This fact sheet uses data from the 2025 California Health Interview Survey (CHIS) to describe which adults report avoiding public programs out of fear it could impact their own immigration status or that of a family member. It also examines associations between avoiding public programs and access to healthcare, food security, and housing security. Because these data were collected largely before the new public charge rule was proposed, they offer a view of the chilling effect on program participation in the period leading up to the policy change.

Findings:

• About 1 in 7 (15%) immigrant adults with incomes below 200% of the federal poverty level (low-income immigrants) reported avoiding public programs in the past year because they worried it could negatively impact their or a family member's immigration status, a significant increase from 2024 (11%). 
• Avoidance of public programs in the past year was highest among adults ages 18–39, families with children, non-citizens, and those living in the U.S. for less than 10 years.
• Low-income immigrants reported delays in needed medical care and filling prescription medications that were more than twice as high among those who avoided public programs in the past year (26% vs. 12% and 20% vs. 8%, respectively).
• More than one-third (36%) of low-income immigrants who avoided public programs reported no preventive visits in the past year compared with one-quarter (24%) who did not avoid programs.
• Nearly 1 in 3 (32%) low-income immigrants who avoided public programs visited an emergency room in the past year compared to 1 in 5 (20%) who did not avoid public programs.
• More than half of low-income immigrants who avoided public programs experienced food and housing insecurity compared to about one-third of those who did not avoid programs (60% vs. 38% and 51% vs. 33%, respectively).