From 18 September 2026, United States officers deciding whether someone is likely to become a public charge may weigh the receipt of any means-tested public benefit, rather than the narrower list the 2022 rule allowed. Canada has no public charge rule at all. It has a cost threshold, set at $144,390 over five years for 2026.
Those are two different tests, and people with disabilities are affected by both in different ways. This article reports what each rule says. It is not immigration advice, and nobody should make a decision about a benefit or an application on the strength of an article.
What the United States is changing
The Department of Homeland Security published a final rule in the Federal Register on 20 July 2026 rescinding the public charge regulations made in 2022. In the department’s own summary: “DHS is rescinding the 2022 public charge ground of inadmissibility regulations (‘2022 Final Rule’). The 2022 Final Rule was not the best implementation of the statute.”
The rule takes effect on 18 September 2026. It applies to applications for admission made on or after that date, and to applications for adjustment of status postmarked or submitted electronically on or after that date.
The rule is being challenged in court. On 14 September 2026, four days before the effective date, two lawsuits were filed in the United States District Court for the Southern District of New York. One is led by New York Attorney General Letitia James and joined by other states. The other is led by New York City with Chicago, the City and County of San Francisco, Santa Clara County, Seattle, King County in Washington, and the Public Rights Project. Both ask the court to block the rule, and the city coalition argues that it “dramatically and unlawfully expands the government’s authority to consider an immigrant’s use of public benefits.” The Immigrant Legal Resource Center, writing the same day, said the effective date might be delayed.
We checked on 19 September 2026 and found no published order blocking the rule, and the Federal Register entry still gives 18 September 2026 as the effective date. That is where it stood on the day this was written, and it is not where it will necessarily stay. Anyone whose application turns on the date should check the current position rather than rely on an article.
What the rescission removes is the narrow framework. DHS describes the 2022 regulations as having “imposed narrow definitions of statutory terms and minimum factors as well as limited the public benefits that DHS could consider”, and says of its own new approach that “DHS is moving away from a bright line primary dependence standard.” Officers will instead be empowered to consider the statutory factors, “the alien’s receipt of means-tested public benefits”, any other individualized case-specific factors, and any empirical data relevant to self-sufficiency. The quoted phrasing is the Federal Register’s, including its use of the word “alien”, which is the statutory term rather than ours.
DHS also states that it is not replacing the definition it removed: “DHS is not providing a definition for public charge in this final rule.” DHS said USCIS would issue that guidance on or before the effective date, to “inform, but not prescribe” the outcome of individual determinations. It did: on 18 August 2026 USCIS announced that it was “issuing updated guidance in the USCIS Policy Manual” on how it will decide whether an applicant for permanent residence “is likely at any time to become a public charge”, which categories of applicants are exempt, and what evidence it will consider.
The date matters, because the rule splits benefits by when they were received
This is the mechanical point that most affects anyone who has ever used a public program, and it is stated plainly in the rule.
Before 18 September 2026, only two things count: public cash assistance for income maintenance, and long-term institutionalisation at government expense. On or after 18 September 2026, any means-tested public benefit may be considered. The Federal Register puts it in one sentence: “DHS will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date of this final rule and will consider the receipt of any means tested public benefits on or after that date.”
Long-term institutionalisation at government expense being one of the two pre-existing categories is worth reading twice, because it has always been the part of the public charge test that reaches disability most directly.
What DHS itself expects to happen next
Two figures from the department’s own analysis are worth stating, because they are not estimates from an advocacy group. They are the government’s.
DHS received 8,846 comments on the proposed rule, “the majority of which opposed the rule.”
DHS also estimates that federal and state transfer payments could fall by “approximately $13.05 billion annually due to disenrollment or forgone enrollment in public benefits programs by members of households that include aliens who may be receiving public benefits”, and notes that the households affected include United States citizens in mixed-status families. Over ten years, DHS puts the discounted total at approximately $111.28 billion at a 3 per cent discount rate. The department also anticipates downstream effects on healthcare providers, Medicaid-participating hospitals, SNAP-participating grocery retailers and landlords in federally funded housing programs.
A projection of people stopping their benefits is not the same thing as a projection of people being refused. It is a projection about behaviour, and it is the government’s own.
The criticism, and where it comes from
The disability sector’s objection to public charge rules is long-standing rather than new, and it should be dated honestly.
When the Department of Homeland Security proposed a public charge rule in 2018, the American Association of People with Disabilities said in an October 2018 statement that “the proposed rule is blatantly discriminatory and would cause great harm to people with disabilities and their families” and that “it would exclude individuals from this country just because they have a disability.” AAPD’s objection then was that “individuals could be denied admission to the United States or have their application for lawful permanent residency denied because they used or applied for government services such as Medicaid, housing assistance, or food assistance.”
That statement is from 2018 and concerns the rule proposed in 2018, not the rescission that took effect on 18 September 2026. We looked for a 2026 statement from the same organization on this specific rule and did not find one. The 2018 statement is included because it sets out the objection in the sector’s own words, dated, and not because it is a response to the current rule.
For criticism of the current rule, the most reliable record available is DHS’s own preamble, which summarizes the objections commenters raised and the department’s answers to them.
Canada does not have a public charge rule
Canada’s test is not about benefits at all. It is about the projected cost of health and social services, assessed once, from an immigration medical exam.
Under section 38(1)(c) of the Immigration and Refugee Protection Act, a foreign national is inadmissible on health grounds if their health condition “might reasonably be expected to cause excessive demand on health or social services”. The Regulations define excessive demand as anticipated costs that “exceed triple the average Canadian per capita health services and social services costs over a period of five consecutive years”, or a demand that would add to existing waiting lists and would increase morbidity or the mortality rate in Canada because timely services could not be provided to citizens or permanent residents. Both limbs of that second branch have to be met, not just the first.
