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Administration Actions Against Immigrant Families Harming Children Through Increased Fear, Loss of Needed Assistance

These children represent an important part of our nation’s future.One in four U.S. children — about 18 million children under age 18 — live with at least one immigrant parent.[1]  About 5 million children live with an unauthorized immigrant parent, and nearly 80 percent of these children are U.S. citizens;[2] the other 13 million live with a parent who is foreign born but either a legal resident or a U.S. citizen.  These children represent an important part of our nation’s future.  Unfortunately, the Trump Administration has taken several steps that have harmful consequences, in both the short and long term, for children in immigrant families and their communities.

The Administration has:

  • Stepped up immigration arrests in line with the President’s January 2017 executive order listing virtually any immigrant without legal immigration status as a priority for deportation.[3]  This is a departure from the prior policy, which identified specific categories of undocumented immigrants as priorities.
  • Declared an end to the Deferred Action for Childhood Arrivals (DACA) program, which shielded about 800,000 young undocumented immigrants from deportation and permitted them to legally work and drive in the United States.  (Court injunctions have temporarily halted the Administration action.)[4]
  • Announced that it will end Temporary Protected Status (TPS) for about 390,000 immigrants from Central America, Haiti, Nepal, and Sudan.  TPS is granted to foreign nationals who cannot return to their homelands, which either have unsafe conditions or are unable to handle the return of their nationals.  TPS allows individuals to work and drive legally in the United States.[5]  An estimated 273,000 U.S.-born children whose parents are TPS recipients from El Salvador, Honduras, and Haiti will have to leave or separate from their parents due to this policy change.[6]
  • Signed into law a tax bill denying the Child Tax Credit to roughly 1 million low-income children in working families who lack a Social Security number even though their parents pay payroll taxes and other taxes.[7]
  • Drafted a proposed rule that would put immigrants at risk of being denied a green card if their family members, including U.S. citizen children, receive certain government benefits for which they are fully eligible under federal law.[8]
  • Endorsed legislation that would harm immigrant communities, including the Reforming American Immigration for a Strong Economy (RAISE) Act, which would deny basic food and medical assistance to family members of new immigrants; the No Sanctuary for Criminals Act, which would bar federal grants from sanctuary cities; and Kate’s Law, which would increase penalties for those charged criminally for reentry into the United States.
  • Used inflammatory, prejudiced rhetoric against immigrants and people of color.[9]  This has amplified fear and stress among immigrants by directly intimidating them and indirectly fomenting discriminatory acts against them.[10]

Increased fear of deportation and potential changes in the immigration consequences of receiving benefits such as food and medical assistance have led some immigrant families — including families with citizen children — to forgo needed assistance for which they or their children are eligible.

Policies that lead families to forgo nutrition and medical assistance for eligible children or impose new restrictions on benefit receipt could adversely affect these children’s health and well-being, their success in school, and ultimately their potential to contribute to our country’s future prosperity.  Numerous studies indicate that government assistance programs can have positive effects on children’s development.[11]  For example, studies have found that:

  • People with access to SNAP (food stamps) as young children are likelier to complete high school and have lower rates of certain health problems in adulthood, such as heart disease and obesity.
  • People with health coverage through Medicaid in childhood have better health as adults, with fewer hospitalizations and emergency room visits; they also earn more and pay more in taxes.
  • Children whose families receive more income through the Earned Income Tax Credit and other tax credits for low- and moderate-income working families tend to score better on reading and math tests in middle school and are likelier to graduate from high school and attend college.

In addition, the severe stress that children of immigrants can face due to fear that they or their parents will be deported may create “toxic stress,” which studies show can alter children’s brain development in ways that affect their school performance and health and earnings in adulthood.

Rising Fear and Anxiety in Immigrant Communities

A range of organizations that provide nutrition, health, education, and public safety services report that a number of their clients — citing fear due to Trump Administration actions — are afraid to seek or to continue receiving needed services for themselves or their children, including many U.S. citizen children.

