More than 8 million children are at risk of losing their public health coverage or SNAP benefits if the Trump administration finalizes its proposed “public charge” rule aimed at the immigrant community, according to a new study.
Researchers at Harvard estimate that of the 8.3 million children who face disenrollment in Medicaid, the Children’s Health Insurance Program and the Supplemental Nutrition Assistance Program, 5.5 million have specific medical needs that require such benefits.
The study, published in JAMA Pediatrics this week, used data on a nationally representative sample of 4,000 noncitizens under the age of 17 to project how the rule could impact their access to benefits.
Under the public charge rule, which was proposed last fall by the Department of Homeland Security, the federal government would have the power to weigh how likely an applicant for permanent residency is to use public programs in their approval.
Since children that drop out of public programs like CHIP often then become uninsured rather than gaining insurance elsewhere, this poses a significant risk to their future health.
“Without coverage, they are likely to forgo or delay needed care, and some, such as children with epilepsy or asthma, as well as newborns who require immunizations, are likely to incur higher long-term care costs,” the authors wrote.
Steffie Woolhandler, M.D., a lecturer at Harvard Medical School and one of the study’s authors, said that, using asthma as an example, there can be significant economic impacts in addition to the health risks associated with children missing care. In the study, the research team notes that undertreatment of asthma led to $719.1 million in lost parental productivity—particularly due to child and adult absenteeism—in 1996 alone.
“It’s very penny wise and pound foolish to refuse to treat asthma in a child,” she told FierceHealthcare. “That’s not a wise economic decision.”
Healthcare groups, including America’s Health Insurance Plans and the American Hospital Association, have come out against the proposal, warning that it would lead many immigrants to leave government health programs, driving up costs and worsening their health.
Previous studies from the Kaiser Family Foundation and the Urban Institute have also suggested that millions of people—both children and adults—could drop out of public coverage if the rule was finalized.
Woolhandler said that the rule will likely have a “chilling effect,” as even those who would not be impacted themselves—many of the children at risk are citizens themselves, for example, she said—avoid government programs to protect relatives or friends.
“If you just saw your uncle dragged away and deported you might feel very frightened about doing anything that could conceivably put other family members at risk,” she said. “People are seeing this all the time—they're watching the same news that you and I are.”