Self-Pay Emergency Department Visits by Undocumented Patients After 2018 Public Charge Announcement

Was the September 2018 public charge announcement associated with changes in self-pay emergency department (ED) visits among likely undocumented patients in Los Angeles County’s safety-net hospitals?In this cohort study of 375 258 adult ED encounters, the public charge announcement was associated with a mean 2.10–percentage point increase in self-pay visits among likely undocumented patients (equivalent to 1755 additional visits) compared with US-born patients.These results suggest that undocumented patients are more likely than US-born counterparts to self-pay for their ED care, reflecting a chilling effect of public charge.

Corresponding Author: Alein Y. Haro-Ramos, PhD, MPH, Department of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, Quad, 856 Medical Sciences, Irvine, CA 92697 (ayharo@hs.uci.edu).

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