Beginning September 18, 2026, DHS will apply updated public charge guidance when reviewing green card applications. 

If you're an international nurse or healthcare professional pursuing permanent residence in the United States, these changes may sound concerning. The good news is that nurses are generally in a strong position because of their education, professional skills, and employment opportunities. 

Here's what has changed, what we know so far, and how you can prepare. 

What Is Changing? 

The public charge rule helps DHS determine whether someone is likely to depend primarily on government assistance in the future. 

The standard has changed several times over the years: 

• 2019: The first Trump administration expanded the definition of public charge to include a wider list of noncash benefits, creating a stricter standard. 
  
• 2022: The Biden administration narrowed the standard, focusing mainly on cash assistance programs like Supplemental Security Income (SSI) & Temporary Assistance for Needy Families (TANF), along with long-term institutionalization. 
  
• 2026: U.S. Department of Homeland Security (DHS) rescinded the 2022 regulation without replacing it with a new formal rule. USCIS and NVC officers now apply broad, case-by-case guidance that considers a wider range of factors. 

Instead of relying on a strict checklist, USCIS and NVC officers will review an applicant's overall circumstances. 

The Five Factors USCIS Will Evaluate 

Officers will utilize a "totality of the circumstances" review, meaning officers evaluate your entire situation rather than making decisions based on a single factor. 

They will consider: 

1. Age: Whether your age supports your ability to work and support yourself. 
   
2. Health & health insurance: Your overall health and whether you have health coverage or access to care.
   
3. Family status: Your household members. This includes spouse, parents, unmarried siblings under 21 years of age, and children who will physically reside with the primary applicant. All eligible dependents will be considered during the vetting process. 
   
4. Financial Situation: Your Income, savings, assets, debts, and overall financial stability 
   
5. Education & skills: Degrees, certifications, licenses & work experience 

For a list of tips and recommendations to prepare, check out our recent blog, 6 Tips for International Nurses Amid Changing Visa Policies. 

How to Strengthen Your Application 

Demonstrating self-reliance with no evidence of dependency on U.S. taxpayer funded government benefits is the best way to overcome the public charge policy. You can take several steps now to support your case: 

• Secure stable, documented employment 
  
• Keep pay stubs and employer verification letters 
  
• Maintain organized financial records 
  
• Ensure health insurance coverage (provided to WWHS candidates through their employer) 
  
• Maintain sufficient savings and financial reserves to demonstrate financial stability 
  
• Do not sell assets, i.e. house, businesses, cars, etc. 

What Are Public Charge Bonds? 

A public charge bond is a financial guarantee paid to the U.S. government to allow an immigrant visa or green card applicant to enter or stay in the U.S. when officials believe they might otherwise become dependent on public assistance. 

Here's how they work: 

• Minimum amount: Bonds start at $1,000.00 USD though the NVC Officer will set the exact amount on a case-by-case basis. 
  
• When they apply: NVC may invite an applicant to post a bond after an immigrant interview, if the applicant is deemed inadmissible only on public charge grounds but otherwise admissible. 
  
• What they secure: A bond operates as a security to the government in the event an applicant becomes a public charge after adjusting status or arrival in the U.S. 

If this ever applies to you, you will be notified at the end of your immigrant interview. 

What We Don't Know Yet 

Because the guidance is new, several questions remain unanswered: 

• How Officers Will Apply Their Discretion: NVC Officers now have broader authority to evaluate individual cases. It will take time to understand how consistently the guidance is applied. 
  
• Typical Bond Amounts: While the minimum is $1,000.00 USD, actual bond amounts may vary significantly. 
  
• Approval Trends: There is not yet enough data to understand how approval and denial rates may change under the new guidance. 
• Consular Processing Impact: Nurses applying through a U.S. embassy or consulate are subject to Department of State rules rather than USCIS adjustment-of-status procedures. How individual consular officers interpret public charge factors may vary. 

Premium Processing: Why Some Employers Are Taking a Closer Look 

Many healthcare employers use premium processing to speed up immigration petition processing. However, the new public charge guidance may influence how some employers approach that decision. 

Because officers now have more discretion when evaluating public charge factors, there is still uncertainty about how the rules will be applied in practice. As a result, some employers may be more cautious about paying additional fees to accelerate a petition before they have a clearer understanding of the potential risks later in the immigration process. 

When evaluating whether to use premium processing, employers may consider a candidate’s ability to overcome the factors that will be reviewed by adjudicators. 

For some employers, the concern is not the I-140 petition itself, but what happens afterward. If an I-140 petition is approved by USCIS but later faces a visa denial at the embassy interview, the additional cost of premium processing may not provide the expected benefit. It is also important to note that a visa denial is not appealable, therefore careful evaluation of premium processing for each candidate is necessary. 

At this stage, employers, attorneys, and healthcare organizations are closely monitoring how the new guidance is applied in real cases. As more outcomes become available, they will have a better understanding of the actual level of risk and when premium processing makes the most sense. 

Steps You Can Take Right Now 

Regardless of your immigration pathway, these actions can help strengthen your application: 

• Maintain Stable Employment for Yourself & Your Spouse (if applicable) 
  
• Keep employment records organized. 
• Save offer letters and pay stubs. 
• Organize Financial Documents 
• Gather bank statements and tax documents. 
• Maintain records of income and assets. 
• Keep Health & Health Coverage Records 
• Maintain proof of insurance when available. 
• Keep documentation of any chronic illnesses that might prevent you from working. 
• Respond promptly to requests for medical documentation. 
• Review Immigration Forms Carefully
• Pay close attention to public benefit questions.
• Seek professional guidance if your situation is complex. 
• Highlight Your Professional Qualifications 
• Keep copies of licenses and certifications. 
• Be prepared to discuss your experience and career plans during interviews. 

You're Not Navigating This Alone 

While these changes bring more uncertainty and discretion to the process, healthcare professionals remain deeply valued in the U.S. workforce, and preparation makes a real difference. 

Because every immigration case is unique, working with a qualified immigration attorney is always recommended for guidance specific to your situation. 

WorldWide HealthStaff Solutions (WWHS) has spent over 25 years helping international healthcare professionals navigate exactly this kind of transition. With more than 12,000 successful placements & partnerships with 2,500+ U.S. healthcare facilities, WWHS pairs every candidate with dedicated advisors who support you through immigration, licensure & relocation every step of the way. 

Sign up with WWHS today and take the next step toward your U.S. nursing career with a trusted partner beside you. 

Frequently Asked Questions 

When do the new public charge rules take effect? 

The updated DHS guidance takes effect on September 18, 2026, and applies to Form I-485 applications, embassy interviews, and visas issued on or after that date. 

Will this make it harder for nurses to get a green card? 

Not necessarily. The NVC evaluates your overall circumstances, and nursing skills, education, and employability are generally positive factors. 

Does premium processing guarantee visa approval? 

No. Premium processing speeds up USCIS petition review but does not affect embassy interview timelines. 

Will my employer use premium processing? 

That decision depends on your situation, visa availability, employer preferences, and legal guidance. 

Do I need a public charge bond? 

At this time, we don't know which candidates will be required to post a public charge bond. If you are required to post bond, you will be officially notified by the officer at the end of your embassy interview. AOS candidates will be notified by mail during the adjudication of the I-485 application. 

What is the most important thing I can do right now? 

Focus on maintaining documented employment, organizing financial records, keeping your information current, maintaining assets, and preparing strong supporting documentation.