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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.

Suggested Citation

  • Tara Watson, 2010. "Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation," NBER Working Papers 16278, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:16278
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    References listed on IDEAS

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    1. Davila, Alberto & Pagan, Jose A, 1997. "The Effect of Selective INS Monitoring Strategies on the Industrial Employment Choice and Earnings of Recent Immigrants," Economic Inquiry, Western Economic Association International, vol. 35(1), pages 138-150, January.
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    3. Robert Kaestner & Neeraj Kaushal, 2005. "Immigrant and native responses to welfare reform," Journal of Population Economics, Springer;European Society for Population Economics, vol. 18(1), pages 69-92, July.
    4. Tara Watson, 2014. "Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation," American Economic Journal: Economic Policy, American Economic Association, vol. 6(3), pages 313-338, August.
    5. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
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    10. repec:aph:ajpbhl:2003:93:1:67-74_9 is not listed on IDEAS
    11. Lara D. Shore-Sheppard, 2005. "Stemming the Tide? The Effect of Expanding Medicaid Eligibility on Health Insurance," NBER Working Papers 11091, National Bureau of Economic Research, Inc.
    12. Aizer, Anna & Currie, Janet, 2004. "Networks or neighborhoods? Correlations in the use of publicly-funded maternity care in California," Journal of Public Economics, Elsevier, vol. 88(12), pages 2573-2585, December.
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    14. 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 327-345, June.
    15. 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.
    16. 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.
    17. Thomas Buchmueller & Sean Orzol & Lara Shore-Sheppard, 2014. "Stability of children’s insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 109-126, June.
    18. 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.
    19. Gee Emily R. & Giuntella G. Osea, 2011. "Medicaid and Ethnic Networks," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(1), pages 1-31, December.
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    Citations

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    Cited by:

    1. James Marton & Angela Snyder & Mei Zhou, 2016. "Enhanced Citizenship Verification And Children'S Medicaid Coverage," Economic Inquiry, Western Economic Association International, vol. 54(3), pages 1670-1683, July.
    2. Mahmud, Mir, 2016. "Immigrant Children’s Access to Public Health Insurance after CHIPRA-2009," MPRA Paper 80602, University Library of Munich, Germany.
    3. Amuedo-Dorantes, Catalina & Antman, Francisca, 2016. "Can authorization reduce poverty among undocumented immigrants? Evidence from the Deferred Action for Childhood Arrivals program," Economics Letters, Elsevier, vol. 147(C), pages 1-4.
    4. Conger, Dylan & Turner, Lesley J., 2017. "The effect of price shocks on undocumented students' college attainment and completion," Journal of Public Economics, Elsevier, vol. 148(C), pages 92-114.
    5. Amuedo-Dorantes, Catalina & Averett, Susan L. & Bansak, Cynthia, 2014. "Welfare Reform and Immigrant Fertility," IZA Discussion Papers 8153, Institute for the Study of Labor (IZA).
    6. repec:spr:demogr:v:54:y:2017:i:6:d:10.1007_s13524-017-0627-6 is not listed on IDEAS
    7. Amuedo-Dorantes, Catalina & Arenas-Arroy, Esther, 2017. "Immigrant Fertility in the Midst of Intensified Enforcement," GLO Discussion Paper Series 1, Global Labor Organization (GLO).
    8. Pia Orrenius, 2013. "How Do Tougher Immigration Measures Affect Unauthorized Immigrants?: Comment," Demography, Springer;Population Association of America (PAA), vol. 50(3), pages 1101-1103, June.
    9. repec:spr:demogr:v:54:y:2017:i:6:d:10.1007_s13524-017-0617-8 is not listed on IDEAS
    10. Vargas, Edward D., 2015. "Immigration enforcement and mixed-status families: The effects of risk of deportation on Medicaid use," Children and Youth Services Review, Elsevier, vol. 57(C), pages 83-89.
    11. Julia Shu-Huah Wang & Neeraj Kaushal, 2018. "Health and Mental Health Effects of Local Immigration Enforcement," NBER Working Papers 24487, National Bureau of Economic Research, Inc.
    12. Watson, Tara, 2013. "Enforcement and immigrant location choice," Working Papers 13-10, Federal Reserve Bank of Boston.
    13. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters,in: Economics of Means-Tested Transfer Programs in the United States, volume 1, pages 21-136 National Bureau of Economic Research, Inc.
    14. Tara Watson, 2014. "Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation," American Economic Journal: Economic Policy, American Economic Association, vol. 6(3), pages 313-338, August.
    15. repec:eee:socmed:v:191:y:2017:i:c:p:19-29 is not listed on IDEAS
    16. Dylan Conger & Lesley J. Turner, 2015. "The Impact of Tuition Increases on Undocumented College Students' Attainment," NBER Working Papers 21135, National Bureau of Economic Research, Inc.
    17. Bronchetti, Erin Todd, 2014. "Public insurance expansions and the health of immigrant and native children," Journal of Public Economics, Elsevier, vol. 120(C), pages 205-219.
    18. Amuedo-Dorantes, Catalina & Arenas-Arroyo, Esther, 2017. "Immigration Enforcement and Foster Care Placements," IZA Discussion Papers 10850, Institute for the Study of Labor (IZA).

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

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