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Immigrant Policies in the U.S.
Steven P. Wallace, PhDProfessor Dept. of Community Health SciencesAssoc. Director, UCLA Center for Health Policy
Research
Brief overview of immigrant demographyCurrent (hot) policy issuesLong trendsWhat to do about it– Research– Advocacy
Where do CA immigrants come from, 2017?
6.4%39.7%
1.7%
0.9%
Mexico38.5%
8.3%2.6%
0.7%
Canada1.2%
https://www.migrationpolicy.org/data/state-profiles/state/demographics/CA
2.7%
More Asians than Latinos now arriving each year
2015=37.4%
2015=28.0%
https://www.pewhispanic.org/2019/06/03/facts-on-u-s-immigrants/
Number of unauthorized immigrants living in the U.S.
https://www.pewresearch.org/fact-tank/2019/06/12/us-unauthorized-immigrant-population-2017/
(1) 2020 CensusAdd citizenship?– Already in ACS
So why not in full census?[hint: It’s all about politics]
(2) Public ChargePersons who rely on government cash assistance (SSI or TANF) can now be denied entry/ green cardsProposal to expand to any use, add SNAP, Medicaid, housingChilling effect will drive US-citizen children away from needed programs
(3) Affordable housingPublic housing to evict families w/ unauthorized members~25k households impacted w/ 55k citizen children1.2 million in public housing nationally https://www.nytimes.com/2019/05/10/us/politics/h
ud-public-housing-immigrants.html
(4) 2020 ElectionsDebate #1 (6/27/19)“Raise your hand if your government plan would provide coverage for undocumented immigrants”
The economic case for coverageAlmost all unauthorized immigrants in working families– Keeping healthy helps econ
Early intervention can cost less than late Prevents medical bankruptcy– Impacts entire household +
creditors
Paying for health care
27.6%
34.6%
42.8%
Ever unable to pay basic needs due to medical debt
US-born Naturalized NonCitizen
9.7%
7.3%
8.9%
Problem paying medical bill past year
US-born Naturalized NonCitizen
Source: California Health Interview Survey 2017
The ethical case for coverageUndocumented pay taxes, should receive servicesReduces the “chilling effect”Universal declaration of human rights– Health care as human
right– We’re all in this together
https://www.vaticannews.va/en/pope/news/2019-05/pope-francis-message-world-day-migrants-refugees-full-text.html
California CoverageMedi-Cal for low-income– PRUCOL/DACA– All pregnant women– All youth through age 25– LPR here <5 years
Covered CA subsidy– LPR <5 years
County plans for undoc– E.g. Healthy San Francisco– Most w/caps (Fresno=400!)
Emergency Medi-Cal
Headlines vs. long trends
Headlines = acute stressDifferential opportunities = chronic stress/ life chances
Mechanisms linking policy to health impacts?
Social/ psychological impact of experiences – most likely to have “spill over” effects across policies/domainsStructured opportunities (rights, eligibility)– Interactions with other structural factors, e.g.
poverty, residential segregation, political disenfranchisement, etc.
Racialization of immigrationPolitical rhetoric makes brown = undocumented immigrant = undesirable2/3 of Latinos are US-bornResult is “spill-over” of anti-immigrant to anti-Latino politics
Research, action
Study on Immigrant Health
Funded by NIH/NIMHD grant #R01MD012292
http://healthpolicy.ucla.edu/RIGHTS
Health in all policies!
Wallace SP, Young MT, Rodríguez MA, Brindis CD. A social determinants framework identifying state-level immigrant policies and their influence on health. SSM PopulHealth. 2018 Nov 2;7:016-16. http://dx.doi.org/10.1016/j.ssmph.2018.10.016
Knows someone personally who has been deported, CA 2018
4%
32%
42%
Asian language (301) English (373) Spanish (386)
Source: RIGHTS study, first 1060 Latin American and Asian immigrant interviews in 2018, preliminary data not for citation
Public Charge ConcernWas there ever a time when you decided not to apply for one or more non-cash government benefits, such as Medi-Cal, food stamps, or housing subsidies, because you were worried it would disqualify you, or a family member, from
obtaining a green card or becoming a U.S. citizen?
9.6%
16.3%
25.4%
Asian language (301) English (373) Spanish (386)
Source: RIGHTS study, first 1060 Latin American and Asian immigrant interviews in 2018, preliminary data not for citation
Reports immigrants get same level of health care as everyone else
10% 11% 9%5%
17%10%
9%
33%35%
0%10%20%30%40%50%60%70%80%90%
100%
Asian language English Spanish
alwaysusuallysometimesrarelynever
Source: RIGHTS study, first 1060 Latin American and Asian immigrant interviews in 2018, preliminary data not for citation
Action
Public comments on regulatory changes https://protectingimmigrantfamilies.org/Connect with community organizationsEvery person makes a difference– Decline Real ID & get regular driver’s license– Decline to answer citizenship question (if
added)Of course, vote
Policies to promote!Protect: University/ employer as sanctuary; inform all of rightsPromote Integration: ESL, worker rights, language accessHealth insurance for all CaliforniansPass: Comprehensive immigration reform
Thank you
http://healthpolicy.ucla.edu/rights
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