In this qualitative study, authors aim to examine how mis- and disinformation about the Public Charge Ground of Inadmissibility final rule ("public charge rule") influences health care access for Latino immigrants in California. Between May 2024 and April 2025, primary data were collected from 32 interviews (38 participants) with healthcare and community-based organizational leaders serving Latino immigrants in California.

Findings: Participants identified the public charge rule as a significant barrier to health care access for Latino immigrants. The policy has discouraged many Latinos from accessing public benefits, particularly the state's Medicaid and Supplemental Nutrition Assistance Program. In addition, immigrants' trusted sources of information (e.g., family, friends, and attorneys) were often misinformed about the policy, which amplified confusion and fear. Organizations respond by providing accurate information and connecting individuals with reliable resources to clarify that using public benefits would not necessarily result in being classified as a public charge. However, most efforts focused on education rather than directly countering mis- and disinformation. 

Governments and firms often employ soft spending limits to restrict overspending while still allowing exceptions on a case-by-case basis. This paper studies a Medicare policy which capped per-patient physical therapy spending, with exceptions for patients with documented medical need.  

Findings: The cap reduced spending by 8% without harming patient health, with the targeting improvements driven by Medicare discretion in granting exceptions rather than improved provider screening. However, the documentation requirement also introduced horizontal inequity: conditional on need, lower-income and minority patients were more likely to be screened out, as they tended to see providers with poorer documentation practices. 

This study examines health care access, utilization, and experiences among Latino children in California by parental citizenship and household language analyzing merged data from the 2021–2022 California Health Interview Survey and the follow-up Latino Youth Health Study of the same years. Primary outcomes were parental reports of children's health care access, utilization, and experiences in the past year. The main predictors were variables stratified by parental citizenship status (both citizen parents versus one citizen and one noncitizen parent versus both noncitizen parents) and household language (English-only versus English and Spanish versus Spanish-only). Multivariable analyses adjusted for parental education, family income, parent-reported child's health status, child's age, and child's insurance.

Findings: Findings showed no significant differences in health care access across groups. However, children with both noncitizen parents and from Spanish-only households were more likely to have had well-child visits and general doctor visits than children with both citizen parents and in English-only households. Additionally, parents of children with both noncitizen parents were more likely to feel respected by doctors than those with both citizen parents. Conversely, compared to parents with both citizen parents, parents of children with one citizen and one noncitizen parent were less likely to report that doctors spent enough time with their children and less likely to express high satisfaction with their children's health care.

Patterns of health care access, utilization, and experiences among Latino children in immigrant families in California are improving, which are likely associated with recent inclusive health policies in the state.
 

Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making. Using data from the 2021–2022 National Survey of Children's Health, authors analyzed the association between ACEs, both individual and cumulative, and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making.

Findings: After accounting for confounders, the number of ACEs experienced and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved providers always engaging in the three measures of shared decision-making. This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that ACEs are associated with lower quality health care. This can be particularly detrimental to children with a history of ACEs because they have a greater need for health care and are less likely to use many types of health care. Efforts to improve health care quality for all children will be of particular benefit to vulnerable groups, like those with a history of ACEs.