Spreading Fear: The Announcement Of The Public Charge Rule Reduced Enrollment In Child Safety-Net Programs
Spreading Fear: The Announcement Of The Public Charge Rule Reduced Enrollment In Child Safety-Net Programs
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DOI：
10.1377/hlthaff.2020.00763
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发表时间：
2020-10-01
期刊：
影响因子：
9.7
通讯作者：
Barrows, Anthony
中科院分区：
文献类型：
--
作者：
Barofsky, Jeremy;Vargas, Ariadna;Barrows, Anthony
安全网计划可在短期和长期内改善低收入儿童的健康。 2018 年 9 月，特朗普政府宣布打算改变如何识别潜在“公共负担”的指导，“公共负担”的定义是主要依赖政府维持生计的非公民。在这一变化之后，移民的永久居留申请可能会因使用更广泛的安全网计划而被拒绝。我们使用县级数据调查了宣布的公共负担规则是否影响参加医疗补助、补充营养援助计划和妇女、婴儿和儿童特殊补充营养计划的儿童比例。结果显示，一个县的非公民比例每增加 1 个百分点，儿童医疗补助使用率就会减少 0.1 个百分点。在全国范围内，这意味着 260,000 名儿童的覆盖率下降。公共负担规则于 2020 年 2 月通过，就在 2019 年冠状病毒病 (COVID-19) 在美国开始大流行之前。这些结果表明，特朗普政府的公共负担公告可能导致数千名符合条件的低收入儿童在严重的健康和经济危机期间无法获得安全网支持。
Safety-net programs improve health for low-income children over the short and long term. In September 2018 the Trump administration announced its intention to change the guidance on how to identify a potential "public charge," defined as a noncitizen primarily dependent on the government for subsistence. After this change, immigrants' applications for permanent residence could be denied for using a broader range of safety-net programs. We investigated whether the announced public charge rule affected the share of children enrolled in Medicaid, the Supplemental Nutrition Assistance Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children, using county-level data. Results show that a 1-percentage-point increase in a county's noncitizen share was associated with a 0.1-percentage-point reduction in child Medicaid use. Applied nationwide, this implies a decline in coverage of 260,000 children. The public charge rule was adopted in February 2020, just before the coronavirus disease 2019 (COVID-19) pandemic began in the US. These results suggest that the Trump administration's public charge announcement could have led to many thousands of eligible, low-income children failing to receive safety-net support during a severe health and economic crisis.