Columbia University Mailman School of Public Health

Approaches to Protect Children's Access to Health and Human Services in an Era of Harsh Immigration Policy

Authors: Hirokazu Yoshikawa, Ajay Chaudry, Sarah A. Rendón García, Heather Koball, and Trenel E. Francis
Publication Date: March 2019

Changes in U.S. immigration policy and enforcement priorities since January 2017 have led more mixed-status immigration families to live in a climate of fear and anxiety.

In October 2018, the Trump administration proposed to use executive rule-making authority to change the definition of 'public charge' from someone who is "primarily dependent on the government for their subsistence" to "someone who uses one or more public benefits" in health, nutrition, or housing.

The proposed U.S. Department of Homeland Security 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.

In the United States, 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.

This proposed policy change builds on the already high levels of family stress and risk of developmental disruption for children in mixed-status families (Brabeck, Sibley, Tuabin, & Murcia, 2016; Yoshikawa, 2011). 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.

Under the proposed change, all immigrants seeking legal permanent resident status would be at risk of denial of admission or receiving a green card if they use Supplemental Nutrition Assistance Program (SNAP, or food stamps), Medicaid, the Children's Health Insurance Program (CHIP), or similar public programs.

This report highlights key barriers facing low-income immigrant families in the U.S. immigration policy and enforcement context and discusses strategies that aim to mitigate or overcome barriers to safety-net program access for low-income immigrant families.

Download the full report here.

Visit the dedicated project page on the NYU Institute of Human Development and Social Change website here.

The report is funded by the generous support of the William T. Grant Foundation.