Avoiding Medicaid Enrollment After the Reversal of the Changes in the Public Charge Rule Among Latino and Asian Immigrants (Health Services Research)

​Summary: Authors estimate the avoidance of Medicaid enrollment among Latino and Asian immigrants due to fears about immigration status. In 2019, changes to the “public charge" rule made it difficult for immigrants to receive a green card or permanent residence visa, particularly for those who used health and nutrition benefits. Despite the Biden administration's reversal of these changes, fear and misinformation persist among immigrants.

Researchers used adjusted predicted probability models to estimate differences in access to and use of health care and health insurance coverage among Latino and Asian immigrant adults with and without green cards, using U.S. citizens as the reference. They estimated the avoidance of Medicaid enrollment among immigrants without a green card, the immigrant population subject to the public charge rule. Researchers pooled data from the 2017–2020 California Health Interview Survey (CHIS) for this study.

Findings: Latino immigrants without a green card were -23.1% less likely to be insured, -9.2% less likely to have Medicaid coverage, -9.3% less likely to have a usual source of care, and -8.4% less likely to have a physician visit relative to citizens. Asian immigrants without a green card were -11.7% less likely to be insured, -8.8% less likely to have Medicaid coverage, -11.6% less likely to have a usual source of care, and -11.0% less likely to have a physician visit. Between 107,956 and 192,905 Latino immigrants and 1,294 and 4,702 Asian immigrants in California likely avoided Medicaid enrollment due to fears about their immigration status.

While their estimates are lower than those of previous studies, the researchers’ findings highlight barriers to health care for immigrants despite the reversal of the changes in the public charge rule. Since the public charge rule was not abolished, immigrants with low incomes might choose not to seek health care, despite recent efforts in California to expand Medicaid coverage to all eligible immigrants regardless of documentation statuses. 
 

Read the Publication:

• Policy Brief: Avoiding Medicaid Enrollment After the Reversal of the Changes in the Public Charge Rule Among Latino and Asian Immigrants (Health Services Research)