“This is a moral failure.”
With those words, Dr. Giridhar Mallya described the human consequences of policies that may cause immigrant families to withdraw from food, health and other assistance programs. Speaking during an American Community Media national briefing, Mallya joined immigration and health policy experts in warning that the Trump administration’s expanded public charge rule could reach far beyond green card decisions, creating fear among families whose children may remain legally eligible for essential services.
A Broader Standard
The rule takes effect September 18, 2026, and applies to certain applications for admission or adjustment of status filed on or after that date. Public charge has been part of federal immigration law since the 19th century, but its meaning and implementation have changed over time. Under the new approach, immigration officers will have broader authority to consider whether an applicant may become dependent on government assistance.
Xiao Wang, co-founder and CEO of Boundless Immigration, explained that officers will examine the “totality” of an applicant’s circumstances. The review may include age, health, family situation, income, assets, education, employment skills and other evidence of self-sufficiency. Unlike the narrower standard used since 2022, the expanded process gives officers greater discretion and allows consideration of a wider range of public benefits.
“We’re going from a world where there’s specific dollar amounts that you need to make,” Wang said, “to a world now where it’s, let me look at your whole background.” He warned that greater discretion could make applications longer and more complicated while producing uneven decisions in similar cases.
Who May Be Affected
The rule primarily affects certain people seeking permanent residency from inside or outside the United States. Statutory exemptions remain for categories that include refugees, asylees, certain trafficking and crime survivors, special immigrant juveniles and some applicants protected under the Violence Against Women Act. The public charge determination also does not apply to naturalization applications from people who already hold green cards.
Wang emphasized that applicants should not assume the rule applies to every immigration category. Families who are eligible and prepared to file before September 18 may remain under the narrower standard. However, each case is different, and he encouraged people to consult a qualified immigration attorney or an authorized nonprofit immigration service provider.
“The fear is bigger than the rule,” Wang said. Benefits received by a family member, including Medicaid or food assistance provided to a United States citizen child, are generally not treated as benefits received by the green card applicant. Yet families may still withdraw their children because they do not understand the distinction or fear that sharing information could expose a relative to immigration enforcement.
Children Losing Health Coverage
Joan Alker, executive director of Georgetown University’s Center for Children and Families, said one in four children in the United States lives in a mixed-status family. Many of these children are citizens, even though a parent or another household member may have a different immigration status.
Alker reported that millions fewer children are enrolled in Medicaid and the Children’s Health Insurance Program than when President Trump took office in January 2025. Although researchers do not yet know how many have become uninsured, she said past trends show that when Medicaid enrollment falls, the number of uninsured children rises.
“When children don’t have health insurance, it’s harder for them to access care, particularly primary and preventive care,” Alker said. A child with asthma may miss medication or regular treatment and eventually require emergency care, increasing both the medical danger and the financial burden on the family.
The consequences can extend into adulthood. Children with reliable health coverage are more likely to receive early treatment, remain healthy, complete high school and earn higher wages later in life. Alker urged frightened parents to seek guidance from trusted pediatricians, school nurses, community health workers and local health centers.
Food Insecurity Grows
Mallya, a public health physician and senior policy officer at the Robert Wood Johnson Foundation, described SNAP as a critical lifeline that helps low-income households purchase groceries. Children account for nearly four in ten participants, while the program also serves seniors, people with disabilities and working adults whose earnings do not cover basic necessities.
He stressed that undocumented immigrants are not eligible for SNAP and have never been eligible. Nevertheless, confusion surrounding public charge can cause eligible citizen children in mixed-status households to lose food assistance. During the first Trump administration, he said, hundreds of thousands of children in such families left SNAP.
“Public charge is going to make a bad situation even worse,” Mallya said. Food banks and churches continue to perform compassionate and necessary work, but he cautioned that charitable organizations cannot replace a nationwide nutrition program. School meals also cannot provide food throughout the day, on weekends or during school vacations.
A Call for Trusted Guidance
For immigrant and faith communities, the briefing presented both a policy warning and a moral responsibility. Families should not surrender benefits out of fear without first obtaining reliable, case-specific guidance. Churches, community organizations and ethnic media can help by sharing accurate information, connecting families with qualified professionals and protecting them from rumors or unlicensed advisers.
A nation’s strength is reflected in how it treats children, families and neighbors facing hardship. As the expanded rule approaches, compassion must be joined with truth. Immigrant families need clear information so that fear does not deprive an eligible child of a doctor’s visit, a nutritious meal or the opportunity to grow and thrive.
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