Undocumented parents fear enrolling their U.S.-born children for insurance

The National Immigration Law Center is hearing more stories of undocumented citizens skipping medical appointments or not signing up their U.S.-born children for healthcare coverage over concerns they'll be deported.

"When you are hearing stories of people being picked up off the street, it has created a level of fear that wasn't there before," said Alvaro Huerta, a staff attorney at the center.

Huerta is referring to the rise in arrests of people living in the U.S. illegally. There was a 40% increase in the number of arrests made in the first six months of this year, compared with the same period last year, according to data from U.S. Immigration and Customs Enforcement.

ICE arrested 75,045 undocumented immigrants from January to June of 2017. Of those, 19,752 or 26% were classified as non-criminals. In the same period for 2016 under the Obama administration, ICE made 54,683 arrests, of which 15%, or 8,053, were noncriminal.

Children Now, a nonpartisan research firm, earlier this year said that a survey of undocumented residents in California reported reluctance in sharing information, decreases in the number of child health appointments and a bump in the number of no-show appointments.

If continued, those actions could have huge ramifications. About 11 million undocumented people live in the U.S. and an estimated 80% of their children are American citizens.

A federal advisory panel that includes providers has asked the CMS to issue guidance or outreach materials assuring undocumented parents of U.S.-born children that they can sign their kids up for Medicaid or the Children's Health Insurance Program without fear of information being used to flag them for deportation.

One agency's assurance likely wouldn't quell fears, said Mara Youdelman, managing attorney at the National Health Law Program.

Earlier this year, President Donald Trump drafted an executive order that declared the Privacy Act, a federal law that protects individuals' information in government databases, applies only to U.S. citizens and lawful permanent residents. Trump has yet to sign the order.

Attorneys cautioned that information submitted on Medicaid and CHIP applications is used only to determine eligibility for the program, but the order still had a chilling effect.

Last month, HHS' Advisory Panel on Outreach and Education said that the current increased attention around immigration could help aid outreach efforts.

"We had created documents, resources and handouts for families, but that has been put on hold for the time being," said Jessica Beauchemin, who works in the strategic marketing group in the CMS' office of communication, at one of the panel's meetings. She did not say why the effort was halted.

A CMS spokeswoman declined comment on the effort and said the agency doesn't gather data on how many U.S.-born children with undocumented parents are on Medicaid or CHIP.

Beauchemin noted that the CMS regularly schedules enrollment outreach for all eligible children. She cited two webinars-one that took place late in the Obama administration aimed at increasing enrollment in Hispanic communities and one that took place back in January aimed at encouraging enrollment for multi-generational families. Neither appeared to specifically target undocumented parents.

It may be too late to reassure the skittish population, said Nadereh Pourat, a UCLA professor who studies the use of health services among the undocumented. After the arrests earlier this year of Oscar and Irma Sanchez, an undocumented couple who were detained at a Corpus Christi, Texas, hospital after admitting their baby for emergency surgery, many worry about seeking medical care without facing deportation.

"You cannot place ICE agents in hospitals or other places where people are likely to request benefits for emergencies and then assure people they are safe to apply for citizen children," Pourat said

A spokesperson for Customs and Border Protection told NPR that agents are required to monitor subjects in custody "at all times" and tried to do so at the hospital "in the least restrictive manner possible."