Refugee Resettlement Program — Cash Assistance, Medical Coverage, and Employment Services for Admitted Refugees

Legal Authority

• 8 U.S.C. § 1522 — Refugee Act of 1980 § 412; primary statutory authority for domestic resettlement assistance; directs HHS Secretary to make grants and contracts for refugee reception and placement, cash and medical assistance, social services, and child welfare; requires an employment-first policy and 8-month time limit on refugee-specific cash and medical benefits
• 8 U.S.C. § 1521 — Establishes the Office of Refugee Resettlement within HHS; directs ORR to develop and implement a comprehensive policy on domestic refugee resettlement
• 8 U.S.C. § 1157–1158 — Refugee admissions ceiling (presidential determination) and asylum; establishes who is eligible for Refugee Act protections
• 45 CFR Part 400 — ORR implementing regulations; governs state plans, refugee cash assistance, refugee medical assistance, employment requirements, social services formula grants, targeted assistance, and voluntary agency oversight

Key Mechanics

The Refugee Resettlement Program provides time-limited cash, medical, and employment support to admitted refugees and related populations through a federal-state-voluntary agency partnership. The 8-month eligibility window after arrival is the program's defining constraint — after that window, refugees must transition to mainstream programs (Medicaid, TANF, SNAP) or sustain themselves through employment. ORR administers through three funding streams: (1) Refugee Cash Assistance (RCA) (§ 400.50–400.56) — available to refugees ineligible for TANF or SSI; payment levels equal state TANF rates; recipients able to work must participate in employability services or lose benefits; states may run RCA through their TANF infrastructure or opt for the Wilson-Fish alternative program (a direct resettlement agency-administered model that bypasses state TANF); (2) Refugee Medical Assistance (RMA) (§ 400.100–400.107) — covers refugees ineligible for Medicaid during the 5-year federal Medicaid bar for non-citizens; states must provide at minimum the Medicaid benefit package; 8-month time limit applies; (3) Refugee Social Services (RSS) (§ 400.140–400.155) — formula grants to states, allocated by three-year arrival shares; must be used primarily for employability services (English training, job placement, case management); other social services are secondary. State participation requires ORR-approved state plans (§ 400.4–400.9); states that withdraw plans lose federal funding, effectively ending resettlement in that state. Eligible populations include admitted refugees, asylees, Cuban/Haitian entrants, Special Immigrant Visa holders (Iraqi/Afghan), Amerasians from Vietnam, and — by ORR policy guidance — Afghan and Ukrainian parolees admitted under humanitarian parole. The federal cost share for cash and medical assistance is 100%; social services require matching. Total program expenditures are limited by the annual ORR congressional appropriation.

Current Rule (2026)

What This Rule Does

When a refugee is admitted to the United States, the admission decision is made by the State Department and Department of Homeland Security — but the resettlement support that determines whether the refugee can actually build a life here is administered by HHS's Office of Refugee Resettlement (ORR) under 45 CFR Part 400. The rule establishes the full domestic resettlement benefit and services system: cash assistance for refugees who cannot support themselves, medical coverage for those ineligible for Medicaid, employment services to promote economic self-sufficiency, social services for families and children, and federal grant funding to the states and resettlement organizations that deliver these services on the ground.

The Refugee Resettlement Program operates through a federal-state-local partnership. ORR makes quarterly formula grants to state agencies, which in turn fund resettlement agencies — a network of nonprofit voluntary agencies (known as VOLAGs), many with religious affiliations — to provide direct services to arriving refugees. Major resettlement partners include the International Rescue Committee, Catholic Charities, Lutheran Immigration and Refugee Service, the Episcopal Migration Ministries, and others. The program is explicitly time-limited: refugee cash assistance and refugee medical assistance are available for a defined window after arrival (typically 8 months), after which refugees are expected to transition to mainstream programs (TANF, Medicaid) or employment. The employment-first philosophy is embedded in the regulation — social service grants must be used primarily for employability services, and cash assistance recipients who are able to work are required to participate in employment services as a condition of eligibility.

Part 400 applies to refugees admitted under the Refugee Act, as well as asylees, Cuban/Haitian entrants, certain Special Immigrant Visa holders (Iraqi and Afghan nationals), Amerasians from Vietnam, and — since 2021 — Afghan parolees and Ukrainian parolees under temporary protected status designations that extended eligibility to additional populations. Each expansion of eligible categories is managed through ORR policy guidance rather than formal rulemaking, which means the regulatory text does not always reflect the current scope of program eligibility.

Key Provisions

• § 400.4–400.9 — State plans: a state must submit a plan to ORR describing how it will administer the program, which state agency (or agencies) is responsible, and how the state will coordinate with local resettlement agencies; the plan must be approved by ORR before funds flow; state plans are updated when the state's organizational structure or program policies change; states that do not have an approved plan may not receive ORR funds, which effectively means the state opts out of federally funded resettlement — a step taken by some governors by executive order but rarely carried through to a formal plan withdrawal

• § 400.11 — Award of grants: ORR makes quarterly grants to states; grants are subject to the availability of appropriated funds; the formula allocation for social services grants (§ 400.149) is based on each state's proportionate share of refugee arrivals over the preceding three-year period

• § 400.50–400.56 — Refugee Cash Assistance (RCA): RCA is available to refugees who are not eligible for TANF (Temporary Assistance for Needy Families) or SSI (Supplemental Security Income) and who meet income and residency requirements; eligibility is limited to the first 8 months after arrival; states may operate RCA through their existing TANF rules and infrastructure (an "AFDC-type" program) or through a separate "Wilson-Fish" alternative program that bypasses the state TANF system and is administered directly through a resettlement agency or public agency; the Wilson-Fish model (named for the congressional sponsors) allows states that choose not to administer ORR programs to have ORR fund an alternative provider

