Organizational Perspectives on the Public Charge Rule and Health Care Access for Latino Immigrants in California

Clara B Barajas; Maria-Elena De Trinidad Young; Arturo Vargas Bustamante; Imelda Padilla-Frausto; Rosa Elena Garcia; Brent A Langellier; Dylan H Roby; Jim P Stimpson; Ninez A Ponce; Jan M Eberth; Mark Stehr; Alexander N Ortega

doi:10.1111/1475-6773.70032

Organizational Perspectives on the Public Charge Rule and Health Care Access for Latino Immigrants in California

Health Serv Res. 2025 Aug 26:e70032. doi: 10.1111/1475-6773.70032. Online ahead of print.

Authors

Clara B Barajas^{1

2}, Maria-Elena De Trinidad Young^{3

4}, Arturo Vargas Bustamante^{4

5}, Imelda Padilla-Frausto⁴, Rosa Elena Garcia⁶, Brent A Langellier¹, Dylan H Roby^{4

7}, Jim P Stimpson⁸, Ninez A Ponce^{4

5}, Jan M Eberth¹, Mark Stehr¹, Alexander N Ortega^{2

4}

Affiliations

¹ Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.
² Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA.
³ Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, California, USA.
⁴ Center for Health Policy Research, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
⁵ Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
⁶ RAND Corporation, Santa Monica, California, USA.
⁷ Department of Health, Society, & Behavior, Program in Public Health, University of California Irvine, Irvine, California, USA.
⁸ Department of Health Economics, Systems, and Policy, Peter O'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

PMID: 40858507
DOI: 10.1111/1475-6773.70032

Abstract

Objective: To examine how mis- and disinformation about the Public Charge Ground of Inadmissibility final rule ("public charge rule") influences health care access for Latino immigrants in California as seen through the perspectives of leaders in health-serving organizations.

Study setting and design: This qualitative study included semi-structured interviews with healthcare and community-based organizational leaders serving Latino immigrants in California. Viswanath et al.'s structural influence model of communication and equity guided the analyses and interpretation of the findings.

Data sources and analytic sample: Between May 2024 and April 2025, primary data were collected from 31 organizations, resulting in 32 semi-structured interviews with 38 participants. Interviews were conducted via Zoom and transcribed verbatim. Researchers coded the data based on recurring themes using Dedoose software.

Principal findings: Participants identified the public charge rule as a significant barrier to health care access for Latino immigrants. The policy has discouraged many Latinos from accessing public benefits, particularly the state's Medicaid and Supplemental Nutrition Assistance Program. In addition, immigrants' trusted sources of information (e.g., family, friends, and attorneys) were often misinformed about the policy, which amplified confusion and fear. Organizations respond by providing accurate information and connecting individuals with reliable resources to clarify that using public benefits would not necessarily result in being classified as a public charge. However, most efforts focused on education rather than directly countering mis- and disinformation.

Conclusions: Healthcare and community-based organizations offer unique perspectives as trusted intermediaries who help Latino immigrant families navigate health care and public benefits. Their close daily interactions reveal how misinformation about the public charge rule deters families from accessing essential services and makes it more challenging for organizations to fulfill their missions. These insights underscore the need for culturally responsive outreach and policy solutions that address information gaps and the climate of fear affecting community health.

Abstract

Grants and funding