The Association of the Publication of a Proposed Public Charge Rule with Preterm Births among Uninsured Foreign-Born Latinx Birthing People in the United States

Following the inauguration, the Trump administration authorized a series of anti-immigrant policies, including modifications to the public charge regulation. This study analyzed the effect of the publication of a proposed public charge rule in 2018 on the risk of preterm birth between uninsured and privately insured Latinx birthing people in the United States by using natality files from the National Center for Health Statistics. In total, 1,375,580 Latinx birthing people reported private insurance as their primary source of delivery from 2014 to 2019, while 317,056 Latinx birthing people reported self-pay as their primary source of delivery during the same period. After the publication of the proposed public charge rule in 2018, the odds of preterm birth among uninsured foreign-born Latinx birthing people increased by 6.2% compared with privately insured foreign-born Latinx birthing people (OR: 1.062; 95% CI: 1.016, 1.110). On the other hand, the odds of preterm births among uninsured US-born Latinx birthing people did not significantly increase after the publication of the proposed rule compared with privately insured US-born Latinx birthing people. These findings suggest the publication of the public charge rule proposed in 2018 may be associated with adverse birth outcomes among uninsured foreign-born Latinx birthing people in the United States.