The Trump administration has reinstated a broader "public charge" policy that will allow immigration officials to consider an applicant's use of certain public assistance programs, including Medicaid and the Children's Health Insurance Program, when deciding whether to grant permanent legal residency.

The Department of Homeland Security published the new rule, which restores a policy largely rolled back during the Biden administration and gives immigration officers broader discretion to evaluate whether applicants for green cards are likely to become dependent on government assistance, reported Axios on Tuesday.

Under the rule, immigration officers may consider an applicant's receipt of means-tested public benefits, including Medicaid, the Children's Health Insurance Program, or CHIP, and the Supplemental Nutrition Assistance Program, or SNAP, as part of a case-by-case review.

The rule states it "restores broader discretion for DHS officers to evaluate all pertinent facts and aligns with long-standing policy that aliens in the United States should be self-reliant and government benefits should not incentivize immigration."

Federal law has long required immigration officials to determine whether certain applicants for permanent residency are likely to become a "public charge," or primarily dependent on government support.

Refugees, asylum-seekers, and some other categories of immigrants are exempt from the requirement.

During President Donald Trump's first term, the administration expanded the policy to include most Medicaid benefits in public charge determinations.

The Biden administration later reversed that policy, limiting the review primarily to cash assistance and long-term institutional care.

The new rule overrides those narrower standards and will apply to applications for lawful permanent residency submitted on or after Sept. 18.

DHS estimated the change could reduce federal and state transfer payments by more than $13 billion annually.

The department acknowledged the rule could also reduce revenue for hospitals, health care providers participating in Medicaid, and companies that manufacture drugs and medical supplies.

Immigrant advocacy and public health organizations criticized the policy, warning it could discourage eligible families from seeking medical care or other benefits.

"This rule will exacerbate the pervasive fear and uncertainty among immigrant families," Andrew Racine, president of the American Academy of Pediatrics, said in a statement.

Racine said the policy could result in children, including U.S. citizens, not receiving healthcare services and other benefits for which they are eligible.

A recent KFF-New York Times survey found that 11% of immigrant adults reported stopping participation in public benefit programs last year because of immigration-related concerns. Among respondents likely to be undocumented, the figure rose to 42%.

Health policy experts have also warned that reduced enrollment in public health programs could increase uncompensated care costs and emergency room visits if families delay treatment out of concern for their immigration status.