The new draft public charge regulation proposed by the Biden Administration can be found here. Public comments, including many submitted by California health care leaders, are available here.

CHCF will provide updates as they become available. For more information, readers can also refer to the Protecting Immigrant Families Campaign, National Immigrant Law Center, and the California Immigrant Policy Center.

This collection of resources was originally designed to highlight the potential impact that the Trump-era public charge rule could have on the ability of immigrants to access the health and social services they need. These resources can be used as references for commenting on the Biden Administration’s new proposed regulation.

External Resource

Despite Documented Status, Many California Immigrants Have Negative Perceptions or Experiences of Public Charge Policy

Data from the Research on Immigrant Health and State Policy Study (RIGHTS) shows the experiences and perceptions among adult Latinx and Asian immigrants in California regarding the federal public charge policy.
External Resource

Keep Your Benefits CA

This website (also available in Chinese and Spanish) is designed to help immigrant families get the basic information they need about the public charge rule. It includes screening tools that help the user understand how accessing public benefits may affect immigration status (their own or that of a friend of family member), which benefits are safe to use, and when and how to seek legal advice.
Publication

Message Testing to Combat Public Charge’s Chilling Effect in California

March 2020
Medi-Cal
In December 2019, CHCF supported focus groups in Los Angeles to identify effective ways to encourage immigrants not subject to public charge to keep using the public benefits they are eligible for, including Medi-Cal and CalFresh. One group was focused specifically on how to encourage young adult immigrants with low incomes to enroll in Medi-Cal.
External Resource

Three in 10 Adults in California Immigrant Families with Low Incomes Avoided Safety Net Programs in 2020

Medi-Cal, Health Equity

This Urban Institute study explores the extent to which California immigrant families avoided public benefits in 2020 due to green card or other immigration concerns.
CHCF Blog

One in Six Adults in California Immigrant Families Avoided Public Benefits in 2019, Study Finds

May 18, 2020
Amy Adams
Coverage Trends, Medi-Cal, Health Equity
Confusion about the public charge rule and the chilling effect it has caused are urgent problems in light of COVID-19 and its economic fallout.
CHCF Blog

Help Prevent the Public Charge Rule’s Chilling Effect

February 12, 2020
Sandra R. Hernández
Medi-Cal, Coverage Trends
Here are tools to help California immigrant families cope with the new public charge rule.
CHCF Blog

Public Charge Rule Could Erode Enrollment in Insurance Coverage

February 3, 2020
Xenia Shih Bion
Medi-Cal, Coverage Trends
Stories That Caught Our Attention: A Supreme Court ruling sets the stage for implementation of the public charge rule in California and across the nation.
CHCF Blog

Five Victories for Public Health: Courts Enjoin the Public Charge Rule

October 22, 2019
Wendy E. Parmet
Coverage Trends
Five federal district courts have issued preliminary injunctions against the Trump administration’s public charge rule. The actions blocked a policy expected to reduce immigrants’ access to health care, burden safety-net providers, and jeopardize public health in immigrant communities.
External Resource

New Evidence Demonstrates That The Public Charge Rule Will Harm Immigrant Families and Others

October 2019
Medi-Cal

This Health Affairs blog summarizes a variety of studies that have been released since the announcement of the public charge rule, many as expert declarations in lawsuits opposing the rule. These studies project lower SNAP and Medicaid enrollment as well as losses in economic output resulting from the new rule. One study predicts 1,300–4,000 excess deaths resulting from declines in Medicaid coverage, while another estimates that the loss of housing benefits will result in worse health outcomes, lower educational attainment, and lower lifetime earnings for certain individuals.
External Resource

Know Your Rights: Public Charge Educational Resources

March 2020

These community-facing materials from the Protecting Immigrant Families (PIF) are intended to better equip immigrants with the information they need to make the best decisions for themselves and for their families. Some materials are specifically for those working with immigrants, including advocates, health care professionals and legal service providers. Resources are in a variety of languages.
External Resource

Safety Net Access in the Context of the Public Charge Rule

Coverage Trends, Medi-Cal

This Urban Institute brief shares insights from in-depth interviews conducted in March 2019 with 25 adults in immigrant families who reported that they or a family member avoided safety net programs like Medicaid, SNAP, or housing assistance in 2018 because of immigration concerns. The study highlights fear and confusion about the proposed public charge rule, a reliance on the media for information with few people seeking professional advice, and hardship for children and adults after losing access to public supports.
CHCF Blog

The Final Public Charge Rule Is Out. Here’s How It Affects Immigrants.

