In a heartless & cruel (but not unexpected) policy shift, Secretary Kennedy declared an end to long-standing interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 – cutting off access to the already limited health and social services for immigrants and even most asylum seekers.
HHS Bans Illegal Aliens from Accessing its Taxpayer-Funded Programs | HHS.gov
The 1998 interpretation of PRWORA (crafted under the Clinton administration) had allowed for limited access to some essential services like community health centers, Head Start, and certain mental health and addiction recovery programs.
Kennedy is ending access to any and all of the already limited benefits, undercutting public health practice grounded in compassion, prevention, and pragmatism.
Denying people access to basic healthcare services, behavioral health programs, early childhood education, and family planning care is morally indefensible and harmful to our entire society.
History of Considering Public Benefits – AZ Public Health Association
His ban impacts access to Certified Community Behavioral Health Clinics, Community Mental Health Services Block Grants, Head Start, Title X Family Planning services, SAMHSA programs for substance use disorder treatment and prevention, homeless transition services, and even support for foster care and kinship placements.
These programs are lifelines not just for immigrants but for the public health system as a whole.
For example, community health centers treat infectious diseases, manage chronic illness, and ensure people (regardless of status) aren’t left to suffer or deteriorate in silence. Restricting access doesn’t make health needs disappear; it just increases suffering and shifts costs elsewhere like to emergency rooms and jails.
Immigration Status, Public Benefits, Health & Access to Care: A Primer – AZ Public Health Association
Secretary Kennedy is using the narrowest and harshest possible reading of the law.
PRWORA allowed flexibility in defining who could be served under specific exceptions for programs addressing public health emergencies, immunizations, and short-term, non-cash disaster relief.
Asylum seekers fleeing persecution are being told they can’t get mental health support or even basic health services.
Parents trying to keep their families healthy are being locked out of family planning and Head Start.
The long-term consequences? Higher rates of untreated mental illness, addiction, and preventable disease, and more children entering emergency foster placements and driving up government spending in other areas. Because undocumented folks will no longer be able to access community health centers, they’ll be stuck going to emergency departments instead, driving up expensive uncompensated care.
Note: Because Kennedy doesn’t have the authority to tell hospital emergency departments to turn away undocumented people (protected under a different law called EMTALA) he didn’t do that today… but he would have if he could have.
When some people are excluded from care, the entire community suffers. Diseases don’t ask for a green card. Addiction doesn’t care about immigration status. Denying care won’t stop people from needing it… it will only make it harder and more expensive to address later.
In short, this is yet another intentional harm from Kennedy… one that APHA will shortly be challenging in court.
Note: There’s no information yet about the details about how programs like FQHCs might implement the requirement for status verification. The policy becomes effective upon official publication in the Federal Register, expected July 11, 2025. A 30-day comment period on the notice will begin upon publication, followed by Kennedy’s rubber stamp.