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tv   Urban Institute Discussion on Assistance for Immigrant Families  CSPAN  April 1, 2021 3:32pm-4:19pm EDT

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>> good afternoon everyone. first, a few housekeeping rules. today's event be recorded. all participants are automatically muted, but we do
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have closed captioning. type your questions or comments into the question box at any time. even if we don't answer them all, it is helpful to us to know what you're thinking about. please join the conversation on twitter, use the hashtag live urban. long overdue with our nations ongoing structural brief to them. they have encountered a safety net that can be very helpful to navigate with eligibility varying language barriers and fear about the patient only problem green part or
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nationalization. since 1940 two our immigration laws have included the concept of public charge when deciding whether the person is likely to become dependent on certain government programs in the future. the trump administration first proposed and sought to implement a final revised public charge with the end of the circumstances in which applicants might be given admission to the united states. even though those who are qualified for fear of immigration. the pandemic hit.
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these populations were further disconnected from a u.s. safety net than they ever had been -- been before. biden administration recently withdrew the appeal of the court decision struck down the public charge rule. the relief bills have banded opportunity for some aid. yet, immigrant families continue to baste many barriers, both formal and informal in accessing the safety net. all of the complications that existed before remain. these barriers decrease the well-being of families while the
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economic setbacks continue. we will have a two-part conversation. in the first part, i am pleased to include judy chu. after that, i will tap also with two other experts to talk more about these rules and regulations. thank you congresswoman for joining us today, i hope you are well. before we turn to today's topic, i do what take a moment to express only half -- expressed support from all of those who are facing rising wave of hp hate -- of hate violence. we stand strongly with you.
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thank you for being here. >> nearly 40% of your l.a. defect is foreign-born. haas the pandemic affected the community and their family members? >> first, let me say thank you because you have laid the groundwork for us to fight the anti-immigrant federal policy that have been put on this and the last four years. with your data and research, and believe me, it is a powerful tool that i have relied on time and time again when i'm speaking to people on capitol hill, when i am at hearings, so it is incredible what you are able to do. this pandemic of course has
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exposed deep inequalities in our health care system. each of us are equally susceptible to the virus, but not all the -- for instance, most frontline workers tend to come from immigrant communities, which means they are putting themselves at risk for our take. and yeah, these communities have less access to quality health care, is why you are seeing higher infection and utility rate in -- in fact is your research documents and anti-immigration policy, have deterred mccrimmon families from seeking health care, food, and economic assistance even as the
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economic burden has fallen most heavily on them. that is why we work so hard when developing the american rescue program to ensure that we blocked any efforts to restrict coverage, testing, in ways that would've let the immigrant community behind. we cannot afford to leave -- believe -- we cannot afford to leave an entire population out of our relief effort. which is what -- which is what republicans were trying to do over and over again. nonetheless, we still have work to do. for instance, i attempted to get those with the eye to economic checks, but we were unable to do that. clearly, there is more relief that we need for area community.
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these problems extend the business community as well. i pushed for the small business administration to translate their material into other languages so that in nonspeaking business owners -- not -- non-business owners have achieved for this aid. there certainly just as deserving for this relief. at the beginning there was a huge problem where the big banks were giving loans to their ongoing loan customers, so it shut out you truly small business who did not know how to get through. to make sure that was the community banks and community development corp. that
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corporation that served the immigrant communities that we intended for. >> you touched on a whole bunch of things that i want to come back on, but wanted to start the new administration of -- and the implications of policy choices on the equity gap. the weather and new or piece of legislation would widen workload cap snack is to opportunity, whatever the issue may be, the executive order focuses particularly on race, ethnicity, and other aspects of identity. does not speak to murray data.
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i'm current -- i'm curious to your reaction. >> even though he did not specify immigrant communities, i think they will benefit from this order. that is why put so hard for aid to target underserved communities as well. as well as translating material into other languages. that's why with this plan we have set aside community navigators to help businesses figure out how to go through the system to get the forgivable on that they need. -- forgivable loan that they need.
