Health Care Use Among Children With Hispanic Parents Declined After Shifts In US Immigration Policy In 2018.

Anti-immigrant rhetoric, changes in US immigration policy, and increased enforcement have been linked to poor health outcomes among Hispanic populations, but less is known about how these shifts have affected children's health care use. Using 2012-22 data from the Medical Expenditure Panel Survey, we examined patterns of health care use among children after changes to the federal public charge rule were announced in 2018. Compared to children without Hispanic parents, children with at least one Hispanic immigrant parent experienced a 6.5-percentage-point decrease in the probability of having at least one medical visit and a 6.8-percentage-point decrease in the probability of having at least one dental visit after 2018. These effects represent relative declines of 9.9 percent and 15.3 percent, respectively, compared with pre-2018 utilization levels. Children with a Hispanic US-born parent experienced similar but smaller effects. Because most children in the sample, including those with Hispanic immigrant parents, were US-born citizens, these findings suggest that shifts in the immigration policy environment may reduce access to care for US citizen children through parental fear, documentation concerns, and broader chilling effects on families. Rebuilding trust between immigrant and Hispanic populations and health care institutions is essential to protecting access to care.