Unintended Consequences?

Immigration enforcement policies target people present within the United States without legal status, but the wide-ranging effects of enforcement actions accrue beyond these populations to related children. While children in immigrant families in which someone is at risk of deportation are more likely than their peers to qualify for public benefits targeting low-income families, they are less likely to access these programs, including Medicaid and CHIP. This study develops an identification algorithm to isolate likely undocumented respondents to the Current Population Survey's Annual Social and Economic Supplement in order to compare Medicaid drop-out rates among eligible children in families with a variety of statuses. This study also develops two novel quantitative measures of immigration enforcement intensity and benefit provision in order to examine the effect of the on-the-ground environment on Medicaid drop-out. Medicaid-eligible children with a family member at high risk of deportation were found to drop out to uninsurance at triple the rate of their counterparts in fully native-born families. Stratified by family status, children with a family member at high risk of deportation living in local areas with high immigration enforcement intensity were more likely to drop out than their peers living in areas with low enforcement intensity. Further, a chilling effect against continued Medicaid enrollment was also found among children in immigrant families with little to no risk of deportation. Much like an individual child is part of a family and is affected by the status of other members of that family, a family is a part of a community — and policymakers should be taking this context into account.