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we did not even understand how much that was happening because of the lack of aggregated data that limited our understanding of the needs of the diversity in the community, whereas we do know that certain steps but -- subsets of communities like the native hawaii civic islanders -- other factors are keeping us from bonding appropriately. one third of a apis are limited english efficient. numeral pandemic information is still not available that's readily available in all languages. for us, the first year there was
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a 35% increase in the mortality rate of asian americans compared to the average from the five previous years. from december to january there was a twofold increase in death and asian americans. we know other immigrant communities are similarly suffering. in order to bring more targeted aid to the neighborhood, there is an order directly for immigrants. survival text one new -- were not sent to undocumented workers who do not use i 10 for filing. that is so unfair. they deserve to have the same health as everyone else. the lease we were able to make sure that makes status families
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could be included and those with social security numbers are able to cash the checks they towed deserve. >> as you know well, quite better than most, so many of the programs and their eligibility criteria. other programs that you would like to see further work being done on eligibility to help expand access to immigrant population, and if so what sort of priority are you thinking for that? >> i feel there is work that has to be done, and that is why i introduced the coronavirus immigrant family protection act early on, which ensures any
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benefit received during the pandemic not count -- improvement -- for him it's termination based on immigration status. it makes emergency medicaid available to nonimmigrant and the disaster snap program would be extended to allow individuals and families to receive individual if infant from fema. of course it would address di 10 problem so that they can contest that they deserve, and also make sure eight and it will be able to translate the relief effort. the community-based organizations also have culturally and linguistically appropriate -- follow -- finally
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even modify policy for the duration of the covid-19 emergency. by suspending in person checks through making sure they feel safe. i feel that, guess, our efforts and be updated -- need to be updated and more sensitive to immigrants. we can do more in terms of the underlying system of our safe net. that is why i support the heel for immigrant families act. it would provide access to prevent -- public and affordable health care coverage, access to
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medicaid or the children's health insurance program. without that by your waiting. and allow undocumented immigrants to purchase health insurance through the affordable care act marketplace. so that they can get the health care they need. the safety net has to be there on -- be there for an ongoing basis were all immigrants. >> i wanted to close with this question, the last couple of years was a period in which there was a great deal of anxiety and confusion across immigrant communities. about immigration and enforcement -- about immigration enforcement and how it can affect so many families. the fact that the rule is no longer in effect does not that's
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a fairly remedy the overnight challenge of confusion. what can we be doing as a country to try to provide more information or clarity to people , and try to overcome some of the barriers to participation in programs that people are completely eligible to participate in? >> the public charge role has caused so much confusion across the united states. i had nonprofits that saw an immediate drop in those who normally use their services because people were so afraid of the consequent. it had its intended effect by the trump administration, it was an intentionally proved rule
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meant to punish immigrants who took advantages of services that they were legally entitled to. so many immigrants reviewed -- won't go to a doctor because they are afraid it will impact their immigration that. this was a specially cruel because it was during the pandemic when it is more important than ever that we have health care access. anyway, that is why i am thankful that biden directed agency to review the rule and rescinded the memorandum and is no longer in effect. i don't know if immigrants really know that death know that it is not in effect. that is not enough. that is why the american plan includes something i'm proud of, a billion-dollar for a pandemic
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urgency assessment fund to enable state come from, and territories to help families with the lowest income help cover pandemic -- addictions and hardship. it made it more difficult for immigrant families to adjust their status as legal permanent resident or u.s. citizens if they use these public funds to pay rent or buy food or cover basic necessities. this was important because excluding immigrant around covid belief benefits is detrimental, but this emergency assistance fund allows those that are administering it to be able to provide those services regardless of ground. >> thank you for coming and
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sharing these thoughts with us. our thoughts are with you and your constituents. we are enormously grateful to you and your partnership and working on these issues. thank you so much for being here. take care. now i'm going to be doing by comes up who is a rentable research associate. and she has been working to help band access to immigrant communities to get health care benefit. so to both how mattel and bloom, thank you for being with us. i'm going to ask you to step back and -- and lay a little bit more about the groundwork.
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what were the rules for immigrant access to safety net before the final rule on public charge mark haddad to change and where does it stand now? >> that is a tough question to start off on because -- in two minutes or less. it is hard because there is variation across states and immigration status. in general, undocumented and were going to are not eligible for federal benefits. there are some exceptions for things like emergency medicaid, immunization and school meals. many immigrants with a lawful status are also not eligible for enteral benefits. in general, and immigrant with a
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green card, permanent resident is not eligible for benefits for the first five years of that status. there is also a lot of differences at the state level. since the 1996 form, it led to passive policies. many states eliminated the five-year bar for pregnant women and children for medicaid and chip. the groups not eligible for federal programs may be eligible for other state and local programs. some say truly lead the way we will talk more about that. all of these basics come on
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paper they did not change during the trump administration. but, a combination of immigration enforcement and policy, including the public charge role, led to a trend -- and immigrant families grew even more reluctant debating in the program. save that the no charge role was put in place in the previous administration, it did not change eligibility rules. it attached immigration consequences for this participation. for non-cash programs like food stamps and housing. so that is the basics in brief, i hope that answers it. >> again it is not that the public charge rule is gone, what we are back to the pre-trump public charge rule.
