The Immigrant Access to Health and Human Services project describes the legal and policy contexts that affect immigrant access to health and human services. The study aims to identify and describe federal, state, and local program eligibility provisions related to immigrants, major barriers to immigrants’ access to health and human services for which they are legally eligible, and innovative or promising practices that can help states manage their programs. This brief describes innovative practices that community-based organizations have used to address under-enrollment of low-income immigrant families in SNAP, TANF, Medicaid, and CHIP in four states – Maryland, Massachusetts, North Carolina, and Texas.
The Immigrant Access to Health and Human Services project maps and describes the legal and policy contexts that govern and affect immigrant access to health and human services. Through a synthesis of existing information, supplemented by in-depth visits to purposively selected sites, the study aims to identify and describe federal, state, and local program eligibility provisions related to immigrants; major barriers (such as language and family structure) to immigrants’ access to health and human services for which they are legally eligible; and innovative or promising practices that can help states manage their programs.
Nearly 18 million children, or 24 percent of those ages 0 through 17, in the United States live in families with one or more foreign-born parents (see the appendix for definitions of terms). Most of these children are citizens by birth or naturalization and therefore qualify for federal means-tested programs, such as Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP). In contrast to their children, most low-income, foreign-born parents are not eligible for such programs. Mixed eligibility within families presents a particular set of challenges that may prevent families from accessing benefits for eligible children. While native-born parents may also face challenges in accessing benefits, a previous brief under this study found that foreign-born parents face additional challenges such as language or cultural barriers, unclear eligibility requirements, and fears and misperceptions about immigration consequences related to receiving benefits (Perreira et al. 2012). This brief presents data on the differences in poverty rates and receipt of SNAP and TANF1 for immigrant families versus native families. The data in this brief reveal that although children with foreign-born parents are overrepresented among poor families, they are underrepresented in public benefits enrollment.
Children with Foreign-Born Parents Are More Likely to Live in Poor Families
Children with foreign-born parents are more likely to live in poverty than children with native-born parents. As shown in the left side of figure 1, children living with at least one foreign-born parent are one and a half times as likely to live in poor families as children with native parents (23 percent of children with foreign-born parents versus 16 percent of children with native-born parents). The right side of figure 1 shows that among children with at least one foreign-born parent, poverty rates vary significantly depending on parent and child immigration status. Citizen children living with only immigrant parents (that is, living with two noncitizen parents or with a single parent who is a noncitizen) and immigrant children (who are noncitizens themselves and typically have noncitizen parents) have especially high poverty rates. The appendix defines the terms used in this chart.
Compared with children living with only native-born parents:
- Citizen children with only naturalized parents (i.e., their foreign-born parents have naturalized) are less likely to live in poor families (11 percent versus 16 percent).
- Citizen children with mixed-citizenship parents (i.e., one parent is not a citizen and one is either naturalized or native-born) are equally likely to live in poor families (15 percent versus 16 percent).
- Citizen children with only immigrant parents are more than twice as likely to live in poor families (37 percent versus 16 percent).
- Immigrant children (who typically live with only immigrant parents) are twice as likely to live in poor families (33 percent versus 16 percent).
These results suggest that the citizenship status of parents is highly associated with whether their children are living in poverty. Families with mixed-status parents (i.e., one parent is not a citizen and one is either native-born or naturalized) are no more likely to live in poverty than native-born families, and families in which both parents are naturalized citizens (or if it is a single-parent household, the only parent is a naturalized citizen) are less likely to live in poverty than native-born families. Overall poverty rates for foreign-born and native-born families do not capture important differences between citizen and noncitizen foreign-born families.
Children with Foreign-Born Parents Are Less Likely to Receive SNAP and TANF
Children living in poor families with foreign-born parents are less likely to receive SNAP and TANF than those with native-born parents, regardless of their parents’ citizenship status. As shown on the left sides of figures 2 and 3, children who live in poor families with foreign-born parents are less likely to receive SNAP and TANF than children in poor families with native-born parents. The right sides of these figures show that, regardless of parental citizenship, children in poor families with foreign-born parents are less like to receive SNAP and TANF than those with native-born parents. Because SNAP and TANF eligibility rules for naturalized citizens are the same as for native-born people, these results raise the potential that naturalized-citizen parents face other barriers to accessing SNAP and TANF, such as language or cultural barriers.
Disparity in Poverty Rates by State
Nationwide, children with foreign-born parents are more likely to live in poor families than children with native-born parents. Relative poverty rates, however, vary widely from state to state. Figure 4 shows the percentage of children with foreign-born parents living in poor families, relative to the percentage of children with native-born parents living in poor families. In most states children with foreign-born parents are more likely to live in poor families than children with native-born parents. However, there are 18 states in which poverty rates are similar across these two groups and 1 state in which children with foreign-born parents are less likely to live in poor families than children with native-born parents. These differences may be caused by a variety of factors, such as differences in the characteristics of foreign-born parents, economic opportunities, state public assistance polices, and attitudes toward the foreign-born.
