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Many immigrant families have avoided safety net and pandemic relief programs in recent years over concerns that their participation would have adverse immigration consequences. These chilling effects on program participation occurred in the context of a restrictive immigration policy environment under the Trump administration, including the expansion of the "public charge" rule. Though the Biden administration has reverted to prior guidance on the public charge rule and reversed many other immigration policy changes, chilling effects may continue to deter adults in immigrant families from seeking safety net supports for which they or their children are eligible.This study draws on Well-Being and Basic Needs Survey data collected in December 2020 and interviews conducted with adults in immigrant families and people who work at organizations that connect immigrant families to health, nutrition, and other support programs in California. The interviews were conducted between March and May 2021, in the early months of the Biden administration, offering unique insights as policy priorities were shifting.
California policymakers continue to weigh strategies for making health insurance universal and health care accessible to all—including for undocumented immigrant residents. The state expanded Medi-Cal to undocumented children and young adults using mostly state funds, and budget negotiations are underway to expand coverage to older undocumented adults. While coverage for all undocumented immigrants has been on the legislative agenda for several years, COVID-19 has underscored how gaps in health insurance coverage for immigrants, fear and avoidance of health care systems, and lack of access to vaccines can have consequences for entire communities.This report updates PPIC's past work on health care and insurance coverage for undocumented immigrants, from presenting updated uninsured rates among immigrant groups to unpacking systematic differences in health care access by documentation status. We also examine aspects of how children in mixed-status families—where at least one member is undocumented—engage with the health care system.