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there are still consequences for participation in some of those programs. >> that's a great transition for you. why was it so hard for people to access benefits even before the overcharge rule? out of these experiences very across the different statuses that immigrant and their families might have? >> there are multiple factors that make it challenging for immigrants to access need in support. first, eligibility restrictions for certain programs based on immigration status. that means that your status impacts to services and support you can access and determine
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whether you can actually access food, housing, health care and financial support. if you are a citizen, or have temporary protected status or have undocumented or permanent resident that is, and whether or not you have met that five-year bar and a permanent resident impact foot type of public benefits you are eligible for. then there are other considerations, such as whether folks are aware that the programs exist. once they know they're eligible for those, based on income resources as well as immigration data filled ability criteria, and other things like whether the application process remains, meaning is it understandable --
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the unfamiliar fission play out in the health coverage context. as i mentioned, your immigration status helps determine what health coverage program you may be eligible for. those who are uninsured are less likely to have a regular talk her or get timely and routine care and are more likely to be hospitalized for preventable conditions. just to get some context among the nonelderly population, 22% of undocumented immigrants were any debts were uninsured in 2018. among students and children, are more likely to be uninsured compared to those with both parents being citizens. >> these rat dust rates -- these rates are going to change
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between immigrants when you consider the eligibility restrictions tied to the programs based on immigration status. that will including naturalized citizens eligible for all publicly funded health insurance programs which include medicaid, the children's health and. program, medicaid and medicare. for people with lawful permanent resident status, as we just discussed, if they met the five-year bar, they could be eligible for medicaid or medicare if they meet the rest of the eligibility criteria. if they have known that the there are other categories that are eligible to purchase plans. the thing to know is that affordability remains a barrier to accessing health care services. many people who have access to health plans still have to pay
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out-of-pocket costs, so unlike medicaid, which in most circumstances, there are no out-of-pocket costs, qualified health plans to include out-of-pocket costs, and that serves as a barrier for lower income folks to accessing the services that they need. there is data that shows even out-of-pocket costs cost as little as -- out-of-pocket costs as little as one dollar to three dollars prevent access to things like prescription medication. then there are undocumented folks who had the least available to them. they are not qualified for qualified health plans or medicare. there are programs, and folks who have not met the five-year bar are eligible for this emergency medicaid.
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states have flexibly and how the medicaid program is implemented. coverage varies from state to state. there is also the emergency medical treatment and labor that requires anyone who goes to an emergency department to be stabilized and treated without regard to their insurance status or ability to pay, but in 1986 -- there are charity mandates, federal and state, that help make some of this, but it varies from state to state and hospital to hospital. some are more generous than others. in washington state, the state law is for folks up to 100% of federal poverty, the hospital care should be written off, but there are policies that go beyond that in our writing off out-of-pocket costs up to 400%. there are also health centers and rural health clinics, but
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those also include schedules so some cost-sharing is required of patients. the washington immigrant solidarity network conducted a survey of 5700 undocumented individuals or people from next status households and found 87% of respondents lack health insurance and the majority cited immigration status instructions or cost as the key barriers to obtaining coverage. 66% identified lack of health insurance as a barrier to accessing needed health care services and 59% identified high cost of care as a barrier. despite the health clinics' availabilities, respondents reported inability to access health care services, including things like preventive care, vision, dental, and behavioral health care.
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>> it is a lot, but i think you made the point that the dizzying array of complexity that a family faces when trying to determine whether or not they and their family should and can get access to health care, let alone what consequences it might have for their immigration status. it is very difficult and daunting. i'm going to ask us to step back a moment and obviously each of you and i congresswoman have been working to expand access. the last administration took a different approach and they had an argument that i would like to ask each of you very briefly to join with one or two key points. they argued that the access to the safety net should be restricted to those who have had been in the united states or to those -- or immigration status should be restricted to those
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not likely to take advantage of our social safety net. i think there is a different point of view reflected by the advocate. -- the advocates. can you join that question that that argument, why do you think that is the right way to go or the wrong way to go? a hard thing to do briefly. >> covid has really shown how interconnected we are as a society in at the health and safety of each of us is tied to that of our neighbors and community health generally, regardless of immigration status. our essential workers are, as represented if you, overrepresented by emigrants, yet they do not have access to the support they need so that
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they can continue filling those roles. and when people are supported -- provided with the supports they need, the entire community and nation benefits because people are more likely to succeed and be productive members of society. you cannot expect a child who is hungry to be able to focus in school and meet their full potential. it is not a realistic expectation. as representative chu discussed, immigrants are overrepresented in essential workers and to continue to maintain those vital roles in the community and keep those failed, they need supports -- keep those filled, they need supports. one thing we don't talk about as much is acknowledging the contributions of immigrants to maintaining and funding these social supports that they are excluded from. 44.4 million immigrants in the
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u.s. and they make up 13.6% of the population. they paid over $400 billion in taxes in 2017. then they are excluded from the safety net. it does not make sense. >> many in the field have been studying how immigrant families have fared over the last year, particularly how successfully or not they had been able to access the safety net, and some of the changes that came about. can you talk about what we know? >> sure. immigrant families' participation in safety net programs dropped significantly and dropped more than from non-immigrant families. administered of data -- administrative data and survey and interview data, we have collected over the last several years, we have built up a strong evidence base.
