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    Research Letter
    Health Policy
    July 15, 2020

    Assessment of Perceptions of the Public Charge Rule Among Low-Income Adults in Texas

    Author Affiliations
    • 1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
    • 2Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
    • 3Columbia University School of Social Work, New York, New York
    JAMA Netw Open. 2020;3(7):e2010391. doi:10.1001/jamanetworkopen.2020.10391

    In January 2020, the US Supreme Court allowed the Trump administration to implement a new rule regarding the definition of public charge. The rule establishes participation in public programs (Medicaid, the Supplemental Nutritional Assistance Program [SNAP], and subsidized housing), health status, and income as criteria in determining whether legal immigrants are able to gain permanent residency (green cards). Critics contend that this creates a chilling effect that dissuades individuals from participating in programs or obtaining medical care, even among people outside the policy’s intended scope (such as citizens with immigrant relatives).1 We surveyed low-income adults in Texas, a state with a large immigrant population, to examine perceptions of the public charge rule and its association with program participation and receipt of medical care.