Researchers at the Migration Policy Institute (MPI) released a commentary in December documenting the chilling effects of the public charge rule on immigrant families’ use of benefits. Sadly, the American Community Survey (ACS) data confirm concerns raised by experts and advocates that the new public charge rule would deter large numbers of immigrant-led households from using public benefits for which they are eligible, including a potentially harmful reduction in benefit use among citizen children in mixed status families.

The commentary is short and easily digestible. I encourage SayAhhh! readers to read it in its entirety but here are just a couple of key points:

• Use of SNAP, TANF and Medicaid/CHIP declined for all groups over the 2016-2019 period due to improving economic conditions.
• But the declines were doubly large for noncitizens compared to citizens – Medicaid/CHIP participation for citizens dropped 8% compared to a 20% decline for noncitizens. (See MPI Figure 1.)
• Declines were nearly as sharp for citizen children with noncitizens in the household (mixed status families) as they were for noncitizens – Medicaid/CHIP participation for citizen children in mixed status families dropped 18% compared to an 8% decline for citizen children with only US citizens in the house. (See MPI Figure 2.)
• The declines in participation accelerated over the period studied – Medicaid/CHIP participation among low-income noncitizens dropped 4% from 2016-2017, 6% from 2017-2018, and 12% from 2018-2019. (See MPI Figure 4.)

This research is consistent with the findings from the Urban Institute surveys showing that 1 in 5 adults in immigrant families with children reported chilling effects on public benefit receipt in 2019. It is also consistent with the pre-pandemic declines my colleagues have noted in Medicaid/CHIP enrollment and the steady increase in the number of uninsured children. The number of uninsured children increased every year during the Trump Administration, with the largest increase from 2018-2019 despite a strong economy. The new commentary from MPI suggests that dropping Medicaid/CHIP participation among noncitizen children and citizen children in mixed status families contributed to the overall increase in the number of uninsured children.

President-Elect Biden has committed to rescinding the public charge rule and other anti-immigrant policies such as family separation at the border. California Attorney General Xavier Becerra, the nominee for U.S. Secretary of Health and Human Services, is committed to restoring access to care for families, including immigrant families. As the past few years have proven, leadership on these issues matters. Let’s hope the new Administration will turn things around quickly.