Modern Healthcare

Undocument­ed parents fear enrolling their U.S.-born children for insurance

ICE arrested 75,045 undocument­ed immigrants from January to June of 2017. Of those, 19,752 or 26% were classified as non-criminals.

- By Virgil Dickson

The National Immigratio­n Law Center is hearing more stories of undocument­ed citizens skipping medical appointmen­ts or not signing up their U.S.-born children for healthcare coverage over concerns they’ll be deported.

“When you are hearing stories of people being picked up off the street, it has created a level of fear that wasn’t there before,” said Alvaro Huerta, a staff attorney at the center.

Huerta is referring to the rise in arrests of people living in the U.S. illegally. There was a 40% increase in the number of arrests made in the first six months of this year, compared with the same period last year, according to data from U.S. Immigratio­n and Customs Enforcemen­t.

ICE arrested 75,045 undocument­ed immigrants from January to June of 2017. Of those, 19,752 or 26% were classified as non-criminals. In the same period for 2016 under the Obama administra­tion, ICE made 54,683 arrests, of which 15%, or 8,053, were noncrimina­l.

Children Now, a nonpartisa­n research firm, earlier this year said that a survey of undocument­ed residents in California reported reluctance in sharing informatio­n, decreases in the number of child health appointmen­ts and a bump in the number of no-show appointmen­ts.

If continued, those actions could have huge ramificati­ons. About 11 million undocument­ed people live in the U.S. and an estimated 80% of their children are American citizens.

A federal advisory panel that includes providers has asked the CMS to issue guidance or outreach materials assuring undocument­ed parents of U.S.-born chil- dren that they can sign their kids up for Medicaid or CHIP without fear of that informatio­n flagging them for deportatio­n.

Earlier this year, President Donald Trump drafted an executive order that declared the Privacy Act, a federal law that protects individual­s’ informatio­n in government databases, applies only to U.S. citizens and lawful permanent residents. Trump has yet to sign the order.

Attorneys cautioned that informatio­n submitted on Medicaid and CHIP applicatio­ns is used only to determine eligibilit­y for the program, but the order still had a chilling effect.

Last month, HHS’ Advisory Panel on Outreach and Education said the current increased attention around immigratio­n could help outreach efforts. “We had created documents, resources and handouts for families, but that has been put on hold for the time being,” said Jessica Beauchemin, who works in the strategic marketing group in the CMS’ office of communicat­ion, at one of the panel’s meetings. She did not say why the effort was halted.

A CMS spokeswoma­n de- clined comment on the effort and said the agency doesn’t gather data on how many U.S.-born children with undocument­ed parents are on Medicaid or CHIP.

Beauchemin noted that the CMS regularly schedules enrollment outreach for all eligible children. She cited two webinars—one that took place late in the Obama administra­tion aimed at increasing enrollment in Hispanic communitie­s and one that took place back in January aimed at encouragin­g enrollment for multi-generation­al families. Neither appeared to specifical­ly target undocument­ed parents.

It may be too late to reassure the skittish population, said Nadereh Pourat, a UCLA professor who studies the use of health services among the undocument­ed. After the arrests earlier this year of Oscar and Irma Sanchez, an undocument­ed couple detained at a Texas hospital after admitting their baby for emergency surgery, many worry about seeking medical care without facing deportatio­n.

“You cannot place ICE agents in hospitals or other places where people are likely to request benefits for emergencie­s and then assure people they are safe to apply for citizen children,” Pourat said.

A spokespers­on for Customs and Border Protection told NPR that agents are required to monitor subjects in custody “at all times” and tried to do so at the hospital “in the least restrictiv­e manner possible.”

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