WASHINGTON — The American Civil Liberties Union (ACLU) filed a comment Wednesday warning that the U.S. Department of Health and Human Services’ (HHS) new directive would exclude noncitizens from dozens of community health, early education and social support programs. In a press release Thursday, the ACLU called the directive both “unlawful” and “harmful” to vulnerable communities.
The ACLU said HHS issued the directive last month, restricting access to 13 programs that had previously been open to everyone. Under a reinterpretation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), which allowed noncitizens to access federal public benefits, HHS now considers an expanded list of services as limited to U.S. citizens.
Programs at stake include Head Start, which provides early childhood education to low-income families, and community health clinics that offer primary care to underserved areas. Other restricted services include mental health and substance use disorder support programs, family planning, and homeless assistance projects—all of which were previously open regardless of immigration status, according to the ACLU.
Since the late 1990s, federal administrations from both parties have taken a narrower view of PRWORA, with the Clinton administration allowing undocumented immigrants to access such services on the grounds that they were not “federal public benefits.” The HHS directive reverses that approach.
“The directive conflicts with PRWORA and upends longstanding guidance respected by four prior administrations,” the ACLU said. The group warned that HHS’s reinterpretation ignores decades of administrative precedent.
Backing the directive, HHS Secretary Robert F. Kennedy Jr. said, “For too long, the government has diverted hardworking Americans’ tax dollars to incentivize illegal immigration.” Kennedy added that the directive “enforces the rule of law.”
“This arbitrary and harmful directive exemplifies this administration’s tunnel vision, which prioritizes its anti-immigrant crusade, no matter the harm,” said Ming-Qi Chu, deputy director of the ACLU Women’s Rights Project.
Chu said the directive could strip medical and educational access from millions of children, immigrants with disabilities and individuals recovering from substance use disorder, as well as survivors of gender-based violence. “It serves no one’s interest to deny people these essential services, and HHS must withdraw this incredibly misguided directive,” Chu said.
The ACLU also warned that the directive fails to consider the toll on immigrant families who rely on these programs for health, education and basic stability.
“The directive has triggered chaos and uncertainty both for administering agencies and the individuals, families and communities who rely on the services at stake,” the ACLU’s filing said. “It will deprive children of access to crucial early educational programming and undermine access to essential and life-saving health care for children and their families. It will also disproportionately burden mixed-status families, people with disabilities and survivors of gender-based violence.”
Public health experts have highlighted the health and economic risks of the policy under a second Trump administration. The Kaiser Family Foundation (KFF) has reported that immigrants, including those without legal status, contribute billions in taxes each year and play a crucial role in the health care sector. KFF warned that restricting access could harm public health and economic stability nationwide.
The foundation also noted that many immigrant families may already avoid seeking health care due to fear and confusion. The Trump administration’s “public charge” policy likely decreased coverage for millions of noncitizens under Medicaid or CHIP, as families feared assistance would jeopardize residency.
Those fears may now be worsened by the HHS directive, deepening health disparities and limiting critical services for immigrant communities.
The 30-day public comment period on the policy closed this week, and the revised directive is set to take effect immediately upon publication in the Federal Register, according to HHS.
Advocates including the ACLU continue to demand its withdrawal, warning that implementation will disrupt access to essential health care, education and social services for millions.