Disparity in Benefit Receipt by State
In most states children living in poor families with foreign-born parents are less likely to receive SNAP or TANF than their peers who live with native-born parents. Figures 5 and 6 show the difference between the percentage of children with foreign-born parents in poor families and the percentage of children with native-born parents in poor families receiving SNAP and TANF.
In all but two states, children in poor families with foreign-born parents are less likely to receive SNAP than those with native-born parents. The two exceptions are Minnesota and Rhode Island, where SNAP receipt rates among children with foreign-born parents are less than 5 percentage points higher than rates among children with native-born parents.
In most states, children in poor families with foreign-born parents are also less likely to receive TANF benefits than those with native-born parents. In seven states, receipt of TANF is about the same for children living in poor families with both foreign-born and native-born parents. In only one state, Minnesota, children living in poor families with foreign-born parents are more likely to receive TANF than children living in poor families with native-born parents, but again the rates differ by less than 5 percentage points.
A previous brief in this series showed substantial variation across states in the provision of state-only-funded cash and food assistance for immigrants who are ineligible for federal assistance (Fortuny and Chaudry 2012). States that use state-only funds to expand benefit programs to include immigrant children and pregnant women do not always have higher rates of enrollment in benefit programs among the foreign-born. Out of the six states in our dataset that provide state-only-funded SNAP benefits (California, Connecticut, Minnesota, Nebraska, Washington, and Wisconsin), five have either lower or much lower SNAP receipt2 among children living in poor families with foreign-born parents than among their peers with native-born parents. Only Minnesota has a higher percentage of children with foreign-born parents in poor families receiving SNAP benefits.
Though only six states provide state-only-funded SNAP benefits, 22 states provide state-only-funded cash assistance, such as TANF, to some or all qualified immigrants. These states include Arizona, California, Connecticut, Georgia, Hawaii, Illinois, Iowa, Maryland, Minnesota, Nebraska, Nevada, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Utah, Washington, and Wisconsin.3 In most of these states, a lower percentage of children with foreign-born parents in poor families receives cash assistance than children with native-born parents. Only Minnesota has a higher percentage of children with foreign-born parents receiving cash assistance.
These results for both SNAP and TANF suggest that benefit receipt rates may be affected by factors other than income eligibility, such as state-to-state differences in access barriers and in the demographic characteristics of foreign-born parents. Recent research shows that families with foreign-born parents in states providing state-only SNAP benefits are more likely to receive federal SNAP benefits than their counterparts in states that do not provide state-funded SNAP benefits (controlling for other factors such as income and demographic characteristics of families with foreign-born parents) (Koball et al. 2013).
Children of foreign-born parents are more likely to live in poor families than children with native-born parents; however, poverty rates among these families vary significantly depending on whether foreign-born parents have obtained citizenship. Among children who live in poor families, children with foreign-born parents (regardless of citizenship status) are less likely to receive SNAP and TANF than children with native-born parents. These results show that not only are children with foreign-born parents more vulnerable to poverty, but they are also less likely to receive two key benefits that could help meet their basic needs.
Appendix. Methods and Definitions
Data source: The statistics used in this brief were generated by the Urban Institute Children of Immigrants Data Tool, available at http://datatool.urban.org/charts/datatool/pages.cfm. The tool’s primary data sources are the Integrated Public Use Microdata Series (IPUMS) datasets (Ruggles et al. 2010). The IPUMS datasets are drawn from the 2000 US Census of Population and Housing, 5 percent samples, and the 2008 and 2009 American Community Surveys (ACS) that together make up a 2 percent sample of the US population.
Child-parent relationships: The IPUMS data identify one or both parents if the parent(s) are living in the same household as the child. The child-parent relationship in the IPUMS data is biological and social; for example, stepfathers and adoptive fathers are identified in addition to biological fathers. In a small number of cases, child-parent relationships have been imputed using information about all household members. Child-parent relationships are not defined in the data for a small number of children. When a child is identified as a grandchild of the householder (about 2 percent of children in the sample), the immigration status of the grandparent is used to determine the immigration status and citizenship of the parent. Parental immigration status has not been determined for around 2 percent of children in the sample.
For more information on the child-parent relationship in the IPUMS data, see the IPUMS documentation on Family Interrelationships at http://usa.ipums.org/usa/chapter5/chapter5.shtml.
Income and poverty: Family income includes income from all sources for the previous 12 months for all members of the family. Poor families have family income below the federal poverty level (FPL), and low-income families have family income below twice the FPL. Poverty levels are adjusted for family size. In 2009, the FPL was $21,954 for a family of four, slightly higher for larger families, and lower for smaller families. Twice the FPL in 2009 was $43,908 for a family of four.
Public benefits: The estimates in this brief are based on self-reported data in the ACS on public benefits receipt. There is significant underreporting of public benefits use in the ACS (as well as other large nationally representative surveys) when reported receipt is compared with administrative data (Meyer, Mok, and Sullivan 2009).
Cash assistance income includes Temporary Assistance for Needy Families and General Assistance payments received during the past 12 months. Cash assistance receipt is for anyone in the family.