August 16, 2019
Billy Wynne, Dawn Joyce
Medi-Cal, Health Equity
The government has finalized immigration restrictions, creating a preference for wealthy, English-speaking, insured, and educated immigrants, while erecting hurdles for immigrants who are poor. 
External Resource

How Trump’s New Rule on Immigrants Endangers Public Health

The Department of Homeland Security finalized radical changes to immigration rules that go against America’s traditional values of inclusion. The San Francisco Chronicle published this opinion piece by CHCF’s CEO Sandra R. Hernández.
External Resource

One in Seven Adults in Immigrant Families Reported Avoiding Public Benefit Programs in 2018

In this brief, the Urban Institute uses data from the December 2018 Well-Being and Basic Needs Survey to provide the first systematic documentation of the number of immigrant families avoiding public benefit programs due to fear of the pending public charge rule.
Publication

Select Comments Opposing Proposed Public Charge Regulation

April 2019
Medi-Cal, Coverage Trends
A compilation of organizational statements and official comments submitted to the Department of Homeland Security by health care organizations and philanthropies in opposition to the Trump administration's proposed changes to the public charge rule.
External Resource

How Would Proposed Changes to the “Public Charge” Rule Affect Your Region?

The UCLA Center for Health Policy Research and Education estimates, for each California region and county, how changes to the “public charge” test could impact enrollment in Medi-Cal and/or CalFresh, jobs, economic output, and tax revenue. Use this PDF to see how your area could be affected.
CHCF Blog

Proposed Public Charge Rule Would Hurt Californians

November 27, 2018
Sandra R. Hernández
Coverage Trends
Federal officials recently proposed changes to the public charge rule for immigrants. The California Health Care Foundation's CEO shares key points from the public comment she filed with the federal government to explain how the rule would take the health care system backward — especially in California.
Publication

Comments on Proposed Regulation — Inadmissibility on Public Charge Grounds

November 2018
Sandra R. Hernández
Medi-Cal
CHCF submitted this letter to express our strong opposition to the Department of Homeland Security's Notice of Proposed Rulemaking ("proposed rule") on "public charge," published in the Federal Register on October 10, 2018.
CHCF Blog

Public Charge Rule Could Prompt Up to 455,000 California Kids Who Need Care to Leave Medi-Cal

November 15, 2018
Leah Zallman, Karen Finnegan
Medi-Cal
New research from the Institute for Community Health estimates that the Trump administration’s proposed changes to the public charge rule could prompt up to 455,000 California children in need of medical attention to leave Medi-Cal.
External Resource

Final Federal Rule on Immigrants and Public Charge: Fact Sheet

On August 12, 2019, the U.S. Department of Homeland Security released the final rule on “public charge,” which will likely increase the number of uninsured in California. ITUP summarizes the final rule alongside existing federal law related to public charge and health care programs. The fact sheet also assesses the potential impacts on immigrant access to health care in California.
Publication

Changing Public Charge Immigration Rules: The Potential Impact on Children Who Need Care

October 2018
Leah Zallman, Karen Finnegan
Coverage Trends
This issue brief explores how a proposed change to public charge laws and their impact on immigration could affect children with medical needs.
CHCF Blog

Immigrants and the New Proposed ‘Public Charge’ Rule

October 2, 2018
Billy Wynne, Dawn Joyce
Medi-Cal
The Department of Homeland Security has released highly anticipated proposed changes to "public charge" rules that could disqualify many immigrants from gaining permanent residency in the US. Our Washington, DC, experts explain what the proposals mean.
CHCF Blog

‘Public Charge’ Rule Would Disrupt Safety-Net Access for Some Immigrants

June 5, 2018
Billy Wynne, Dawn Joyce
Expanding Health Coverage, Coverage Trends
The Trump administration signaled plans to make it harder for immigrants to enter the country and to reduce access to a broad range of health and human service safety net programs for immigrants already living here, including US citizen children.