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Forgoing Healthcare in a Global Pandemic: The Chilling Effects of the Public Charge Rule on Health Access Among Children in California

Publication Topics

Access to Health Care; Barriers to/Disparities in Health Care; Health Insurance Coverage and Programs; Population Focus; Adolescents/Children; Immigrant; Low-Income; Hispanic/Latino; Child Development; COVID-19

Publication Type

External Publication

Publication Date


Author 1

<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=1239\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=1239&amp;RootFolder=*">Alma D. Guerrero</a>

Author 2

<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=570\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=570&amp;RootFolder=*">Arturo Vargas Bustamante, PhD, MPP, MA</a>

Author 3

<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=151\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=151&amp;RootFolder=*">et al</a>

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Summary: In this policy brief, authors estimate the potential chilling effects of the approved changes to the public charge rule on children in the state of California who are living with at least one parent without a green card. First, authors calculate the number of children who live with at least one parent without a green card (and are therefore potentially subject to the chilling effect) across seven regions in California. Second, for U.S.-born Latino children who live with at least one parent without a green card, authors estimate the following potential impacts of chilling effects:

  1. The number of children who would lose access to a usual source of care other than the emergency room (ER)
  2. The number of children who would stop receiving a yearly doctor visit, and
  3. The number of children forgoing care.

Authors use three different disenrollment rates to illustrate three possible assumptions regarding the percentage of individuals who might change their behavior in response to the changes to the public charge rule.

Findings: Authors learned that Los Angeles County would be the most affected of the seven regions studied, as between 42,911 and 65,458 children in that county could lose access to public programs due to chilling effects. In addition, up to 132,062 Latino children in California could lose access to a usual source of care if someone in their household refrains from participating in public health programs out of immigration concerns. Authors found that there are currently 98,840 children living with a non-green card-holding parent who did not visit a doctor in the past year. Authors found that this number could more than double (as it could increase by at least 107,359 children) due to the chilling effect of changes to the public charge rule.

The findings highlight the vulnerability of non-green card holders and their children in the face of immigration and public assistance reform. These individuals might lose their usual source of care or forgo care as a result of the public charge rule and potential chilling effects. This situation could become particularly harmful as the U.S. faces COVID-19, which has disproportionately affected Latinos and immigrants in California. The chilling effect would aggravate existing health disparities that stem from citizenship, migratory status, and ethnicity. Moreover, it could deter individuals from seeking care even in the presence of COVID-19 symptoms and further aggravate disparities already existing between Latinos and non-Latino whites. In this sense, the changes to the public charge rule could have both immediate and long-term effects on the health of noncitizens. 


Article 1

Report: Forgoing Healthcare in a Global Pandemic: The Chilling Effects of the Public Charge Rule on Health Access Among Children in California

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Press Release

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Version: 5.0
Created at 5/18/2021 1:07 PM by i:0#.f|uclachissqlmembershipprovider|celeste
Last modified at 5/18/2021 4:13 PM by i:0#.f|uclachissqlmembershipprovider|celeste