“We encounter families who, for example, are in the middle of a mom getting chemotherapy, and she's concerned about dropping out of Medi-Cal because she's like, ‘What do I do? Is my family going to be separated if I continue to get access to my healthcare?’”
For Daniel Torres, chief equity officer and special counsel at the California Health and Human Services Agency, the question illustrates the decisions facing immigrant families under the Trump administration’s revised public charge rule, which took effect September 18.
During a statewide briefing hosted by American Community Media, immigration attorneys, public health officials and community advocates discussed how the policy could affect California families who rely on government assistance. The rule broadens the factors immigration officials may consider when determining whether certain applicants are likely to become dependent on public benefits, potentially affecting their eligibility for permanent residency.
The changes rescind federal protections established under the Biden administration in 2022, which generally limited public charge evaluations to cash assistance for income maintenance and government-funded long-term institutional care. The revised policy allows immigration officers to consider a wider range of means-tested benefits, including certain assistance received by an applicant's family members.
Adriana Cadena, executive director of the Protecting Immigrant Families Coalition, explained that public charge has been part of federal immigration law since 1882. The provision was historically used to restrict immigration among low-income populations, although its interpretation has changed substantially over time.
Federal guidance issued in 1999 limited public charge evaluations primarily to cash assistance, including Supplemental Security Income and Temporary Assistance for Needy Families, and government-funded long-term institutional care. The first Trump administration expanded the definition in 2019 to include Medicaid, food assistance and certain housing subsidies. Following litigation and widespread opposition, that rule was vacated in 2021.
The Biden administration subsequently formalized a narrower definition in 2022, excluding benefits received by children and other household members from consideration. The latest rule removes those protections and gives immigration officers greater discretion to assess an applicant's financial circumstances.
Cadena said the policy could discourage families from accessing services they are legally entitled to receive. She cited figures showing that approximately 38% of Californians rely on Medicaid coverage and that 62% of California Medi-Cal recipients are employed. Nationally, she said, most Medicaid recipients under age 65 either work or face barriers to employment.
Ariel Brown, an attorney with the Immigrant Legal Resource Center, said the latest revision differs from the 2019 rule in its approach. While the earlier policy introduced additional criteria and weighted factors, the new regulation removes many of the guidelines used to determine how benefits should be evaluated.
Brown described the standard as “highly subjective, discretionary and prone to bias,” making it difficult for attorneys to predict how individual applications will be assessed.
She emphasized that public charge does not apply to all immigrants. Refugees, people granted asylum, certain humanitarian visa holders and lawful permanent residents applying for citizenship are generally exempt. The rule also does not independently change eligibility for public assistance programs.
Legal challenges are expected to continue. Brown noted that lawsuits against the 2019 rule raised questions about federal administrative procedures, discriminatory impacts and the government's failure to adequately consider the consequences of reduced participation in public assistance.
A Supreme Court decision limiting nationwide injunctions could complicate similar challenges this time, potentially producing different outcomes across states.
The implications are particularly significant in California, where immigrant households account for a substantial share of families with children.
Sarah Dar, vice president of policy and advocacy at The Children's Partnership, said approximately 44% of California's 8.6 million children live with at least one foreign-born parent. That represents more than 3.7 million children, roughly nine in ten of whom are U.S. citizens.
More than one million California children are estimated to have at least one undocumented parent. Many live in mixed-status households, where parents and children have different immigration classifications and eligibility for public services.
Under the revised policy, certain benefits received by U.S. citizen children may be considered when immigration officers evaluate a parent's application for permanent residency. Dar explained that this does not automatically result in a denial, but it introduces another consideration for families deciding whether to enroll in assistance programs.
Children in immigrant families also experience higher rates of poverty. Approximately 17% live below the federal poverty threshold, compared with 13% of children whose parents were both born in the United States.
Dar presented findings from Stanford University's RAPID Survey, which examined the experiences of California parents with children ages three and younger between September 2025 and June 2026.