Immigration, Refugees and Citizenship Canada publishes the resulting figure. The 2026 excessive demand cost threshold is $144,390 over five years, or $28,878 per year. That figure is stated on IRCC’s medical inadmissibility page, last modified 23 July 2026, and it is recalculated for each year.
The exemptions matter as much as the threshold. IRCC states that the excessive demand rules do not apply to refugees and their dependants, to protected persons, or to certain people being sponsored by family, including dependent children, spouses and common-law partners.
If IRCC believes an applicant may be medically inadmissible, it sends a procedural fairness letter setting out why, before a final decision. The applicant has 90 days from the date of that letter to respond with further information, and may request an extension by contacting the office named in the letter. IRCC states that professional representation is permitted but not required. In some cases IRCC also invites a mitigation plan.
One discrepancy on IRCC’s own website, worth knowing about
The definition of “social services” in the Regulations is narrow. As consolidated to 21 July 2026, it reads: “social services means residential or institutional care, including the provision of devices related to the care, that is recommended by a health professional and for which more than half of the funds are contributed by governments, either directly or through publicly funded agencies.”
Special education, social and vocational rehabilitation, and personal support services are not in that definition. Their removal was the point of the reform announced in 2018, when the department said those services “should instead be seen as investments that enable participation and inclusion” rather than costs borne by society.
IRCC’s public-facing medical inadmissibility page, however, still lists “special education”, “social and vocational rehabilitation”, “personal support” and “devices that support social services” among its examples of social services. We read that page again on 19 September 2026 and all four examples were still there.
The Regulations are the law and the guidance page is a plain-language summary of it, so the two are not equal in weight. We are not telling anyone what to do about it. We are noting that a reader comparing the two pages will find they do not match, and that the mismatch is on the government’s side rather than the reader’s.
What this is and is not
Both of these rules turn on individual facts and both are administered by officers exercising judgment. Canada’s is settled law. The United States rule is in force on the Federal Register’s own dates and is under active challenge in court, which is one more reason the position on any given day is not something an article can carry. Anyone with an application in progress, or contemplating one, needs a qualified immigration representative looking at their actual file, in the country concerned. Nothing here is a substitute for that, and nothing here should be treated as a prediction about any individual case.
Frequently asked questions
What changes for US immigration applicants on 18 September 2026?
The Department of Homeland Security’s rescission of the 2022 public charge regulations takes effect. From that date officers may consider the receipt of any means-tested public benefit as part of a public charge determination, alongside the statutory factors and other case-specific circumstances, rather than applying the narrower 2022 framework. It applies to applications for admission made on or after 18 September 2026 and applications for adjustment of status postmarked or submitted electronically on or after that date. Two lawsuits filed on 14 September 2026 in the Southern District of New York ask the court to block the rule, so check the current position before relying on the date.
Do public benefits received before 18 September 2026 count under the new US rule?
Only two categories do. The Federal Register states that DHS will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date, and will consider the receipt of any means-tested public benefits on or after that date.
Does Canada have a public charge rule?
No. Canada assesses medical inadmissibility under section 38(1)(c) of the Immigration and Refugee Protection Act, which asks whether a health condition might reasonably be expected to cause excessive demand on health or social services. The assessment is based on the projected cost of services from an immigration medical exam, not on benefits a person has received.
What is the excessive demand cost threshold in Canada for 2026?
Immigration, Refugees and Citizenship Canada states the 2026 cost threshold as $144,390 over five years, or $28,878 per year. The threshold comes from the regulatory definition of excessive demand, which is anticipated costs exceeding triple the average Canadian per capita health and social services costs over five consecutive years, and it is recalculated annually.
Who is exempt from Canada’s excessive demand rules?
IRCC states that the excessive demand rules do not apply to refugees and their dependants, to protected persons, or to certain people being sponsored by their family, such as dependent children, spouses and common-law partners.
What happens if IRCC thinks you may be medically inadmissible?
IRCC sends a procedural fairness letter explaining the reason before a final decision is made. The applicant has 90 days from the date of the letter to send further information, such as an updated diagnosis, a change of medication, or the cost of lower-priced equivalent services, and can contact the office named in the letter to request an extension. In some cases IRCC also invites a mitigation plan.
Related reading: The Care You Rely On Is in Court: A 25-State Medicaid Lawsuit, and Where Canada’s Home-Care Gaps Sit.
Sources
- Department of Homeland Security, “Public Charge Ground of Inadmissibility”, final rule, Federal Register, 20 July 2026.
- U.S. Citizenship and Immigration Services, “USCIS Issues Guidance on Making Public Charge Inadmissibility Determination”, 18 August 2026.
- Immigration, Refugees and Citizenship Canada, “Medical inadmissibility”, last modified 23 July 2026, read 19 September 2026.
- Government of Canada, Immigration and Refugee Protection Regulations, SOR/2002-227, section 1, current to 21 July 2026.
- Government of Canada, Immigration and Refugee Protection Act, section 38.
- Immigration, Refugees and Citizenship Canada, “Temporary Public Policy Regarding Excessive Demand on Health and Social Services”, 1 June 2018, archived.
- American Association of People with Disabilities, “The American Association of People with Disabilities Opposes the ‘Public Charge’ Rule”, 15 October 2018.
- Office of the Mayor, City of New York, “New York City Leads Cities and Counties in Lawsuit Challenging Federal Government’s New Public Charge Rule”, 14 September 2026.
- Immigrant Legal Resource Center, “Latest on Public Charge”, last updated 14 September 2026, read 19 September 2026.
