Alexander Somodevilla, Ross Margulies, Sara Rosenbaum, Feygele Jacobs, Kay Johnson
July 2025
On July 10th, the Trump Administration announced a policy change significantly limiting noncitizen access to federally funded benefits and services across a broad range of federal programs, restricting access to additional programs and reversing settled policy in place for over 25 years. Several federal agencies, including the Department of Health and Human Services (HHS), issued notices expanding the types of federal programs under their purview that will be considered “federal public benefits” subject to eligibility restrictions based on immigration status pursuant to federal law.
Despite the fact that by statute (42 U.S.C. §254b), community health center funding supports services to populations and provides no individual benefits as the term is used in the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), the new policy reclassifies community health centers as a federal public benefit and thus, subject to the access restriction. The policy thus appears to lack a basis in law. It is true that as non-profit entities, community health centers are exempt from PRWORA’s verification requirements. But this is not the end of the matter, since it is possible that HHS conceivably could try to make compliance with the new federal public benefit standard a condition of grant award. Thus, the question of whether HHS incorrectly extended the “federal health benefit” classification to community health centers is a matter of critical concern given the impact of such a requirement as a result of its chilling effect on entire communities.
While the Notice took effect immediately upon publication in the Federal Register on July14th, HHS is accepting public comments through August 13th, and the importance of public comments on the community-wide health and operational impact of this change in policy cannot be overstated.
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA)
The July 14th Notice is based on the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), which is the principal federal law clarifying the relationship between non-U.S. citizens and federal programs and benefits. Enacted in 1996, PRWORA imposes certain restrictions on the receipt of federal public benefits by immigrants, while also giving states the ability to determine noncitizen eligibility for state- and locally-funded services.
“Qualified and Nonqualified” Immigrants
PRWORA divides immigrants and other noncitizens (e.g., temporary visa holders) into two categories: “qualified” and “nonqualified.” An immigrant’s eligibility to use services is tied to this classification.
Qualified immigrants: “Qualified” immigrants include lawful permanent residents (green card holders), asylees, refugees, certain humanitarian parolees, and certain other groups. These individuals can receive “federal public benefits,” although they must wait 5 years (“five-year bar”) to become eligible for certain “means-tested” programs, such as Medicaid, SNAP, SSI, and TANF. ( Table 1)
Nonqualified immigrants: Nonqualified immigrants include undocumented immigrants, as well as all other noncitizens who do not fall under the “qualified” immigrant categories, including individuals with Temporary Protected Status (TPS), individuals with a pending asylum application, Deferred Action for Childhood Arrivals (DACA) recipients, and holders of work and student visas. These people are barred from receiving “federal public benefits”.
Verification
Programs designated as federal public benefits must verify immigration status. But PROWRA exempts non-profit organizations such as community health centers from having to verify.
Federal public benefits
The term “federal public benefit” under PRWORA means:
Any grant, contract, loan, professional license, or commercial license provided by an agency of the U.S or by appropriated funds of the U.S.; and
Any retirement, welfare, health, disability, public or assisted housing, postsecondary education, food assistance, unemployment benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit by an agency of the U.S. or by appropriated funds of the U.S.
Public programs that do not fall into the meaning of federal public benefit remain completely available to all noncitizens, qualified or nonqualified. Until the July 14 Notice was issued, community health centers and a dozen other public health and social services programs were considered NOT to be federal public benefits. The Notice reverses this earlier exemption.
1998 HHS Notice – Community Health Centers are not Federal Public Benefits
In 1998, HHS concluded that health centers and other public health programs such as the Title X family planning program, mental health and addiction programs administered by SAMHSA, and similar programs do not fit within the meaning of “federal public benefit” because they do not provide benefits to individuals (like, for instance, a scholarship program) nor must individuals meet specific eligibility requirements to use the services funded under the program. Community health centers, for example, are open to all people, although, of course, copayments might vary depending on income and there may be a wait for a non-urgent appointment. HHS also decided that Head Start remained fully available since it did not fall under a separate educational benefit exclusion.
July 2025 Notice – Reverses the 1998 Exemptions
In the 2025 Notice, the Trump Administration reverses HHS’s long-standing interpretation by broadening the meaning of “federal public benefit” to include programs that deliver no benefit to individuals but are instead for general broad public health and social welfare purposes. Swept into the new definition are community health centers and a dozen other programs, shown on Table 2. Beyond health centers’ 330 grants, other funding sources that help support health centers’ services such as Title X family planning and SAMHSA grant programs are also now on the federal public benefit list. HHS has indicated that the list is not exhaustive, and additional programs may be identified in the future.
Immigration-Status Verification and the Non-Profit Exemption
As noted above, PRWORA exempts non-profit organizations from any requirement to “determine, verify, or otherwise require proof” of an individual’s immigration status when seeking or applying for federal public benefits. The 1998 Notice confirmed that PRWORA “exempts all providers that are nonprofit charitable organizations from these verification rules, even if they provide services or benefits funded by HHS programs identified” by the agency as federal public benefits. But the Department of Justice (DOJ) does have regulatory authority on this matter, which is being closely watched to determine whether the administration will attempt to impose verification requirements.
Implications and Next Steps
The policy is being closely monitored by multiple organizations and the public health implications are both real and severe. Under law, Section 330 expressly focuses on services to entire communities; as a result, the program appears to fall entirely outside the meaning of a federal public benefit. Furthermore, communities are expected to feel enormous effects because of what is known as the chilling effect. We will update as new information becomes available.