Community anti-hunger groups have seen eligible families declining to enroll in, or even disenrolling from, nutrition assistance programs such as SNAP, free school lunches, and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).[12]  The National WIC Association has received stories from across the country about families expressing concern to local WIC providers about White House immigration pronouncements.[13]  Local health centers that serve immigrant communities have seen a decline in enrollment in Medicaid and local health programs.[14]  Early education programs have reported lower attendance, fewer applicants, and reduced parent participation in classrooms and at events.[15]  Mayors, prosecutors, and police officials have reported that, due to a climate of fear, fewer immigrants are cooperating with law enforcement — often declining to report crimes or testify in court cases.[16]

This climate of fear partly reflects more aggressive practices by U.S. Immigration and Customs Enforcement (ICE) officials, researchers have found.[17]  ICE officials, sometimes out of uniform, have reportedly patrolled and arrested immigrants near places like schools, hospitals, and service providers.[18]  As a result, some families are afraid to leave their homes.  For example, a mother in California said she didn’t send her children to school for a week because she heard ICE officials were in the area.  Another parent noted, “Even going to places like the library or to buy groceries, one no longer feels safe just walking like before.  You don’t know when you’re going to run into ICE.”[19]  Local officials, justices, attorneys, and advocates have also criticized ICE for seeking and arresting immigrants in front of courthouses because it may deter them from attending hearings and testifying about crimes.[20]

Numerous articles and studies have documented the growing fear, stress, and hardship among immigrant families.  Some parents, fearing deportation, are picking guardians for their U.S.-born children.[21]  Some families are so fearful that they’re forgoing assistance even in the direst circumstances, such as recovering after a natural disaster.  Only 40 percent of immigrants with property damage to their homes due to Hurricane Harvey applied for emergency federal assistance from either the Federal Emergency Management Agency or the Small Business Administration after the hurricane, compared to 64 percent of native-born residents, a Kaiser Family Foundation study found.  And 48 percent of immigrants with home damage said they were worried that requesting help would draw unwanted attention to their or a family member’s immigration status.[22]

Although immigrant parents often try to shield their children from these issues, children apparently are experiencing acute stress as well, either directly or more generally through their parents.  For example, nearly 90 percent of school administrators representing over 730 schools in 12 states noted observing behavioral or emotional problems with their students that appear related to concerns about immigration enforcement, a survey done between October 2017 and January 2018 found.[23]  These behavioral problems usually included crying, refusing to speak, being distracted, and acting anxious or depressed.  Many respondents indicated that their immigrant students (whether U.S.-born or not) were terrified that their families and friends, and occasionally they themselves, might be picked up by ICE.  Students were worried about losing their parents and having to survive on their own and look after their siblings.  About 70 percent of administrators and school staff reported noticing a decline in student academic performance that may be related to concerns about immigration issues.  Many respondents also reported that some students’ family members had been deported and that the entire school community was aware of these incidents, reinforcing students’ fears about their own families.[24]

Fear of familial separation has disrupted children’s daily routines as well.  In fact, many citizen children with undocumented parents feel the need to take on “parent-like” roles to protect their parents.  These children are thus exercising extreme caution and hyper-vigilance within their communities and withdrawing themselves.  For example, children are reportedly more fearful and distrusting of police, possibly because they cannot distinguish confidently between the roles of immigration officers and local law enforcement.[25]  “[Children] see the fear in their parents, and they try to respond to it and alleviate it, which are things a kid shouldn’t have to do,” stated Dr. Charles Sophy, medical director of the Los Angeles County Department of Family Services.[26]

The climate of fear and anxiety extends beyond the unauthorized population, in part due to confusion about existing policy or concerns about future policy changes.  In a recent survey of 213 Latino parents of adolescent children, published in the Journal of Adolescent Health, 33 percent reported changes in daily routines, 39 percent avoided medical care, police, and services, and 66 percent feared familial separation.[27]  This fear extended across the immigrant population, regardless of legal status.  For example, 88 percent of undocumented parents, 84 percent of TPS status holders, 57 percent of legal residents, and 22 percent of U.S. citizen Latino parents surveyed worried “very often” or “almost always/always” that family members will be separated due to immigration enforcement actions.

In addition, 23 percent of a representative sample of Los Angeles County residents were afraid that they, a family member, or a friend would be deported because of their immigration status, a poll released in April 2018 found.  Of those, 71 percent said that enrolling in a government health, education, or housing program would raise the risk of deportation.[28]  The survey found a decline in anxiety over deportation from March 2017, but it’s unclear if this decline indicates a nationwide trend; other studies and media reports from late 2017 and early 2018 document continued high levels of fear and anxiety in immigrant communities.[29]

