Immigrants’ access to public benefits and work supports raises difficult challenges that bear on federalism, equity, budget, and integration issues. While legal immigrants had historically been eligible for benefits on the same terms as citizens, these rules changed with the 1996 Welfare Reform law.

The 1996 Welfare Reform law changed the landscape and represented a major departure in welfare and integration policy in the United States. Prior to the law’s enactment, legal immigrants were eligible for public benefits on more or less the same terms as citizens. Following the law’s enactment and subsequent amendment, most legal immigrants arriving after 1996 are barred for at least five years from the core federal safety net programs: Food Stamps, Medicaid and the State Child Health Insurance Program (SCHIP), Temporary Assistance to Needy Families Program (TANF), and the Supplemental Security Income Program (SSI). 

While reforms to the 1996 law have basically restored benefits to legal permanent residents in the United States before 1996, over 40 percent of immigrants with green cards arrived after that date. Some states have replaced federal health and other benefits by subsidizing service programs with their own funds. These subsidies, although voluntarily borne, can be seen as a form of federal cost shift.

Immigration Reform: A Long Road to Citizenship and Insurance Coverage
In an article in the April issue of Health Affairs, Migration Policy Institute Senior Policy Analyst Randy Capps and Senior Vice President Michael Fix examine the key questions surrounding legalization and the Affordable Care Act (ACA). With Congress poised to consider a major overhaul of US immigration laws and legalization for many of the nation’s unauthorized immigrants, how legalization affects implementation of the ACA is a key policy question. The article examines current coverage rates for unauthorized immigrants, eligibility for coverage under expansion of Medicaid, the distribution of costs of uncompensated care, and options for covering those who will remain uninsured under ACA.
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Immigrants and Health Care Reform: What’s Really at Stake?
By Randy Capps, Marc R. Rosenblum, and Michael Fix
Health care reform proposals under consideration in Congress that would exclude many legal immigrants from core benefits and impose new verification requirements would have important spillover consequences for taxpayers and other health care consumers. In a new report, MPI’s National Center on Immigrant Integration Policy offers the first-ever estimates of the size of uninsured immigrant populations in major immigrant-destination states, the number of immigrant workers covered by employer-provided plans, and the share of immigrants employed by small firms likely to be exempted from employer coverage mandates. The report, based on MPI analysis of Census Bureau data, also examines health coverage for immigrants by legal status, age, and poverty levels.
Download Report | Press Release

Federal Spending on Immigrant Families' Integration
By Julia Gelatt and Michael Fix
Securing the Future: US Immigrant Integration Policy, A Reader
February 2007

Access to Health Care and Health Insurance: Immigrants and Immigration Reform
By Leighton Ku and Demetrios G. Papademetriou
Securing the Future: US Immigrant Integration Policy, A Reader
February 2007

Access to Health Care after Immigration Reform: Lessons from New York
By Adam Gurvitch
Securing the Future: US Immigrant Integration Policy, A Reader
February 2007

Immigrants' Costs and Contributions: The Effects of Reform
Michael Fix's Testimony before the US House of Representatives Committee on Ways and Means, July 26, 2006

Immigrants and Welfare: The Impact of Welfare Reform on America’s Newcomers
This volume, edited by MPI Senior Vice President Michael Fix, rigorously assesses the 1996 welfare reform law, questions whether its immigrant provisions were ever really necessary, and examines its impact on legal immigrants’ ability to integrate into American society. The book probes the politics behind the welfare reform law, its legal underpinnings, and what it may mean for integration policy. It also focuses on empirical research regarding immigrants’ propensity to use benefits before the law passed, and immigrants’ use and hardship levels afterwards.
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The use of TANF, SSI and Food Stamps by low-income legal immigrant families with children was lower than that of their native counterparts both before and after welfare reform.

Low-income, legal, non-citizen children are twice as likely to be uninsured as their native counterparts.

A recent Massachusetts experiment involving intensive outreach boosted insurance coverage rates for Latino and immigrant children from 57 to 96 percent.

The president released his fiscal year 2008 annual budget on February 5, 2007. The budget request will shape Congressional appropriations for the range of public benefits and work supports provided to immigrant families including food stamps, Medicaid, SCHIP, refugee resettlement, migrant head start, and migrant health, among others. To view the president’s FY 2008 budget, click here.

The Immigrant Child Health Improvement Act is expected to be reintroduced in Congress this year. The Act, last introduced in 2005, would allow states to use federal funds to provide Medicaid to legally present pregnant women and their children regardless of when they entered the United States.

"A Randomized Controlled Trial of the Effectiveness of  Community Based Case Management in Insuring Uninsured Latino Children"
By Glenn Flores, et al., Pediatrics 116(6):1433-1441, December 2005

“Food Insecurity and Public Assistance”
By George Borjas
Journal of Public Economics 88, 2004, 1421-1143

Welfare Reform’s Chilling Effects on Noncitizens: Changes in Noncitizen Welfare Recipiency of Shifts Citizenship Status?
By Jennifer Van Hook
Social Science Quarterly 84, No. 3 (2003): 613-631

The Scope and Impact of Welfare Reform’s Immigrant Provisions
By Michael Fix and Jeffrey S. Passel
Urban Institute, 2002

“Patchwork Policies: State Assistance for Immigrants Under Welfare Reform” 
By Wendy Zimmermann and Karen C. Tumlin
Assessing the New Federalism Occasional Paper No. 24, Urban Institute, 1999