Will getting health insurance through Medicaid, CHIP, or Health Insurance Marketplaces affect an individual’s ability to obtain lawful permanent resident status or citizenship?

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Some people who apply for a green card (lawful permanent residence) or a visa to enter the U.S. must pass a “public charge” test – which looks at whether the person is likely to become primarily dependent on the federal government as demonstrated by the use of cash assistance programs for income maintenance or government-funded institutionalized long-term care.  In making this determination, immigration officials consider certain factors in their totality, including a person’s age, family status, income and resources, health, education or skills, and their sponsor’s affidavit of support or contract. If immigration officials determine that a person is likely to become a public charge in the future, they can deny that person permission to come to the U.S. or deny their application for a green card or lawful permanent resident status.

In 2021, the Biden Administration eliminated changes to the public charge test made by the Trump Administration.  Under current rules, immigration officials will NOT consider Medicaid (except for payment for long-term institutional care), Emergency Medicaid, Children’s Health Insurance Program, Marketplace coverage, state and locally-based health care programs (for services other than long-term care), and any other health coverage in a public charge test.  The only benefits that will be considered in a public charge test are cash assistance for income maintenance, such as Supplemental Security Income, Temporary Assistance for Needy Families, and state-based cash assistance programs, and government-funded long-term institutionalization, such as mental health or nursing home care.

This information is based on analysis of federal regulations and is not legal advice.  Get help deciding what is best for your family and consult with an immigration attorney if you can.  You can use this online directory to search for local nonprofit organizations that provide legal help and advice:

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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