Studies have begun to document harmful effects of the Administration’s immigration policies on children’s mental health and well-being.[30]  Experts note that rising fear is affecting children’s behavior and could do lasting harm.  Immigrant parents and pediatricians who serve immigrant communities have indicated that growing fear and anxiety among children are contributing to behavioral issues, psychosomatic symptoms, and mental health issues, according to interviews during the fall of 2017.[31]  For example, children are experiencing problems sleeping and eating, restlessness and agitation, headaches, nausea, panic attacks, and depression.  Some pediatricians mentioned an increase in school reports of attention-deficit/hyperactivity disorder as well, which they believe may stem from anxiety or stress.  Children also may not be receiving needed care and attention if their parents are likewise experiencing significant stress and anxiety.[32]

Previous research has shown that fear and stress about immigration enforcement aren’t limited to unauthorized immigrants.  Sociologist Joanna Dreby finds that children in immigrant families, regardless of their immigration status or whether a family member has been deported, were prone to emotional distress, fears of separation, and conflating immigration with illegality.[33]  A University of Michigan study found that the stress from a large immigration raid in 2008 in Postville, Iowa was associated with Latina mothers delivering babies with lower birth weights, regardless of their immigration status.[34]  The increased risk of low birth weight applied to infants born to both immigrant and U.S.-born Latinas, the authors found; white mothers’ infants, on the other hand, had no change in risk of low birth weight.  The researchers explained that psychosocial stressors can affect pregnant mothers by shifting stress hormone balances in ways that trigger premature birth or lead to growth restriction and low birth weight even for babies born at full term.  Low birth weight is associated with worse adult outcomes in health, educational attainment, and earnings.[35]

Experts warn that the fear may be severe enough in some cases to physically harm children, such as by altering the architecture of their developing brains. Young children who live in severely stressful situations, and whose parents or caregivers cannot effectively cushion against this stress, may experience what is called “toxic stress.”  This stress can alter the physical growth and functioning of children’s brains in ways that impede their ability to thrive in school and develop the social and emotional skills to function well in adulthood, according to researchers at Harvard’s Center on the Developing Child.[36]

Disparities in exposure to stress and related stress hormones may help explain why some children have lower levels of cognitive ability and achievement as well as poorer health later in life, researchers say.  High childhood stress has been linked to “a host of inflammatory diseases later in life” such as early-onset arthritis, according to Kathleen M. Ziol-Guest, Greg Duncan, and their colleagues.[37]

For this reason, the current climate of fear puts children at risk of adverse health effects and poor outcomes.  In fact, in January 2017, the American Academy of Pediatrics (AAP) assessed President Trump’s immigration executive orders as harmful for the health of children in immigrant families.  AAP President Fernando Stein wrote:

Far too many children in this country already live in constant fear that their parents will be taken into custody or deported, and the message these children received today from the highest levels of our federal government exacerbates that fear and anxiety.  No child should ever live in fear.  When children are scared, it can impact their health and development.  Indeed, fear and stress, particularly prolonged exposure to serious stress — known as toxic stress — can harm the developing brain and negatively impact short- and long-term health.[38]

Failure to Receive Needed Assistance Can Hurt Children’s Future

Government health insurance programs and economic security programs such as food assistance, housing subsidies, and working-family tax credits not only bolster income, help families afford basic needs, and keep millions of children above the poverty line; they also have longer-term benefits, studies say: they help children thrive in school and lift their earning power in adulthood.[39]  Thus, policies that either lead families not to apply for benefits for their eligible children or deny aid to eligible children can have negative long-term consequences.

One way that assistance programs help children is by improving nutrition in their earliest years, starting before birth.  Researchers note that even mild voluntary daytime fasting in the first trimester of pregnancy is associated with lower child test scores by age 7,[40] as well as lower adult earnings and a 20 percent increase in the likeliness of disability, especially mental disability.[41]  Similar effects may have been at play when SNAP (then called the Food Stamp Program) was phased in across the country in the 1960s and 1970s; rising birth weights in the newly served areas indicated that newborn health improved promptly after the program arrived.[42]  The researchers found that adults given access to food stamps as young children had lower rates of certain health problems such as heart disease and obesity, and women who had access to food stamps as young children showed improved economic self-sufficiency.  High school completion, in particular, rose dramatically.  Poor nutrition in early childhood has been linked with a lifelong shift in the body’s metabolism and a cluster of chronic metabolism-related illnesses including diabetes, high blood pressure, and heart disease, a connection that researchers say may explain food stamps’ lasting effects on reducing these illnesses in early adulthood.[43]

SNAP’s strong, positive impact on children’s near- and longer-term well-being is one reason it is available to legal immigrant children during their first five years in the United States, even though adults are barred from participation during their first five years here.

