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A Shift in Coverage: HHS Reinterprets “Federal Public Benefit” Under PRWORA

Client Alert

On July 10, 2025, the U.S. Department of Health and Human Services (HHS) rescinded a 1998 interpretation of “federal public benefit” as used in Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). PRWORA was passed to restrict benefit eligibility for immigrants without legal status as well as many legal immigrants during their first few years in the U.S. The 1998 interpretation limited the scope of what qualified as a “federal public benefit,” allowing states to extend exemptions to immigrants for programs such as emergency services or public health.  

With this new notice, HHS intends to reverse what it calls “outdated exclusions” from the bill’s language, and newly includes the following programs as “federal public benefits” under PRWORA:

  • Certified Community Behavioral Health Clinics
  • Community Mental Health Services Block Grant
  • Community Services Block Grant (CSBG)
  • Head Start
  • Health Center Program
  • Health Workforce Programs not otherwise previously covered (including grants, loans, scholarships, payments, and loan repayments).
  • Mental Health and Substance Use Disorder Treatment, Prevention, and Recovery Support Services Programs administered by the Substance Abuse and Mental Health Services Administration
  • Projects for Assistance in Transition from Homelessness Grant Program
  • Substance Use Prevention, Treatment, and Recovery Services Block Grant
  • Title IV-E Educational and Training Voucher Program
  • Title IV-E Kinship Guardianship Assistance Program
  • Title IV-E Prevention Services Program
  • Title X Family Planning Program

The notice establishing the revised policy took effect immediately upon publication in the Federal Register on July 14, 2025. Comments on the proposed rule are due no later than 11:59 p.m. Eastern Time on August 13, 2025.

To learn more about “federal public benefits” under PRWORA and how this policy shift could impact your health care operations, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


CMS Rescinds EMTALA Guidance for Emergency Abortions

On June 3, 2025, CMS withdrew its 2022 guidance on emergency abortion care under EMTALA, eliminating federal protection for providers in states with abortion restrictions. This policy change could significantly impact how hospitals handle emergency care involving pregnancy complications.

Supreme Court Eliminates Higher Burden for Majority-Group Plaintiffs in Title VII Claims

In Ames v. Ohio Department of Youth Services, the U.S. Supreme Court unanimously ruled that all Title VII plaintiffs, whether from majority or minority groups, must meet the same evidentiary standard. The decision eliminates the “background circumstances rule” and reinforces equal treatment in workplace discrimination claims.

Understanding Reasonable Fear vs. Credible Fear Interviews: A Critical Guide for Immigrants Facing Removal

In his latest article, Immigration Attorney and former Immigration Judge Rob Ratliff offers a clear breakdown of Reasonable Fear vs. Credible Fear Interviews—key procedures for noncitizens seeking protection from persecution or torture. Citing Judge Brian Murphy’s recent ruling on unlawful deportations to South Sudan, Ratliff connects these critical legal standards to current judicial developments. Read the full article at www.removal-defense.com.

House Republicans Propose Cuts to Medicaid to Finance Savings

House Republicans have introduced legislative language that proposes substantial cuts to the Medicaid entitlement program, aiming to achieve significant budget savings through policy changes. The proposed measures include stricter eligibility verification, work requirements for certain adults, and federal funding cuts to states providing coverage to undocumented residents. The Congressional Budget Office (CBO) estimates that the proposed healthcare provisions would reduce spending by $715 billion and could result in 8.6 million fewer people having health insurance by 2034.

Protecting Your Image in the Age of AI-Generated “Deepfakes”

The rapid evolution of artificial intelligence (AI) has transformed how we create and consume digital content, but it also poses significant risks. Among the most troubling developments in AI is the proliferation of AI-generated fraudulent content, often called “deepfakes”.