expanded to include those considered “lunatic, idiot, maimed, aged, or infirm.” Nascent America only wanted the world’s wealthy, healthy, and white; the public charge was a way to ensure it got what it wanted. 

In 1882, “public charge” formally entered federal law in the Chinese Exclusion Act. It permitted the government to bar any person ‘unable to take care of himself or herself without becoming a public charge’ from entry and enabled the deportation of anyone who did become a public charge within a year. What exactly constituted a public charge was not defined. Such ambiguous language granted individual immigration officials the power to determine whether someone could or could not enter the country—and gave the dominant culture another tool to wield in crafting an exclusionary definition of “American” since it could be altered to target any group deemed undesirable. What grew from anti-Blackness and classism was later used to exclude Chinese immigrants, then Italians, Eastern Europeans, Jewish and Catholic people, and now, predominantly those immigrating from Latin America.

Today, “public charge” is a ground of inadmissibility–meaning a reason that an immigrant could be denied a green card, visa, or admission into the United States. An immigration officer decides whether an applicant is likely to “become dependent” on certain government benefits in the future. However, not all government programs count, family members’ program usage is not included, and not every immigration application requires it. 

However, frequent rule changes and purposeful fear-mongering have spread untrue information about public charge. Half the power of the public charge comes from this fear communities feel about its potential impacts and confusion about what it is and is not. This “chilling effect” keeps immigrants and their families from accessing the public programs for which they are eligible.

Such programs like SNAP, SSI, WIC, TANF, and Medicaid help people access the food and services they and their families need to get and stay healthy. Almost ironically, in the late 19th and early 20th century, justifications for public charge and broader immigration policy took on the language of keeping the population healthy, which co-opted racist ideology deeming certain entire groups of people public health concerns. Now, the same rule is being used to systematically exclude immigrants from programs that foster better health outcomes. The common thread between the two is exclusionary deservingness: who deserves to enter the country in the first place and who deserves a fair opportunity to thrive once they’re here.

Using public charge rules to implicitly define health as a privilege only accessible to some not only has severe negative impacts on immigrant communities but also distracts the rest of the country from fighting for a better reality for all of us. When Americans continue to worry about whether someone who isn’t “deserving” of Medicaid is accessing it, they don’t ask why it is we must be deserving of the opportunity to be healthy in the first place. They don’t ask why our health coverage must be tied to our employment or why the tax structure defunds aid and benefits for the 99% so the 1% can pay less in taxes. 

Public charge definitions directly impact immigrant communities, and the confusing rule changes have a chilling effect on public program uptake that we all must combat. Our advocacy must be multifold. After the back-and-forth swings over the past two administrations, we must re-establish trust within immigrant communities. We must think more broadly about the wrongs of our immigration system. And, we must all work to call the narrative of “deservingness” into question, instead asking larger questions about why anyone should have to earn the right to be healthy at all.


For families

Determination tool

For advocates

OmniSalud/Colorado Option FAQs

Translate »