Food assistance is defined as Food Stamp or Food Stamp benefit card receipt for anyone in the household for the last 12 months. This includes government benefits from the Supplemental Nutrition Assistance Program (SNAP), the new name for the Food Stamp Program. It does not include the Special Supplemental Nutrition Program for Women, Infants, and Children or the National School Lunch Program. The relevant question in the ACS does not make the distinction between SNAP and the food assistance that the state funds, so both are captured in the responses.
Foreign-born: Someone born outside the United States and its territories, except those born abroad to US-citizen parents. The foreign-born include those who have obtained US citizenship through naturalization and people in different immigration statuses. People born in the United States, Puerto Rico, and other territories, or born abroad to US-citizen parents, are native-born.
Immigrant: A foreign-born person who is not a citizen of the United States as defined by the Immigration and Nationality Act, Section 101 and the following (similar to the statutory term “alien”). This definition of immigrant is narrower than some common definitions that treat any foreign-born person as an immigrant, including those who have become naturalized citizens. Since a central focus of this study is on immigrant eligibility, and citizenship is a key factor in determining eligibility for benefit programs, this brief adheres to the legal definition of immigrant.
Lawful permanent residents (LPRs): People lawfully admitted to live permanently in the United States by either qualifying for immigrant visas abroad or adjusting to permanent resident status in the United States. Many but not all LPRs are sponsored (i.e., brought to the United States) by close family members or employers.
Naturalized citizens: LPRs who have become US citizens through naturalization. Typically, LPRs must be in the United States for five or more years to qualify for naturalization. Immigrants who marry citizens can qualify in three years, and some smaller categories can qualify sooner. LPRs generally must take a citizenship test—in English—and pass background checks before qualifying to naturalize.
Children with foreign-born parents have at least one foreign-born parent living in the household. This includes children with a single foreign-born parent living in the household.
Children with only immigrant parents are children with foreign-born parents who are not US citizens or a single foreign-born parent who is not a citizen.
Children with only naturalized-citizen parents are children with one or two parents who are naturalized US citizens and no noncitizen parents. Children with one naturalized-citizen parent and one native-born parent are included in this category.
Children with native-born parents live with two parents who are both native-born or a single parent who is native-born. Less than 1 percent of children with native-born parents are foreign-born.
Children with mixed-citizenship parents are children with foreign-born parents who have one US-citizen parent and one noncitizen (immigrant) parent. Children with one noncitizen (immigrant) parent and one native-born parent are included in this category.
1. Because of limitations in how the American Community Survey reports public assistance and welfare payments, references to TANF receipt throughout this brief may include receipt of additional cash assistance benefits. SNAP receipt may include receipt of other state-funded food stamps.
2. Maine and Wyoming also provide state-only-funded food assistance but are excluded because of insufficient observations in our dataset.
3. Maine and Wyoming are excluded because of insufficient observations in our dataset.
About the Authors
Devlin Hanson is a research associate in the Center on Labor, Human Services, and Population at the Urban Institute; she is a labor economist whose research focuses on vulnerable children and families, including child welfare involving families and immigrant families. Hanson specializes in conducting analysis using large longitudinal and cross-sectional administrative and public-use microdata, including the American Community Survey and the decennial Census.
Heather Koball is a senior fellow in the Center on Labor, Human Services, and Population, where her areas of expertise include immigration and at-risk youth. Koball has directed multiple projects on issues faced by children of immigrants, including a study of the well-being of children whose families have been affected by immigration enforcement, access to public benefits among immigrant families, the implications of the Affordable Care Act for immigrants’ health care, and immigrant integration in new destination areas.
Karina Fortuny is currently employed at the Trust for Social Achievement (TSA) foundation in Sofia, Bulgaria. TSA’s mission is to support innovative, results-driven approaches that increase self-sufficiency and improve life outcomes for Bulgaria’s poor, with a focus on the Roma. While working on this project, Fortuny was a research associate at the Urban Institute. Her work at Urban focused on immigrants and minorities.
Ajay Chaudry was until recently the deputy assistant secretary for human services policy in the Office of the Assistant Secretary for Planning and Evaluation at the US Department of Health and Human Services. From 2007 to 2011, he was a senior fellow and director of the Center on Labor, Human Services, and Population at the Urban Institute, and contributed to this project in that capacity. Chaudry has led public policy research on child poverty, child well-being and development, human services programs in the social safety net, and the early childhood care system. From 2004 to 2006, he was deputy commissioner for child care and Head Start at the New York City Administration for Children’s Services, where he oversaw early childhood develop-ment programs serving 150,000 children in low-income families. He is the author of Putting Children First: How Low-Wage Working Mothers Manage Child Care.
This issue brief is one of several under the Immigrant Access to Health and Human Services project; for more information, see http://aspe.hhs.gov/hsp/11/ImmigrantAccess/index.shtml.
This study was conducted by the Urban Institute under contract number HHSP23320095654WC, task order number HHSP2333014T, with the Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation. The authors take full responsibility for the accuracy of material presented herein. The views expressed are those of the authors and should not be attributed to ASPE or DHHS.