• § 400.75–400.81 — Employability requirements: adult RCA recipients who are able to work must register for employment services, participate in employability service programs, go to job interviews, and accept appropriate offers of employment as a condition of cash assistance eligibility; failure to comply — without good cause — results in reduction or termination of RCA; the regulations specify exemptions (medical incapacity, care of a child under 6, care of a disabled household member) and define "appropriate" employment (must not require a skill level significantly below the refugee's demonstrated ability, or pay below the comparable wage in the area); each eligible refugee must have an individualized employability plan developed in coordination with their case manager

• § 400.100–400.107 — Refugee Medical Assistance (RMA): refugees who are not eligible for Medicaid (because, for example, they are in the five-year bar period for federally-funded Medicaid that applies to most non-citizens, or because they do not meet their state's Medicaid eligibility criteria) may receive RMA for up to 8 months after arrival; states must provide at least the same medical services they provide under Medicaid; refugees who earn income during the RMA period may continue to receive coverage until their income stabilizes (a "spend-down" provision prevents cliff effects); states may provide medical screening as part of RMA to identify health needs identified during the immigration process

• § 400.140–400.155 — Refugee Social Services (RSS): formula allocation grants to states for social services must be used primarily for employability services designed to enable refugees to obtain jobs within one year of becoming enrolled in services; the priority order for social services is: (1) employable refugees and those receiving cash assistance within the first year of arrival, (2) refugees within their second year of arrival, (3) other refugees; the permitted service categories include English language training, employment services, case management, youth services, and — only after employability needs are met — translation, transportation, and other support services

• § 400.180–400.188 — Targeted Assistance (TA) grants: ORR allocates targeted assistance funds to counties and municipalities that have disproportionately high refugee concentrations relative to their fiscal capacity to serve them; unlike formula state grants, targeted assistance flows directly to the county or city level to pay for services where refugee concentration has outpaced state-level support; the TA formula weights areas with high refugee arrival rates in the preceding three years

• § 400.206–400.212 — Federal funding matching and limitations: states must match federal ORR administrative funds; for cash and medical assistance, the federal share is 100% (no match required); for social services, the federal share is 100% up to the formula allocation; total federal expenditures are capped by the annual ORR appropriation

How It Affects You

Newly arrived refugees and other eligible populations: The first 8 months after arrival are critical — this is when you are eligible for refugee cash assistance (if you don't qualify for TANF or SSI) and refugee medical assistance (if you don't qualify for Medicaid). Contact your resettlement agency as soon as you arrive to apply; the clock starts at arrival, not at the date you apply. Employment services are not optional if you are able to work — participation is a condition of cash assistance. Your resettlement agency will help you develop an employability plan and connect you with English language training, job placement, and other services. After 8 months, you will need to transition to mainstream programs; your case manager should help you apply for SNAP, Medicaid (if now eligible), and other benefits before your refugee-specific eligibility ends.

State refugee coordinators and resettlement agencies: The Wilson-Fish alternative allows states that decline to administer the refugee program directly to have ORR fund an alternative provider — typically the state's largest resettlement agency or a statewide coordinating body. If your state has taken executive action discouraging resettlement or declining to administer the program, the Wilson-Fish pathway may be available to ensure services continue. ORR maintains the current list of Wilson-Fish states; agencies in those states operate under ORR grants directly. Social service grant funds must be used primarily for employability services — overhead, administration, and wraparound services come after. ORR conducts monitoring reviews; document that your employment services are the primary use of social service grant funds.

Immigration advocates and legal aid organizations: Part 400's eligibility framework is distinct from immigration law — who is "admitted" for resettlement purposes includes not only Convention refugees with refugee visas, but asylees (including those who applied affirmatively and those granted in removal proceedings), Cuban/Haitian entrants, certain parolees, and SIV holders. ORR periodically expands eligibility by designating new populations through policy guidance rather than notice-and-comment rulemaking, which can mean eligible individuals are not aware of their access to ORR programs. Clients who entered as parolees under Afghan or Ukrainian special programs should be screened for ORR eligibility even if they arrived without a formal refugee designation.

State and local governments: Refugee resettlement generates both costs (schools, public health, housing) and economic benefits (labor force addition, tax base growth). The targeted assistance formula is specifically designed to redirect federal funds to localities with high refugee concentrations; local governments with large refugee populations should ensure their county is receiving targeted assistance and that local nonprofit providers are coordinating with state refugee offices to maximize TA utilization. Refugee arrivals are tracked by the State Department's Reception and Placement program; ORR data on state and county-level placements is publicly available and can inform local planning.

Statutory Authority

This rule implements:

• 8 U.S.C. § 1522 — Refugee Act of 1980 § 412; directs the Director of ORR to make grants and contracts with states and non-governmental organizations to support domestic refugee resettlement; authorizes cash, medical, and social service assistance; requires that the assistance promote economic self-sufficiency as quickly as possible; establishes the state plan requirement and the federal-state-local partnership structure

Recent Rulemakings

• 2011 (76 FR 15393): Updated Part 400 to reflect ORR policy on the Wilson-Fish alternative program and to clarify eligibility standards for Cuban and Haitian entrants
• 2012 (77 FR 35473): Amended social services priority ordering to clarify that employability services must be the primary use of social service grant funds; strengthened documentation requirements for employability plans
• Program eligibility expansions for Afghan parolees (2021), Ukrainian parolees (2022), and other designated populations have been implemented through ORR policy guidance and Federal Register notices rather than formal rulemaking, so the regulatory text does not capture the full current scope of eligible populations

Pending Action