Similarly, extensive research finds that WIC improves the nutrition and health of low-income families — leading to healthier infants, more nutritious diets and better health care for children, and subsequently to higher academic achievement for students.[44]  Women who participate in WIC give birth to healthier babies who are more likely to survive infancy.  Children whose mothers participated in WIC while pregnant scored higher on assessments of mental development at age 2 than similar children whose mothers did not participate, and they later performed better on reading assessments while in school.

Obtaining access to health care through Medicaid also offers long-term benefits.[45]  Children eligible for Medicaid do better in school and miss fewer school days due to illness or injury; they also are likelier to graduate from high school and college.[46]  Moreover, people eligible for Medicaid in childhood have better health as adults, with fewer hospitalizations and emergency room visits, research shows.[47]  They also earn more and pay more in taxes as adults, on average.[48]

Other economic security programs have been found to improve health outcomes at birth, raise reading and math test scores in middle school, increase high school completion and college entry, lift lifetime income, and extend longevity.  The findings come from programs such as the Earned Income Tax Credit and Child Tax Credit, anti-poverty and welfare-to-work pilot programs in the 1990s, an early 1900s public assistance program for mothers, and a number of negative income tax experiments in the late 1960s through early 1980s.  In addition, housing vouchers that help poor families move to less poor neighborhoods before their children turn 13 have been found to raise young-adult earnings by approximately 30 percent.[49]

Recognizing that these economic security programs have an important impact on children’s long-term trajectories, federal and state policymakers have acted to ensure that children in immigrant families have access to these benefits.  As noted, lawfully present immigrant children can receive SNAP without the five-year wait imposed on adults.  Similarly, many states have opted to give immigrant children access to Medicaid and the Children’s Health Insurance Program (CHIP) without the five-year wait.[50]  Nevertheless, U.S. citizen children in low-income immigrant families have lower participation rates in safety net programs than U.S. children in low-income native-born families.[51]  If immigration-related policies lead families to forgo benefits that children need, it could adversely affect these children’s health, well-being, and long-term success. 

Conclusion:  Helping All Children Reach Full Potential Should Be Priority

Children in immigrant families represent an important part of our nation’s future prosperity; public policies should aim to help them reach their full potential.  Harsh rhetoric on immigration, aggressive enforcement actions, and legislative changes that deny needed assistance to children living in immigrant families can create damaging stress in immigrant communities and impose roadblocks to needed assistance.  The weight of research evidence suggests that toxic stress can have a long-term damaging effect on children and that economic security programs not only reduce low-income children’s poverty and hardship in the near term, but also improve their future health and productivity and ability to contribute to their communities in ways that benefit society as a whole.  Therefore, policies that create harmful stress and lead families to forgo needed assistance for eligible children will negatively affect these children and weaken their ability to contribute to society.

End Notes

[1] Jie Zong, Jeanne Batalova, and Jeffrey Hallock, “Frequently Requested Statistics on Immigrants and Immigration in the United States,” Migration Policy Institute, February 8, 2018,

[2] Randy Capps, Michael Fix, and Jie Zong, “A Profile of U.S. Children with Unauthorized Immigrant Parents,” Migration Policy Institute, January 2016,

[3] Sarah Pierce and Andrew Selee, “Immigration under Trump: A Review of Policy Shifts in the Year Since the Election,” Migration Policy Institute, December 2017,; National Immigration Law Center, “Understanding Trump’s Executive Order Affecting Deportations and ‘Sanctuary’ Cities,” revised February 24, 2017,; and Brian Bennett, “Not Just ‘Bad Hombres’: Trump is Targeting up to 8 Million People for Deportation,” Los Angeles Times, February 4, 2017,

[4] Two separate preliminary federal court injunctions have halted the cancellation of DACA and required U.S. Citizenship and Immigration Services to continue accepting DACA renewal applications.  In addition, a third injunction has given the Department of Homeland Security 90 days after April 24, 2018 to better justify its reasoning for canceling the program.  If it fails to do so, the department will have to process renewal and new DACA applications.  For more, see Miriam Jordan, “U.S. Must Keep DACA and Accept New Applications, Federal Judge Rules,” New York Times, April 24, 2018, and National Immigration Law Center, “DACA,” April 25, 2018,

[5] Currently, TPS protects immigrants from ten countries, six of which will lose their TPS designation at varying points in 2018 and 2019: Sudan, Nicaragua, El Salvador, Haiti, Nepal, and Honduras.  For more, see Nick Miroff, Seung Min Kim, and Joshua Partlow, “U.S. embassy cables warned against expelling 300,000 immigrants. Trump officials did it anyway,” Washington Post, May 4, 2018,

