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Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies

President Trump has intensified national debate about immigration by implementing policies to enhance immigration enforcement and restrict legal immigration. Recent findings show that the climate surrounding these policies has significantly increased fear and uncertainty among immigrant families, broadly affecting families across different immigration statuses and locations. The effects extend to lawfully present immigrants, including lawful permanent residents or “green card” holders, and children in immigrant families, who are predominantly U.S.-born citizens. In particular, findings point to both short- and long-term negative consequences on the health and well-being of children in immigrant families.

Potential changes to public charge policies intended to reduce use of public programs by immigrant families, including their citizen children, could further increase strains on immigrant families and lead to losses in health coverage. To provide insight into the scope of potential impacts of continually evolving immigration policy on children, this data note provides nationwide and state-level estimates (Table 1) of citizen children living in immigrant families and the number currently covered by Medicaid/CHIP coverage.

NEW: Nearly 20 million children live in immigrant families that could be affected by evolving immigration policies

In 2016, nearly 20 million or one in four children had at least one immigrant parent, and nearly nine in ten (89% or 17.7 million) of these children were citizens (Figure 1). An immigrant parent is a foreign-born parent, including naturalized citizens, lawfully present immigrants, and undocumented immigrants. Over half of children with an immigrant parent live in California (23%), Texas (13%), New York (8%), and Florida (8%).

Figure 1: Children by Parental Immigration Status, 2016

Over 8 million citizen children with an immigrant parent have Medicaid/CHIP coverage. Medicaid and CHIP provide these children access to preventive and primary care as well as care for chronic conditions. In addition, the coverage provides families financial protection from high medical costs. Recent findings indicate that growing fear and uncertainty among immigrant families is leading to decreased participation in Medicaid and CHIP. Moreover, potential forthcoming changes to public charge policies would likely lead to sharp declines in enrollment in Medicaid and CHIP as well as other programs among immigrant families, including their citizen children. Decreased participation in Medicaid and CHIP would increase the uninsured rate among immigrant families, negatively affecting the financial stability of families and the growth and healthy development of their children. Such coverage losses also would widen disparities in coverage citizen children in immigrant families already face compared to those with U.S.-born parents. Today, citizen children with an immigrant parent are more likely to be uninsured compared to those with U.S.-born parents (Figure 2).

Figure 2: Uninsured Rate for Citizen Children by Parental Immigration Status

In sum, although changes in immigration policy may target specific groups of immigrants, they often have much farther-reaching effects. One group significantly affected by such changes is children living in immigrant families, who are predominantly U.S. citizens. The effects on these children may have long-term negative consequences on their health and well-being across their lifespan.

This data note was prepared by Samantha Artiga, with the Kaiser Family Foundation, and Anthony Damico, an independent consultant to the Kaiser Family Foundation.

Table 1: Medicaid/CHIP Coverage for Citizen Children With an Immigrant Parent, 2016
  All Children Citizen Children with an Immigrant Parent
Total Total with Medicaid/CHIP Coverage
United States 78,150,000   17,674,000 8,112,000
Alabama 1,155,000  95,000  49,000
Alaska 202,000  23,000 NA
Arizona 1,715,000  451,000  205,000
Arkansas 742,000  63,000  30,000
California 9,678,000  4,122,000  2,039,000
Colorado 1,318,000  217,000  108,000
Connecticut 804,000  171,000  81,000
Delaware 215,000  41,000  19,000
DC 128,000  23,000  7,000
Florida 4,450,000  1,329,000  519,000
Georgia 2,666,000  484,000  260,000
Hawaii 319,000  77,000  25,000
Idaho 473,000  66,000  34,000
Illinois 3,048,000  791,000  341,000
Indiana 1,694,000  104,000 NA
Iowa 756,000  82,000  48,000
Kansas 763,000  107,000  41,000
Kentucky 1,104,000  60,000 NA
Louisiana 1,176,000  63,000 NA
Maine 272,000  22,000 NA
Maryland 1,428,000  398,000  141,000
Massachusetts 1,480,000  414,000  157,000
Michigan 2,280,000  222,000  82,000
Minnesota 1,383,000  270,000  106,000
Mississippi 768,000  31,000 NA
Missouri 1,479,000  125,000 NA
Montana 241,000  12,000 NA
Nebraska 500,000  73,000  29,000
Nevada 729,000  240,000  87,000
New Hampshire 283,000  28,000  13,000
New Jersey 2,077,000  751,000  277,000
New Mexico 522,000  101,000  67,000
New York 4,397,000  1,485,000  704,000
North Carolina 2,450,000  404,000  219,000
North Dakota 188,000  12,000  3,000
Ohio 2,792,000  195,000  90,000
Oklahoma 1,023,000  149,000  97,000
Oregon 933,000  203,000  132,000
Pennsylvania 2,836,000  336,000  170,000
Rhode Island 217,000  52,000  27,000
South Carolina 1,183,000  113,000 NA
South Dakota 229,000  14,000 NA
Tennessee 1,550,000  172,000  68,000
Texas 7,731,000  2,353,000  1,135,000
Utah 963,000  123,000 NA
Vermont 131,000  9,000 NA
Virginia 2,013,000  438,000  152,000
Washington 1,721,000  455,000  240,000
West Virginia 398,000 NA NA
Wisconsin 1,396,000  89,000 NA
Wyoming 153,000  9,000 NA
NOTES: Children with an immigrant parent in a household with at least one immigrant parent. NA: insufficient sample size to report.
SOURCE: Kaiser Family Foundation analysis of March 2017 Current Population Survey, Annual Social and Economic Supplement.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.