Millions of citizen children could lose coverage due to public charge rule, study says

Nearly 7 million citizen children of noncitizen parents are enrolled in Medicaid and CHIP. (Getty Images/rrodrickbeiler)

Healthcare coverage for children born in the U.S. to noncitizens has improved significantly over the last several years. But a recently proposed rule from the Trump administration could reverse those gains, according to a new analysis (PDF) from the Urban Institute.

The uninsured rate among citizen children with noncitizen parents decreased dramatically between 2008 and 2016, falling from 16% to 6%.

Many of these children enrolled in Medicaid and CHIP. Of the 10.3 million citizen children with at least one noncitizen parent, 6.8 million were enrolled in Medicaid or CHIP in 2016. The 6.8 million enrolled children represent a fifth of all children in the programs.

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And by 2016, the difference in enrollment among eligible children with citizen and noncitizen parents had become nearly moot. More than 93% of eligible children with noncitizen parents were enrolled, as were 94% of those with citizen parents—increases of 15.5% and 10.5%, respectively, from 2008.

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But the sheer size of this population means “disenrollment from Medicaid/CHIP among even a small share of this group would have large effects nationally,” the report reads.

The report comes in the wake of a proposed public charge rule that would allow the Department of Homeland Security to consider whether someone is likely to use public services when he or she applies for permanent residency. The Department would make this determination based on a variety of factors, including income, education level, English proficiency, enrollment in private health insurance and existing enrollment in benefit programs.

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As citizens, the children would remain eligible for Medicaid and CHIP, but families may drop their children’s coverage out of fear. Millions of these children, who are disproportionately under the age of five, could become uninsured and lose their access to care.

As a ripple effect, the rule could also “adversely affect children’s long-term educational attainment, future earnings, and health and well-being—not only limiting their own potential but their ability to contribute to society later in life,” the report says.

The study used data from the American Community Survey, an annual survey administered by the U.S. Census Bureau.