Opinion: We Need Clear, Fact-Based Guidance to Recover from Trump’s Public Charge Rule

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This spring, a long-sought, hard-fought change in immigration policy became a reality: The Trump-era public charge rule was permanently blocked nationwide. This means immigrants seeking lawful permanent residency in the United States can access services for which they’re eligible, without affecting their immigration status. While we celebrate this win—for inclusion, for fairness and for our shared humanity—we must do more.

Years of xenophobic rhetoric and anti-immigrant policies have fostered deeply entrenched fears and widespread misinformation that keep immigrants from accessing critical resources. We need a proactive, collaborative approach to begin healing the harm caused by the Trump administration’s public charge rule. From community organizations to state agencies, we must provide clear guidance to families and tackle fear with facts. 

More than one in four Californians was born outside of the United States. Immigrants are our neighbors, family members and friends. They are the frontline workers who keep us safe, the farmworkers who produce food for our tables and the health care workers who put their lives on the line to heal others. Life in the COVID era reminds us that even when distanced, we are interconnected and interdependent. We all do better when everyone has the resources needed not only to survive but to thrive.  

Everyone deserves access to food and health care. Nutrition programs and Medi-Cal offer Californians assistance when it’s needed most. Yet a recent study from the UCLA Center for Health Policy Research found that, throughout California, one in four adult immigrants with low income avoided public programs such as Medi-Cal and nutrition assistance for fear of harming their immigration status or that of their family members. Exclusionary policies cause indiscriminate damage: Even immigrants not subject to the public charge rule have avoided public programs. 

These barriers to program participation are tied to harmful outcomes. The UCLA study found that more than half of all immigrants who avoided public programs experienced food insecurity, compared to just over one-third of immigrants who did not avoid programs. Immigrants who avoided public programs were also more likely to be uninsured and to experience delays in accessing medical care, prescriptions, and mental health treatment. 

Under any circumstances, these results are unacceptable. In the midst of a pandemic that has exacerbated life-and-death inequities, these results are unconscionable. A recent statewide survey asked Californians with middle and low incomes about their COVID-era experiences. One third of respondents—and more than 60 percent of parents—reported running out of food before they could afford to buy more. The survey is also one of many sources that shows Black and Latinx households and households with low income are bearing the brunt of the pandemic’s health and economic crises.

These stark findings underscore the need to make public programs truly accessible to immigrant Californians. Through coordinated messages and outreach, we must affirm that participation in nutrition programs and health care coverage will not hurt immigration status. Eligible individuals can participate in existing programs like school meals, WIC, CalFresh and Medi-Cal without affecting their own or their family’s immigration status.

California is poised to launch the next iteration of Pandemic EBT (P-EBT). P-EBT provides nutrition benefits to children, including children in immigrant families, who have lost access to meals at school or child care because of COVID-driven closures. Receiving P-EBT will not hurt a child’s or family’s immigration status. Connecting children with the food they need to learn, grow, and achieve at their fullest potential doesn’t just nourish them, it feeds our success as a state. Programs like P-EBT are especially important in California, where nearly half of all children are the children of immigrants.

For years, the Trump administration and its allies cultivated fear and confusion that kept immigrant Californians from utilizing basic services. Now more than ever, we need state leaders, media outlets, and trusted messengers such as schools, faith leaders and community organizations to help heal the harm by sharing a clear, factual message: You can participate in nutrition and health care programs without fear of harming your family’s immigration status or your own.

Tia Shimada, MPH, is director of programs at Nourish California, and leads the organization’s efforts to advance equitable, inclusive policies that help connect Californians with the food they need to thrive. 

Susan H. Babey, Ph.D., is a co-director of the Chronic Disease Research Program and a senior research scientist at the UCLA Center for Health Policy Research as well as an associate researcher in the Department of Health Policy and Management, UCLA Fielding School of Public Health.

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