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Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation

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  • Tara Watson

Abstract

Economists have puzzled over why eligible individuals fail to enroll in social safety net programs. “Chilling effects” arising from an icy policy climate are a popular explanation for low program take-up rates among immigrants, but such effects are inherently hard to measure. This paper investigates a concrete determinant of chilling, Federal immigration enforcement, and finds robust evidence that heightened enforcement reduces Medicaid participation among children of non-citizens. This is the case even when children are themselves citizens and face no eligibility barriers to Medicaid enrollment. Immigrants from countries with more undocumented U.S. residents, those living in cities with a high fraction of other immigrants, and those with healthy children are most sensitive to enforcement efforts. Up to seventy-five percent of the relative decline in non-citizen Medicaid participation around the time of welfare reform, which has been attributed to the chilling effects of the reform itself, is explained by a contemporaneous spike in immigration enforcement activity. The results imply that safety net participation is influenced not only by program design, but also by a broader set of seemingly unrelated policy choices.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 16278.

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Date of creation: Aug 2010
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Handle: RePEc:nbr:nberwo:16278

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  1. Anna Aizer & Janet Currie, 2002. "Networks or Neighborhoods? Correlations in the Use of Publicly-Funded Maternity Care in California," NBER Working Papers 9209, National Bureau of Economic Research, Inc.
  2. Robert Kaestner & Neeraj Kaushal, 2005. "Immigrant and native responses to welfare reform," Journal of Population Economics, Springer, vol. 18(1), pages 69-92, 07.
  3. Pia M. Orrenius & Madeline Zavodny, 2009. "The effects of tougher enforcement on the job prospects of recent Latin American immigrants," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 28(2), pages 239-257.
  4. Marianne Bitler & Jonah Gelbach & Hilary Hoynes, 2004. "Welfare Reform and Health," NBER Working Papers 10549, National Bureau of Economic Research, Inc.
  5. Thomas DeLeire & Judith A. Levine & Helen Levy, 2006. "Is Welfare Reform Responsible for Low-Skilled Women’s Declining Health Insurance Coverage in the 1990s?," Journal of Human Resources, University of Wisconsin Press, vol. 41(3).
  6. Hungerman, Daniel M., 2005. "Are church and state substitutes? Evidence from the 1996 welfare reform," Journal of Public Economics, Elsevier, vol. 89(11-12), pages 2245-2267, December.
  7. Anna Aizer, 2003. "Low Take-Up in Medicaid: Does Outreach Matter and for Whom?," American Economic Review, American Economic Association, vol. 93(2), pages 238-241, May.
  8. Buchmueller Thomas C & Lo Sasso Anthony T & Wong Kathleen N, 2008. "How Did SCHIP Affect the Insurance Coverage of Immigrant Children?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-25, January.
  9. Borjas, George J., 2003. "Welfare reform, labor supply, and health insurance in the immigrant population," Journal of Health Economics, Elsevier, vol. 22(6), pages 933-958, November.
  10. Davila, Alberto & Pagan, Jose A & Grau, Montserrat Viladrich, 1999. " Immigration Reform, the INS, and the Distribution of Interior and Border Enforcement Resources," Public Choice, Springer, vol. 99(3-4), pages 327-45, June.
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Cited by:
  1. Watson, Tara, 2013. "Enforcement and immigrant location choice," Working Papers 13-10, Federal Reserve Bank of Boston.
  2. Pia Orrenius, 2013. "How Do Tougher Immigration Measures Affect Unauthorized Immigrants?: Comment," Demography, Springer, vol. 50(3), pages 1101-1103, June.

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