The Trump administration on Monday introduced a new rule vastly expanding the list of public benefits federal immigration officials may take into consideration when determining whether an individual should be allowed to enter the country or obtain permanent residence. A Boston-based group estimates that it could affect more than 500,000 residents in the state.

Known as the "public charge" provision, the process evaluates a person's likelihood to become primarily dependent on government assistance. It is used as a basis for admissibility into the U.S. and as a determining factor when someone is trying to adjust their immigration status to obtain legal permanent residency.

Currently, immigration officials can only consider records of cash assistance or long-term care at the government's expense when making these decisions. Under the new provision, any immigrant who lawfully accessed housing, health care or nutritional assistance could be deemed a "public charge."

Non-cash benefits like enrollment in the Supplemental Nutrition Assistance Program (SNAP), or food stamps, certain Medicaid programs and Section 8 housing subsidies, including the Housing Voucher Program, may all be considered by U.S. Department of Homeland Security officials in determining whether an immigrant is likely to become a "public charge."

Individuals deemed "public charges" may be denied entry into the U.S. or denied a green card.

Susan Church, a Cambridge-based immigration attorney, says the new rule mostly affects people married to U.S. citizens or those who have been here long enough to legally obtain some public benefits.

"This will impact people who are applying to become lawful permanent residents of the United States through our legal immigration system," she said.

Beyond this cohort, Church also said the new rule could have a serious chilling effect in what are known as mixed-status households. For instance, an undocumented parent caring for a U.S. citizen child who is eligible for benefits like nutritional assistance may decide to un-enroll from the program out of fear of immigration enforcement.

"You will see undocumented immigrants refusing to even get food stamps for their own children because they're terrified," Church said.

Massachusetts Medical Society President Dr. Maryanne C. Bombaugh said in a statement she feared that the new regulation will have serious consequences for some of the most vulnerable patients. "Physicians recognize that social determinants play a pivotal role in one’s ability to access appropriate, quality medical care, and the fact that those who are disadvantaged will be penalized for utilizing Medicaid, food and housing assistance and other services aimed at addressing social determinants is inhumane," she said.

A report issued in June by the Boston Foundation found these new changes could impact up to 510,000 Massachusetts residents, including 160,000 children. These estimates take into account immigrants who may voluntarily un-enroll or forgo assistance from programs for which they are eligible in order to avoid being deemed a "public charge" which in turn could jeopardize immigration status.

(Courtesy of Boston Foundation)

In a press release issued by the White House, President Trump said, "To protect benefits for American citizens, immigrants must be financially self-sufficient."

In a statement, Ken Cuccinelli, the acting director of U.S. Citizenship and Immigration Services (USCIS), the agency tasked with enforcing the new provision, applauded the expanded rule. “Throughout our history, self-sufficiency has been a core tenet of the American dream," Cuccinelli said. "Through the enforcement of the public charge inadmissibility law, we will promote these long-standing ideals and immigrant success.”

The final rule is scheduled to be published Wednesday and go into effect in mid-October.