[6] Robert Warren and Donald Kerwin, “A Statistical and Demographic Profile of the US Temporary Protected Status Populations from El Salvador, Honduras, and Haiti,” Center for Migration Studies, August 2017,

[7] Jacob Leibenluft, “Tax Bill Ends Child Tax Credit for About 1 Million Children,” Center on Budget and Policy Priorities, December 18, 2017,

[8] The regulation has not been officially proposed.  The draft regulation was partly leaked to the Washington Post and is now at the Office of Management and Budget for clearance.  Nick Miroff, “Trump proposal would penalize immigrants who use tax credits and other benefits,” Washington Post, March 28, 2018,

[9] Josh Dawsey, “Trump derides protections for immigrants from ‘shithole’ countries,” Washington Post, January 12, 2018, and German Lopez, “Donald Trump’s long history of racism, from the 1970s to 2018,” Vox, January 14, 2018,

[10] Dara Lind, “Trump wants immigrants to be afraid. 2 new studies show it’s working.,” Vox, March 5, 2018, and Samantha Artiga and Petry Ubri, “Living in an Immigrant Family in America: How Fear and Toxic Stress are Affecting Daily Life, Well-Being, & Health,” Kaiser Family Foundation, December 13, 2017,

[11] For citations to individual studies, see the body of this report.

[12] Pam Fessler, “Deportation Fears Prompt Immigrants to Cancel Food Stamps,” National Public Radio, March 28, 2017,; Caitlin Dewey, “Immigrants are going hungry so Trump won’t deport them,” Washington Post, March 16, 2017,; and Emily Baumgaertner, “Spooked by Trump Proposals, Immigrants Abandon Public Nutrition Services,” New York Times, March 6, 2018,

[13] National WIC Association, “In Defense of WIC: Guidance for Navigating Uncertainty around WIC and Immigration,” February 9, 2017,

[14] Annie Lowrey, “Trump’s Anti-Immigrant Policies Are Scaring Eligible Families Away From the Safety Net,” The Atlantic, March 24, 2017, and Rebecca Plevin, “Los Angeles Health Clinic ‘A Microcosm’ of the Nation’s Anxieties,” National Public Radio, March 25, 2017,

[15] Wendy Cervantes, Rebecca Ullrich, and Hannah Matthews, “Our Children’s Fear: Immigration Policy’s Effects on Young Children,” Center for Law and Social Policy, March 1, 2018,

[16] Michelle Mark, “Trump’s Immigration Crackdown Appears to be Having an ‘Alarming’ Effect on Public Safety,” Business Insider, March 27, 2017, and James Queally, “Latinos are Reporting Fewer Sexual Assaults Amid a Climate of Fear in Immigrant Communities, LAPD says,” Los Angeles Times, March 21, 2017,

[17] Cervantes, Ullrich, and Matthews.

[18] Ibid.

[19] Ibid.

[20] Mica Rosenberg, “U.S. immigration agency clarifies policy on courthouse arrests,” Reuters, January 31, 2018,

[21] Akilah Johnson, “Parents, fearful of deportation, make plans for their children,” Boston Globe, March 18, 2018, and Colleen Shalby, “Parents ask: What happens to my child if I’m deported?” Los Angeles Times, March 22, 2017,

[22] Bryan Wu et al., “Hurricane Harvey: The Experiences of Immigrants Living in the Texas Gulf Coast,” Kaiser Family Foundation, March 20, 2018,

[23] Patricia Gándara and Jongyeon (Joy) Ee, “U.S. Immigration Enforcement Policy and Its Impact on Teaching and Learning in the Nation’s Schools,” UCLA Civil Rights Project, February 28, 2018,

[24] Ibid.

[25] Cervantes, Ullrich, and Matthews.

[26] Ruben Castaneda, “Immigrant Kids Protective of Their Parents Face Anxiety, Substance Misuse,” U.S. News & World Report, December 18, 2017,

[27] Kathleen M. Roche et al, “Impacts of Immigration Actions and News and the Psychological Distress of U.S. Latino Parents Raising Adolescents,” Journal of Adolescent Health, January 29, 2018,

[28] George Foulsham, “Rising Housing Costs Cause Serious Concerns — Especially for Young People — New UCLA Luskin Survey Finds,” UCLA Luskin School of Public Affairs, April 16, 2018,

[29] Gándara and Ee; Roche et al; and Alexia Elejalde-Ruiz, “Fear, anxiety, apprehension: Immigrants fear doctor visits could leave them vulnerable to deportation,” Chicago Tribune, February 22, 2018,

[30] Cervantes, Ullrich, and Matthews; Artiga and Ubri; Gándara and Ee; Roche et al.; and The Children’s Partnership, “The Effect of Hostile Immigration Policies on Children’s Mental Health,” March 2017,

[31] Artiga and Ubri.

