US public charge policy and Latinx immigrants’ thoughts about health and healthcare utilization

ABSTRACT

Objectives

We examined Latinx immigrants’ perceptions of US policy related to restrictions on immigrants’ use of public resources and their thoughts about the influence of these on immigrants’ healthcare utilization.

Design

A series of 16 focus group discussions with Latinx immigrant men and women (documented and undocumented) (N = 130) were conducted between May and July 2017 across four US cities.

Results

Four central themes emerged: participants attributed the limited resources available for affordable healthcare for many uninsured US immigrants (both documented and undocumented) to the US government’s view of immigrants as burdens on public resources and its subsequent unwillingness to dedicate funds for their care; participants expressed concerns, some unfounded, about negative immigration ramifications arising from diagnosis with health conditions perceived to be serious and/or expensive to treat; participants noted that some immigrants avoided using health programs and services to which they were entitled because of immigration concerns; finally, participants described how access to information on immigration laws and healthcare resources, and conversely, misinformation about these, influenced healthcare utilization.

Conclusions

Participants were acutely aware of the image of immigrants as public charges or potential burdens on government resources that underlies US immigration policy. In some cases, participants came to inaccurate and potentially harmful conclusions about the substance of laws and regulations based on their beliefs about the government’s rejection of immigrants who may burden public resources. This underscores the importance of ensuring that immigrants have access to information on immigration-related laws and regulations and on healthcare resources available to them. Participants noted that access to information also fostered resilience to widespread misinformation. Importantly, however, participants’ beliefs had some basis in US immigration policy discourse. Law and policy makers should reconsider legislation and political commentary that frame self-reliance, the guiding principle of US immigration policy, in terms of immigrants’ use of publicly funded healthcare resources.

KEYWORDS:

• Immigration
• policy
• healthcare
• Latinx immigrants

Acknowledgements

We would like to acknowledge the contribution of the following Proyecto Luz 2.0 research team members: Ruzanna Aleksanyan, MS, Nora Bouacha, MPP, Andrea L. Dakin, PhD, Samantha Garza, MS, Sara LeGrand, PhD, Celina Lopez, Elizabeth Ortiz de Valdez, MD, Juan Reyes, Silvia Valadez-Tapia, MA, Angel Rosado, and Juan Flores.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this document was supported by the National Institute on Minority Health and Health Disparities [award number R01MD011573] and the National Institute of Mental Health [award number P30MH052776]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.