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‘Public charge’ rule may discourage low-income families from getting health care | News

Trump administration immigration rules may be discouraging low-income families from getting health insurance, medical care, food benefits, or public housing, according to a new study from Harvard T.H. Chan School of Public Health researchers.

The findings were reported in a July 15, 2020 research letter in JAMA Network Open.

Led by Benjamin Sommers, professor of health policy and economics, researchers surveyed 400 low-income adults in Texas about their perceptions of the Trump administration’s so-called “public charge” rule. Under the rule, immigrants’ participation in public programs—such as Medicaid, the Supplemental Nutritional Assistance Program (SNAP), or subsidized housing—and their health status and income are used as criteria to determine whether they’re able to gain permanent residency in the U.S. Critics of the rule have said it creates a chilling effect that dissuades people from participating in public programs or seeking medical care, even outside the policy’s intended scope, the authors noted.

More than 45% of respondents to the survey reported being very or somewhat concerned about the potential impact of the public charge rule on their friends or families. In addition, 11.6%, or nearly 1 in 8, said they knew friends or family who’d avoided participating in Medicaid, SNAP, or public housing, or had not visited a doctor or hospital in the past year because of immigration-related concerns.

The findings suggest that nearly half a million people in Texas could be avoiding public programs, the authors wrote. “This is consistent with reported reductions in Texas’ Medicaid enrollment linked to immigration concerns and national estimates that millions of legal immigrants may forego health insurance because of the public charge rule,” they wrote. “These results are even more concerning in the context of the current coronavirus disease 2019 pandemic.”

Other Harvard Chan School co-authors included Aditi Bhanja, Robert Blendon, E. John Orav, and Arnold Epstein.

Read the JAMA Network Open research letter: Assessment of Perceptions of the Public Charge Rule Among Low-Income Adults in Texas



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