Public health experts in Texas are concerned that a growing number of American children are forgoing services like Medicaid and food stamps because their parents are undocumented. The trend could get worse, they say, if a proposed change to immigration policy goes through.
Vela is an East Austin nonprofit that provides free courses and support groups to parents who have children with disabilities. Maria Hernandez, the group's founder and executive director, says she helps parents from 55 different ZIP codes in the area and the majority are immigrants.
“About 70 percent are immigrant families, mostly from Mexico,” she says. “And so we're working with families [where] the parents are immigrant, but the children are born here.”
Hernandez says families in this situation are having an especially hard time lately getting access to health care services for their children. Many have been relying on Medicaid for years because their children have long-term disabilities.
“The last six months, they've already gotten requests for additional proof of eligibility,” she says.
She says that puts "parents in a place where they say, ‘This feels scary, this feels new, and so what I'm going to do is withdraw.’”
That’s the situation Marlene has found herself in. (We're not using her last name because she is undocumented.)
Marlene has two children who were born in the U.S. Her son is on Medicaid because he has speech and learning disabilities. Lately Marlene has been rethinking his enrollment in the program because the government is asking a lot of questions – investigating her life from “head to toe,” she says in Spanish.
“They are asking me a lot of stuff that they didn’t used to ask,” she says. “For me, it’s stressful. I was sick from the stress and fear of it all.”
Marlene says she recently decided to stop applying for food stamps, because the application asked for things she never had to provide before, like pay stubs.
She says her son has another year of Medicaid, which is a big relief.
But, she says, “I don’t know what’s going to happen for the next year. I don’t know what they are going to ask me.”
Compounding the issue is a Trump administration proposal that would change the criteria federal officials consider in green card applications.
“Currently, the only thing that gets held against you, as it were, is if you're likely to be permanently completely dependent on the government for your support,” says Anne Dunkelberg, an associate director with the Austin-based Center for Public Policy Priorities.
Dunkelberg says the test of whether someone will be completely dependent on the government, known as a “public charge,” applies to people who need to be in a hospital or nursing home long-term, among other things.
The administration wants to radically change what “public charge” means. It has proposed adding criteria that could count against people in and out of the U.S. who are seeking green cards. So far, Dunkelberg says, that includes whether they use food stamps, Medicaid, food programs for new mothers, CHIP, health insurance subsidies – and even the earned income tax credit.
And officials will also be looking at whether the person's immediate family members use any of these services.
“Not only would they potentially hold all these new things that they used to vehemently not hold against people," she says, but officials will also hold it against potential immigrants if their "immediate family members use any of these benefits.”
This includes family members who are U.S. citizens, Dunkelberg says, “who may be using those benefits completely appropriately and legally.”
That means families will have to choose between a) getting help for their American children and possibly foregoing a legal status, and b) not getting any help at all and staying in the shadows.
“Whether this is intentional or not, it has the effect of downgrading the value of citizenship of those citizen family members,” Dunkelberg says.
Hernandez says this policy could exacerbate a situation in Texas that started with Senate Bill 4, a law passed last year requiring local law enforcement to cooperate with federal immigration authorities.
“What we're seeing the most with our families is a paralysis,” she says. “Coming off of SB 4, there was already such a withdrawal or a reduced access to services.”
In the last two months, she says, families have said they're not going to renew Medicaid out of fear.
“They are just going to go rely on emergency room visits as needed,” Hernandez says.
A lot of kids with disabilities who have made progress will likely start backsliding, which is something parents like Marlene say they wish they could avoid.
“I am not the only person that is refusing services – and not for me, but for my children who are legally entitled to them,” she says.