Proposed Public Charge Changes Could Reduce Healthcare Coverage for Children

A potential change to immigration rules regarding public benefits could lead to between 875,000 and 2 million U.S. citizen children becoming uninsured, a new study found.

In California, about 1.6 million U.S. citizen children with at least one noncitizen parent use Medicaid or the Children’s Health Insurance Program, according to the Kaiser Family Foundation, a nonprofit that focuses on non-partisan analyses of health policy. That’s about 28 percent of the 5.8 million such children who use these programs nationwide.

Samantha Artiga, one of the study’s authors, said higher numbers of uninsured children can mean greater strains on safety net providers and can negatively impact the economy.

For the children in question, it can mean they don’t have regular checkups and that they don’t receive care for chronic conditions.

“There’s also a body of research that shows that when children have Medicaid and CHIP coverage, it promotes better long-term outcomes for education and economic outcomes,” Artiga said. “Having that health coverage is key to setting them up for success later in life.”

The proposal would not change whether these children are eligible for aid. It would change the potential immigration-related consequences for their parents — being a likely “public charge” (dependent on the government for assistance) can make someone inadmissible to the U.S. under current law.

The change would allow the federal government to consider whether U.S. citizen children receive certain health or food-related aid when determining whether their noncitizen parents are public charges.

Current policy does not allow the government to consider such non-cash benefits.

San Diego County’s Health and Human Services Agency administers aid programs like Medi-Cal locally. A spokesman said the agency does not comment on program changes before they become final.

Based on how many families dropped Medicaid because of welfare reform in 1996, Artiga’s study estimated that between 875,000 and 2 million children nationwide would become uninsured if the change takes effect. That would raise the uninsured rate for U.S. citizen children with a noncitizen parent from 8 percent to between 14 and 22 percent.

Families with at least one noncitizen parent are more likely to have a full-time worker than those with U.S.-born parents, but they tend to have lower family incomes, the study said. That means many of those children qualify for some kinds of aid.

Artiga said that even today without this possible policy in place, immigrant families are often hesitant to sign up for such programs because they believe it could negatively affect their immigration status.

“What we know from policy changes in the past is often it’s very complicated and difficult for families to understand who is affected by policy change,” Artiga said. “What we see is a broader group than those directly affected may make the decision to no longer participate in programs because they want to take the safest route in their mind.”

Though the rule change is listed on the U.S. Citizenship and Immigration Services agenda in the Federal Register, it has not yet been proposed. After it is officially proposed, the public will have a chance to comment before the rule becomes final.

 

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