In 2025, more low-income immigrant adults in California avoided using public safety net programs because of concerns that using them could negatively affect their or a family member’s immigration status, according to a new study published by the UCLA Center for Health Policy Research (CHPR).

The study, which uses data from the 2025 California Health Interview Survey (CHIS), found that more than 1 in 7 (15%) immigrant adults with incomes below 200% of the federal poverty level (FPL) avoided public programs in the past year due to immigration concerns, a significant increase from 2024 (11%). In 2025, 200% of the FPL for a family of four was $64,300.

“The issue isn’t the programs themselves. It’s the fear that using them could jeopardize future immigration opportunities,” said Joelle Wolstein, PhD, UCLA CHPR research scientist and co-author of the fact sheet.

After seven years of rumors, confusion, and two sets of changes to the “public charge” standards immigration officials use to consider whether an applicant for permanent residency (a “green card”) is likely to depend on government support in the future, in 2025, the Trump administration proposed changing the rules again.

The current standards, which took effect on Sept. 18, 2026, allow immigration officials broad discretion to consider use of noncash benefits such as Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and housing assistance, in addition to cash assistance and a need for long-term institutionalized care when making public charge determinations.

The new fact sheet is based on data collected before the new public charge rule was implemented, thus it offers a view of the chilling effect on program participation in the period leading up to the policy change, Wolstein said.

Among the key findings in the 2025 CHIS data:

• Immigrants who avoided public programs because of immigration concerns were more than twice as likely to report delays in obtaining healthcare: Compared with those who did not avoid public programs, low-income immigrants who avoided public programs were more likely to delay needed medical care (26% vs. 12%) and delay filling prescriptions (20% vs. 8%).
• Food and housing hardship were more common among immigrants who avoided public programs: 3 in 5 (60%) low-income immigrant adults who avoided public programs experienced food insecurity and about half (51%) experienced housing insecurity, compared with 38% and 33%, respectively, among those who did not avoid programs. The housing data is from 2024, the most recent year collected.
• Avoiding public programs was associated with lower use of preventive care and greater reliance on emergency departments: More than one-third (36%) of low-income immigrants who avoided public programs reported no preventive care visit in the past year, and nearly one-third (32%) visited an emergency department, compared with 24% and 20%, respectively, among those who did not avoid programs.

Delays in accessing needed healthcare can have negative health consequences, including increased risk of mortality. Food and housing insecurity are directly associated with poor health status and can negatively impact mental health.

The study also showed a chilling effect on naturalized citizens’ use of public assistance programs, despite holding the same legal rights and protections as people born in the United States. CHIS data showed that in 2025, 1 in 20 (5%) naturalized citizens with incomes below 200% of the federal poverty level avoided public programs because of immigration concerns.

Among all non-citizen adults in California with incomes below 200% of the federal poverty level, 25% avoided public programs. Non-citizen adult is defined as anyone born outside the United States who has not become a naturalized citizen including legal permanent residents and those with long-term visas, as well as undocumented immigrants.

“The most recent changes worsened widespread ongoing concern that public program participation could negatively affect immigration status even among families that were eligible for some forms of assistance,” said study co-author Susan H. Babey, PhD, director of research at UCLA CHPR. “This highlights how exclusionary immigration policies allow many to fall through the safety net.”