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Immigration Enforcement and Health

New DHS Guidance on Public Charge Determinations Does Not Specify Key Concepts, Likely Resulting in Immigrant Families Facing Ongoing Confusion and Fear

The guidance leaves key concepts unspecified and grants substantial discretion to individual immigration officers. This will likely result in ongoing confusion and fear among immigrant families that may deter them and their citizen children from participating in programs that help pay for health care, housing, or food even if they are eligible.

See Also: Potential “Chilling Effects” of Public Charge and Other Immigration Policies on Medicaid and CHIP Enrollment

Deaths and Health Care Issues in ICE Detention Centers Under the Second Trump Administration

Health Care Experiences of Immigrant Parents and Their Children in the Second Trump Term

Recent State Actions Related to Immigrants’ Access to Services and Immigration Enforcement

How States Verify Citizenship and Immigration Status in Medicaid

KEY FACTS AND ANALYSIS

Health Coverage of Immigrants

Immigrants generally use less health care and have lower health spending than U.S.-born citizens, and noncitizen immigrants remain far more likely to be uninsured than citizens.

This fact sheet provides an overview of health coverage for immigrants based on data from the KFF/New York Times 2025 Survey of Immigrants and discusses implications of the current policy and immigration enforcement environment for their health and health care.

Analysis: Health and Health Care Experiences of Uninsured Immigrants

State Health Coverage for Immigrants and Implications for Health Coverage and Care

Children in Immigrant Families: Key Facts on Health Coverage and Care

Optional Medicaid and CHIP Coverage for Lawfully Present Immigrant Children Could Mitigate Coverage Losses Due to 2025 Reconciliation Law

1.4 Million Lawfully Present Immigrants are Expected to Lose Health Coverage due to the 2025 Tax and Budget Law

survey of immigrants

KFF-New York Times Survey: Immigrants Report Rising Fear, Negative Economic and Health Impacts, and Changing Political Views During the First Year of President Trump’s Second Term

The 2025 Survey of Immigrants, a partnership between KFF and The New York Times, takes an in-depth look at the experiences of immigrants during the first year of President Trump’s second term, including their worries related to increased immigration enforcement, their health and economic wellbeing, and the political views and preferences of immigrant voters. The survey paints a portrait of families under strain — where fear of detention and economic instability are negatively impacting immigrants’ health and reshaping immigrant families’ daily lives and views of U.S. political parties.

Read the News Release | Explore The New York Times’ Reporting

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  • Many Community Health Centers Report That Immigrant Patients Are Declining to Enroll in Medicaid or Renew Their Coverage Amid Concerns About Changes to Public Charge Rules

    News Release

    Nearly half (47%) of community health centers report that many or some immigrant patients declined to enroll themselves in Medicaid in the past year, according to a new KFF survey, and nearly a third (32%) of centers say that some patients dropped or decided not to renew such coverage. Interviews with health center staff report similar findings and indicate that fear and confusion surrounding recent immigration policy contribute to these changes. The findings come at…

  • Impact of Shifting Immigration Policy on Medicaid Enrollment and Utilization of Care among Health Center Patients

    Issue Brief

    On August 14, 2019, the Trump administration published a final rule to broaden the programs the federal government will consider in public charge determinations to include Medicaid coverage for non-pregnant adults and certain previously excluded nutrition and housing programs. To learn about the possible early effects of the public charge rule and other immigration policies on patients at community health centers, this brief draws on interviews and survey data to capture health center directors’ and…

  • President Trump’s Proclamation Suspending Entry for Immigrants without Health Coverage

    Fact Sheet

    On October 4, 2019, President Trump released a proclamation suspending entry of immigrants into the United States unless they provide proof of health insurance within 30 days of entry or have financial resources to pay for reasonably foreseeable health insurance costs. The proclamation indicates that the suspension is necessary to protect the health care system and taxpayers from uncompensated care costs. This brief provides an overview of the proclamation and data on health coverage and…

  • Nearly 8 in 10 Immigrants Who Entered the U.S. Without Legal Permanent Resident Status Have At Least One Characteristic That Could Count Against Them under the New “Public Charge” Rule

    News Release

    Seventy-nine percent of noncitizen residents who originally entered the United States without legal permanent resident status have at least one characteristic that could count against them under the Trump Administration’s new “public charge” rule, according to an updated KFF analysis. Such characteristics – including having an income below 125 percent of the federal poverty level or lacking a high school diploma or private health insurance -- could make it harder for immigrants to obtain admission…

  • Health Coverage and Care of Undocumented Immigrants

    Issue Brief

    Recently, many of the Democratic presidential candidates indicated support for expanding health coverage to undocumented immigrants. To help inform the implications of such an expansion, this brief provides an overview of current health coverage and care for undocumented immigrants

  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and…

  • Conversation on Health Care and the 2018 Midterm Elections

    Event Date:
    Event

    Health care ranks among the top issues voters want to hear candidates talk about on the campaign trail, with costs being the most concerning health issue for voters. Meanwhile, the constitutionality of the Affordable Care Act (ACA) continues to be challenged in the judicial system with the latest case potentially jeopardizing the law’s protections for people with pre-existing conditions. And in four states, ACA Medicaid expansion initiatives are on the ballot to newly expand or…