[32] Ibid.

[33] Joanna Dreby, “The Burden of Deportation on Children in Mexican Immigrant Families,” Journal of Marriage and Family, 2012,

[34] Nicole L. Novak, Arline T. Geronimus, and Aresha M. Martinez-Cardoso, “Change in Birth Outcomes Among Infants Born to Latina Mothers After a Major Immigration Raid,” International Journal of Epidemiology, January 23, 2017,

[35] Janet Currie, “Inequality at Birth: Some Causes and Consequences,” American Economic Review, May 2011,

[36] National Scientific Council on the Developing Child, “Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper 3,” 2005/2014, updated edition,

[37] Kathleen M. Ziol-Guest et al., “Early Childhood Poverty, Immune-Mediated Disease Processes, and Adult Productivity,” Proceedings of the National Academy of Sciences, vol. 109, October 16, 2012, pp. 17289–17293,

[38] Fernando Stein, “American Academy of Pediatrics Statement on Protecting Immigrant Children,” January 25, 2017,

[39] Hilary W. Hoynes and Diane Whitmore Schanzenbach, “Safety net investments in children,” Brookings Papers on Economic Activity, March 8, 2018, and Arloc Sherman and Tazra Mitchell, “Economic Security Programs Help Low-Income Children Succeed Over Long Term, Many Studies Find,” Center on Budget and Policy Priorities, July 17, 2017,

[40] Douglas Almond, Bhashkar Mazumder, and Reyn van Ewijk, “Fasting During Pregnancy and Children’s Academic Performance,” Center for the Economics of Education Discussion Paper 134, 2012,

[41] Douglas Almond and Bhashkar Mazumder, “Health Capital and the Prenatal Environment: The Effect of Maternal Fasting During Pregnancy,” National Bureau of Economic Research Working Paper 14428, October 2008,

[42] Douglas Almond, Hilary W. Hoynes, and Diane Whitmore Schanzenbach, “Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes,” Institute for Research on Poverty Discussion Paper 1359-08, October 2008,

[43] Hilary Hoynes, Diane Whitmore Schanzenbach, and Douglas Almond, “Long-Run Impacts of Childhood Access to the Safety Net,” American Economic Review, vol. 106, no. 4, April 2016, pp. 903–934.  An earlier version of the paper is at

[44] Steven Carlson and Zoë Neuberger, “WIC Works: Addressing the Nutrition and Health Needs of Low-Income Families for 40 Years,” Center on Budget and Policy Priorities, March 29, 2017,

[45] Jessica Schubel, “Medicaid Helps Schools Help Children,” Center on Budget and Policy Priorities, April 18, 2017,; Elizabeth Cornachione, Robin Rudowitz, and Samantha Artiga, “Children’s Health Coverage: The Role of Medicaid and CHIP and Issues for the Future,” Kaiser Family Foundation, June 27, 2016,; and Center on Budget and Policy Priorities, “Medicaid Works for Children,” January 19, 2018,

[46] Sarah Cohodes et al., “The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions,” National Bureau of Economic Research Working Paper 20178, revised October 2014,

[47] Laura R. Wherry et al., “Childhood Medicaid Coverage and Later Life Health Care Utilization,” National Bureau of Economic Research Working Paper 20929, revised October 2015,

[48] David W. Brown, Amanda E. Kowalski, and Ithai Z. Lurie, “Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?” National Bureau of Economic Research Working Paper 20835, January 2015,

[49] Raj Chetty, Nathaniel Hendren, and Lawrence Katz, “The Effects of Exposure to Better Neighborhoods on Children: New Evidence from the Moving to Opportunity Experiment,” Harvard University and National Bureau of Economic Research, August 2015,

[50] National Immigration Law Center, “Medical Assistance Programs for Immigrants in Various States,”; “State-Funded Food Assistance Programs,”; “State-Funded TANF Replacement Programs,”

[51] Leighton Ku and Brian Bruen, “Poor Immigrants Use Public Benefits at a Lower Rate than Poor Native-Born Citizens,” CATO Institute, March 4, 2013,