New Study Finds Evidence of a “Chilling Effect” in 2016 Marketplace Enrollment

There have been reports in the news of immigrant families decreasing their use of health care services and safety net programs because they fear that their information may be used to identify undocumented family members. A new study in the National Bureau of Economic Research explores this topic. Researchers examine the effects of Secure Communities, a federal ICE program from 2008 to 2014 (and re-started in 2017) that allows the government to confirm immigration status of individuals arrested and increases the probability that non-citizens will be deported. The program led to more than 380,000 deportations. The researchers examine the potential impacts of Secure Communities on Hispanic citizens’ safety net program take-up, as they may fear that participation will put family members and friends at risk of deportation.

The study finds potential evidence of a “chilling effect” in the Marketplace and the Supplemental Nutrition Assistance Program (SNAP) after the implementation of Secure Communities. The authors use many data sources: data on the detainers (immigration-related holds) under SC between 2008 and 2013, the Panel Study of Income Dynamics (PSID) from 2005-2015, the American Community Survey (ACS) from 2006-2016, and the 2016 public-use Marketplace enrollment data from the Centers for Medicare & Medicaid Services (CMS). They estimate that if it were not for Secure Communities, Marketplace enrollment among Hispanics would be 22 percent higher.  The authors point out that the chilling effect on Hispanic enrollment in Marketplace plans will have a spillover effect to the broader community. Research shows that Hispanics tend to have better health outcomes than other groups with similar socioeconomic demographics. If their participation in insurance markets is reduced, it could mean higher premiums for other groups. In SNAP, the authors estimate a 10 percent decrease in take-up using the ACS and a 15 percentage point decline using the PSID.

There is variation in the results. For example, the authors did not detect a chilling effect for families living in sanctuary cities – where detainers are not uniformly enforced – whom appear to be insulated from the full impact of Secure Communities. However, mixed-status households show larger decreases in take-up of safety net programs. Overall, the findings from the study suggest that Hispanic citizens respond to fears that relatives or friends could be put at risk of deportation by reducing their participation in safety net programs, potentially leading to significant risks for the health and well-being of families.

Karina Wagnerman
Karina Wagnerman is a Senior Health Policy Analyst at the Center for Children and Families