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Potential changes in Public Charge assessment 
SMC Health advises everyone to keep accessing benefits


SMC Health is deeply concerned about the proposed changes to federal immigration rules called “public charge,” which define how an immigrant resident’s application to enter the country or receive a green card is assessed, and the potential impacts on the public health.

The proposed changes significantly expand what public benefits are considered as public charge (e.g., Medi-Cal, CalFresh, public housing or Section 8 vouchers). The County is engaged in advocacy around these issues through the Board of Supervisors.

When residents fear obtaining public benefits to access basic healthcare, food, or housing, people’s health conditions can suffer and actions that prevent the spread of disease (such as getting vaccinated) may not occur. 

San Mateo County Health encourages residents to continue accessing the public benefits and services they need and remain available to them. Any rule changes would not go into effect until after public comments are reviewed.

San Mateo County Health is here to protect the health of everyone in our community and create opportunities where everyone in San Mateo County can live longer and better lives. Access to healthcare and insurance, food and housing are critical to a healthy community, and we remain committed to providing excellent services with respect and dignity. These changes would adversely affect our work and mission, with far-reaching implications.

Public comment on the proposed rule closed December 10, 2018 and comments are currently being reviewed. No rule changes have been implemented yet. Residents will have time to make decisions about enrollment in public programs once any rules changes are implemented. 

A few things to note: 

  • Maintaining health benefits in order to remain healthy and employable is important, and being employed is viewed as a positive factor in assessing public charge. 
  • Not all immigrants are subject to the public charge test. The test looks at all the person’s circumstances, weighing positive factors against any negative ones. 
  • If the proposed rule becomes final, non-cash benefits (other than long-term care) used before that time will not be considered. Using benefits now can help you or your family members become healthier, stronger, and more employable in the future. 
  • Federal and state laws protect the privacy of people who apply for or receive health care coverage, nutrition, economic support, or other public benefits. 
  • Get help deciding what’s best for your family and, if you can, consult with an immigration attorney or a Board of Immigration Appeals–accredited representative about your own situation. 


Legal Aid Society of San Mateo County
National Immigration Law Center