Published Date: December 13, 2022

Summary: Although revoked, the Trump Administration’s 2019 changes to the public charge rules contributed to avoidance of public programs among immigrants, even program-eligible immigrants, because immigrants believed access would affect their immigration status or that of a family member. Decreased participation in Medicaid and Supplemental Nutrition Assistance Program (SNAP) can negatively impact health and access to health care. This study examines the association of avoidance of public programs due to immigration concerns with access of health care services and prescription medication in California, home to the largest immigrant population in the U.S.

Authors used data from the 2019 California Health Interview Survey (CHIS) to examine the association of avoidance of public programs due to immigration concerns with delays in obtaining medical care and prescriptions among low-income (<200% Federal Poverty Level) immigrant adults. Race and ethnicity were self-reported as Latino, non-Latino Asian, non-Latino white, and other (including non-Latino American Indian and Alaska Native, Black or African American, and Native Hawaiian and Pacific Islander, self-described other, and more than one race) and included to account for different immigrant experiences across groups.

Findings: Among low-income immigrants in California, 46.1% were men and 53.9% were women; 69.2% were Latino and 23.2% were non-Latino Asian; and 22.9% were uninsured for all or part of the past year. Avoidance of public programs in the past year for fear of harming their immigration status was reported by 13.7%. Compared with low-income immigrants who did not avoid public programs, those who did had more than twice the odds of delaying needed medical care and filling prescriptions.

Delays in accessing needed health care can have negative health consequences, including increased risk of mortality. Authors found that low-income California immigrants who avoided public programs owing to fear of harming their immigration status were twice as likely to delay needed medical care or prescription fills.

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