Association for Public Policy Analysis & Management

Since the 1990s, the US has experienced a new era of immigration marked by record waves of arrivals; dispersion to new destinations; and growth in state and local immigrant policies. Many states and local communities are struggling to adapt to the needs of their first cohorts of immigrants and have adopted policies as a means to regulate immigration within their borders. Though some of these policies have been supportive most are restrictive and aggressively anti-immigrant. 

One of the largest localized efforts to regulate immigration has been the adoption of federal-local partnerships that deputize state and local police to enforce immigration law. Federal immigration reform adopted in 1996 delegated federal immigration powers to state and local governments for the first time through the 287(g) program. During its tenure, the 287(g) program allowed state and local law enforcement to apprehend individuals suspected of residing in the country illegally. Since then, 287(g) and its successor programs, i.e., Secure Communities and the Priority Enforcement Program, have been highly criticized for gross misuse; critics argue local law enforcement use these programs as a universal means to deport unauthorized immigrants. 

These localized immigration enforcement efforts have contributed significantly to the nation’s record deportation levels, which has strong implications for the health and well-being of immigrant families. Deportations and enforcement policies increase the economic disadvantage of family members left behind and generate fear and mistrust in the immigrant community. Growing qualitative and small-scale survey research confirms the health consequences of these enforcement efforts: lower access to health and social services, increased economic hardship, and greater mental distress.

Building on this strong qualitative evidence, we examine how localized immigration enforcement policies impact health care utilization and overall health on a national-level. In so doing, we advance the current literature in three ways. First, we provide a larger-scale assessment of the health consequences of localized immigration enforcement policies. Second, we examine the implications of a broader range of localized immigration enforcement policies. Prior research has mostly focused on 287(g), which officially ended in 2012. We examine 287(g) and its narrower successor programs. We also examine the implications of policies beyond localized policing. Symbolic policies, such as English only laws, may make it more difficult to access health services. Lastly, with our data and identification strategy we provide a stronger causal assessment.    

For our analysis, we use two nationally representative datasets: the public-use Current Population Survey and the restricted-use National Health Interview survey, only accessible in a Restricted Data Center. Taking advantage of the spatial and temporal variation in the adoption of these localized policies we utilize difference-in-difference models to examine how localized immigration enforcement policies impact health care access and utilization (Medicaid, delayed medical care, usual place of care) and overall health (self-reported health) and mental health (depression and anxiety) for immigrant children and their families. Our preliminary results indicate that localized immigrant enforcement policies negatively impact the families most likely to be unauthorized, Mexican foreign-born non-citizens, but also have negative spillover effects on immigrants and Hispanics in general.