Immigrant health policy expert Dr. Drishti Pillai warns that the new HHS guidance could affect thousands of lawfully present immigrants, including work visa holders, creating confusion, fear, and broader community impacts.
For immigration policy watchers, this appears to be a season of bureaucratic tweaks and unprecedented changes. At times, these shifts send shockwaves through entire communities; at others, they leave people anxious about potential repercussions. The rapid pace of policy changes can be especially unnerving for immigrants of color navigating already complex systems.
The latest example comes from Washington, where the Department of Health and Human Services (HHS) has quietly expanded restrictions on federal benefits for even lawfully present immigrants—a move that could ripple through thousands of households, including a growing number of Indian American families.
To unpack the scope, nuance, and human cost of this policy shift, The American Bazaar spoke with Dr. Drishti Pillai, Director of Immigrant Health Policy at KFF, a non-profit organization dedicated to health policy, research, and polling. Dr. Pillai also serves as the associate director of KFF’s Racial Equity and Health Policy Program.
With a career rooted in data analysis, policy evaluation, and health equity, Dr. Pillai has led national research examining how federal policy affects immigrant communities. Before joining KFF, she served as research director at the National Asian Pacific American Women’s Forum and held research and faculty positions at George Washington University. Armed with a Ph.D. in public policy, an MPH from Emory University, and a deep record of studying disparities among historically underserved populations, she brings both academic rigor and practical insight to the discussion.
Our conversation zeroed in on the recent Department of Health and Human Services policy changes that widens restrictions on federal public benefits — even for lawfully present immigrants. Dr Pillai also talks about the far-reaching consequences for Indian American families, particularly those navigating temporary work visas or enduring years-long green card backlogs.
Our conversation focused on the recent Department of Health and Human Services policy changes that widen restrictions on federal public benefits—even for lawfully present immigrants. Pillai also outlined the far-reaching consequences for Indian American families, particularly those navigating temporary work visas or enduring years-long green card backlogs.
HHS move cuts vital benefits for immigrants, including thousands with legal status
Explaining the recent policy change and its potential impact on immigrants in the United States, Pillai said, “Last month, the U.S. Department of Health and Human Services (HHS) issued a notice of a policy change to update the definition of ‘federal public benefits’ as outlined in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) to add an additional 13 programs to the 31 programs considered ‘federal public benefits’ that are restricted to individuals with a ‘qualified’ immigration status.”
According to the updated HHS notice, the list of restricted federal benefits is not final and could expand further—creating confusion and even panic within immigrant communities. Many are now asking which programs are immediately affected and what might be added in the future. “The notice further indicates that the updated list of federal benefits is not exhaustive, and additional programs may be added in the future,” Pillai noted. She added that numerous implementation details remain unclear and subject to future guidance, including how immigration status will be verified and how the policy will be reconciled with existing, and sometimes conflicting, statutory and regulatory requirements that supersede the guidance.
Fear and confusion driving lawful immigrants away from essential services
The policy change has quickly become a source of concern—not only for undocumented immigrants but also for those on work-based visas. It raises pressing questions about how the loss of access to certain resources could affect immigrant families, particularly in terms of health and education outcomes.
“This policy change bars undocumented immigrants as well as many lawfully present immigrants, including those on work or student visas, from accessing basic health and social services such as community health centers—which are an important source of health care for many noncitizen immigrants—the Head Start Program, and Title X family planning services, among others,” Pillai explained.
With enforcement actions ramping up alongside new restrictions on immigrant health care, the policy is likely to foster significant uncertainty and fear among affected communities. “While implementation details of this new policy remain unclear, it is likely to cause confusion and fears among immigrant families and may create new challenges for service providers,” Dr. Pillai said. “This policy change comes at a time of heightened immigration enforcement efforts, including among lawfully present immigrants, as well as other federal actions aimed at restricting health care access for immigrants.”
Discussing how these overlapping measures affect immigrant families’ willingness to seek services—and the challenges this creates for providers on the ground — Pillai said, “Together, these changes will likely have broad chilling effects on immigrant families, resulting in increased reluctance to access services and programs due to fear and confusion. A Spring 2025 survey of immigrant adults conducted by KFF found that, even prior to this policy change, 9% of lawfully present immigrants said they avoided seeking medical care, and 7% said they avoided applying for a government program that helps pay for food, housing, or health care due to concerns about drawing attention to their immigration status. More limited access to programs and services may lead to negative impacts on immigrants’ health and well-being. These effects may extend across immigrant families, who often include citizen children.”
Lastly, as with all restrictive policy changes, the ripple effects are often felt across the broader workforce and community. Dr. Pillai agrees, noting, “These types of restrictive immigration policies can also have negative impacts on communities more broadly, given the important role that immigrants play in the workforce.”