Among surveyed parents, 61% expressed concern that immigration enforcement could affect participation in childcare, while 66% reported a diminished sense of safety and belonging in their communities. Another 62% identified employment losses or financial difficulties associated with immigration enforcement.
The survey also found that 58% reported children experiencing fear, stress or anxiety, while 49% identified school absences or learning and developmental difficulties. These findings reflect broader immigration enforcement concerns rather than the public charge rule alone.
Dar said confusion about the revised policy could further discourage families from using available services. She distinguished between means-tested assistance, which requires demonstrating financial need, and universal programs available regardless of income.
California's universal school meals program, for example, provides free meals to all public school students without requiring families to qualify based on income. Dar said those meals would generally fall outside the means-tested benefits considered under public charge, although questions remain about how federal officials will interpret some programs.
She encouraged families to consult immigration attorneys before withdrawing from assistance. Community clinics and food banks remain available, but she cautioned that these services are already under considerable pressure and may offer less reliable support than established public programs.
Cheryl Branch, executive director of Los Angeles Metropolitan Churches, discussed how community organizations are responding in South Los Angeles, where residents from African American, Latin American and immigrant communities often rely on the same neighborhood services.
Branch described mothers requesting classroom space at a public housing development in Watts to meet with immigration attorneys and discuss their families' options.
Her organization works with immigrants from several countries, including Nigeria, Ethiopia, Haiti, Jamaica and Kenya, alongside other residents experiencing economic hardship.
Through faith-based organizations and local partnerships, Los Angeles Metropolitan Churches provides assistance with transportation to medical appointments, prescription costs and food access. The programs are supported by contributions from residents, small businesses and community members.
Branch said the organization also coordinates food pantries, cooking programs and outreach workers trained to assist residents in familiar community settings, including churches, parks and recreation centers.
She emphasized that faith leaders and neighborhood organizations often serve as trusted sources of information for families reluctant to approach government institutions.
California officials are preparing additional guidance for residents and organizations affected by the federal changes.
Torres said the California Health and Human Services Agency plans to work with community organizations, schools, healthcare providers and faith leaders to distribute information and connect families with legal services.
The state also funds immigration legal assistance through the Department of Social Services, which Torres said will be especially important for applicants with pending green card cases.
The revised rule presents additional challenges because California administers several assistance programs funded through state and local resources. Unlike the 2019 policy, which focused more narrowly on federal benefits, the new framework potentially allows immigration officials to consider a broader range of government assistance.
Torres cited a federal estimate that reduced participation in public programs could save approximately $13 billion annually. He warned that those reductions could also result in delayed medical treatment and increased demand for emergency and community services.
Another concern is how immigration officers will document their decisions. Torres said the new framework provides less clarity about which factors ultimately lead to a denial, making it difficult for attorneys and state officials to identify consistent patterns.
During questions from reporters, Brown explained that the rule does not directly change existing requirements governing financial sponsors. However, benefits received by household members, including a sponsoring relative, may now receive greater scrutiny.
She also noted that immigration applications principally ask applicants to disclose their own use of public benefits, leaving questions about how officials will obtain information concerning assistance received by other family members.
Speakers repeatedly cautioned against assuming that every immigrant receiving government assistance would face immigration consequences. Public charge applies to specific immigration proceedings, and its effect depends on individual circumstances.
Brown advised applicants to seek legal counsel before interviews or other significant steps in the immigration process, particularly when traveling abroad for consular appointments. Dar pointed to nonprofit legal service providers offering free or reduced-cost assistance, as well as information available through the Protecting Immigrant Families Coalition.
Cadena urged reporters and community organizations to provide clear information rather than contribute to confusion about the policy.
“Don't panic,” she said, emphasizing that many families affected by the broader climate of uncertainty will never be subject to a public charge determination.
For Torres, the immediate concern is that families may discontinue essential services before understanding whether the rule applies to them.
“If you got to see a doctor,” he said, “don't withdraw until you get some advice and you make the right choice for yourself.”
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