Co-authored by Dr. Hirokazu Yoshikaw, Dr. Ajay Chaudry, Dr. Heather Koball, Sarah A. Rendón García, and Trenel Francis, Approaches to Protect Children’s Access to Health and Human Services in an Era of Harsh Immigration Policy examines the barriers low-income families face in accessing social services, while outlining strategies that government officials, community-based organizations, and immigrant families can implement to mitigate adverse impacts. Below is an excerpt of the report:
In the United States, 18 million or one in four children live with at least one immigrant parent. Twenty-eight percent of all children of immigrants — 5.3 million children and youth — are growing up with either an undocumented parent or are undocumented themselves. Specifically, 4.5 million children are U.S.-born citizens with at least one undocumented parent and 775,000 have undocumented status themselves. These children and youth are important to the nation’s future, but their development and well-being are at considerable risk from harmful federal policy changes and the pervasive climate of fear these have engendered.
A proposed redefinition of ‘public charge’ for lawfully-residing immigrants follows on prior policy actions to force the separation of children from parents arriving at the U.S. border and heighten immigration enforcement in communities across the interior of the country. The proposed U.S. Department of Homeland Security regulation that targets millions of families, published in the Federal Register on October 10, 2018, would restrict immigrant families’ access to the public safety net. The proposed regulation is remarkably broad and would expand the designation of ‘public charge’ to include the receipt of benefits for most-Medicaid covered care, nutrition, and housing assistance that millions of immigrant working families with children use to supplement their earnings to support the well-being of their families.
There is robust research evidence that suggests these safety net programs — including Supplemental Nutrition Assistance Program (SNAP, or food stamps); Medicaid and the Children’s Health Insurance Program (CHIP) — have substantial positive impacts on child and youth development. One 2011 study published in the American Journal of Agricultural Economics found that the SNAP program reduces children’s food insecurity by 20 to 30 percent. SNAP alone keeps nearly 5 million children out of poverty each year, according to the Center on Budget and Policy Priorities. Access to SNAP in early childhood has been found to reduce the risk of low-birthweight and improve the health of newborns; moreover, SNAP access was associated with multiple positive health outcomes through adolescence and adulthood (e.g., lower rates of childhood obesity, high blood pressure, and diabetes) as well as adult economic outcomes (e.g., higher rates of high school completion and higher earnings). Significant expansions beginning in the 1990s in public health-care coverage for children from Medicaid and CHIP eligibility and enrollment resulted in reduced child mortality and increased probability of accessing and receiving preventive health and dental care, and specialty care.
Policy actions by the Trump administration build on the already high levels of family stress and risk of developmental disruption for children in mixed-status families. These have grown over the prior dozen years as federal immigration enforcement and resultant detentions and deportations significantly increased the actuality and potential of family separations. Immigrant families directly affected by detention and removal undergo severe income shocks that impinge on children’s well-being and can create cascading effects on housing and school instability. These families also experience high levels of psychological distress and children’s mental health problems, including high rates of anxiety, depression, low self-esteem, and withdrawal. In addition, those not directly affected face greater material hardship, and a chilling effect that can reduce their use of essential health and social services for which their children are eligible. Amuedo-Dorantes and Lopez (2015) in an American Economic Review article document how residing in locations with greater exposure to local immigration enforcement activities during this period led to higher retention in grade and dropout among students ages 6 to 13.
This report provides an overview of the impacts of both the pre-existing policies on program benefit use and the enforcement climate and furthering of restrictions on legal immigrants’ access to public benefits on children and youth development, as well as some of the policy responses that can potentially mitigate these adverse impacts. We begin by briefly highlighting key barriers facing low-income immigrant families in the U.S. immigration policy and enforcement context before then discussing strategies that aim to mitigate or overcome barriers to safety net program access for low-income immigrant families.
Visit the Approaches to Protect Children’s Access to Health and Human Services in an Era of Harsh Immigration Policy page to read the full report.