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our recent survey data, which we collected in december of 2020, that showed one and six adults and immigrant families reported avoiding public programs or other held because of immigration concerns, and a brief we are working on now will show it is one in four when you look at low income families. consistently, over the three years we have collected this data, this avoidance was the most common in families where there were individuals without a green card. even in families where people born outside the u.s. were naturalized or had green cards, we saw these showing up. they were also higher in families with children, closer to one in five adults in families with children. the drop started in the context of discussions about the new rule, which had several years of
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buildup from drafting the public eye to the rulemaking process in 2018 and then an limitation in february 2020, just before the covid crisis hit. this was an issue being covered in the media, tons of litigation, twists and turns, and widespread worries and immigrant communities across the country about participating in these programs for themselves or their children could have consequences. there was a lot of confusion about what the rule said. one to nine test programs that would not be considered. the final rule specified participation in nonemergency medicaid, food stamps, federal
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housing assistance would be considered in a green card application but it did not include programs like free or low-cost health care, private support, and we see evidence that immigrants are avoiding those supports as well. another type of spillover was it affected people who would not be subject to a future public charge test. of major concern is children and immigrant families, most of whom are u.s. citizens themselves. there is also the exception groups that would never get a test like refugees, -- like refugees. there was a misperception that it would impact citizenship applications, not just green card applications, so current green card felt those effects. the extent of this misunderstanding was large. in our 2019 data, we found only
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one in five adults in immigrant families knew that children's participation in these programs would not be considered in a public charge test, and similar, one in five new that it would not affect citizenship applications. so there was a lot of confusion and misperceptions about what the rule said. it played out, unfortunately, in jobs and precipitation -- in drops in part precipitation -- in drops in participation. those service providers, health care providers, the enrollment of sisters, -- enrollment assistance had to contend -- rick enrollment -- enrollment assistants had to contend with this to provide accurate information to their clients and work to reassure families and correct those misperceptions
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about what the role -- rule might mean for them. it has been an enormous dynamic for families in communities. >> i want to cover two things quickly before we wrap up. many of the programs we are talking about, there are federal rules and policies, but as you mentioned, they are largely administered at the state and local level. given both the circumstance that how mattel described -- that ham utal describes, what you see as the role of governments in helping people navigate to the programs that may make sense for them? >> state and local governments have continued to play a key role in filling gaps in the safety net and addressing some
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of this confusion and ongoing fear in the community. looking in the health care context, there are states that have expanded coverage to all children regardless of immigration status, coverage for pregnant folks, access to family planning services, then implementing covid specific programs that touch on some of the other determinants that we had discussed previously like programs including emergency cash, rent, and utility assistance. but this varies from state to state. there are still states that have not taken up the option to expand medicaid or chip coverage to children regardless of immigration status, so there is a lot of flexibility, but it does very -- vary based on the
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politics in each state and what is going on there. there are local programs as well, county-based coverage programs that counties haven't lamented to increase access -- counties have implement it -- implemented. there is a lot that can be done. >> i want to ask each of you to briefly close with a thought about intersectionality. the country is rightly coming to understand the extent to which areas built into our society, so many systems and structures that prevent access to opportunity for folks of different ethnic and racial backgrounds, among other things, yet we are also seeing that immigrant communities, for the most case, reflect people from different racial and ethnic backgrounds as
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well, so you see a layering of effects. i am curious if you think about this moment and the opportunity we have to draw attention to racial and other barriers in society and to think about how policies could help to overcome them. how does that affect the conversation that we have been having? please be brief. >> i think improving access to the safety net and health coverage is really tied to systemic racism and how we are in the midst of a public health emergency, a global pandemic, and communities that are disproportionately dying from covid are the ones that are most likely to be uninsured or underinsured and the ones least likely to have access to the needed supports, so it is rethinking the safety net in
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general, removing some of these immigration status restrictions that exist that we discussed earlier and ensuring that everyone has the support they needed to thrive and be productive members of society. >> thank you. >> i guess the main point is when you look at racial disparities in the data, say in covid at -- covid vaccine access, or any range of policy issues, looking at those disparities just by race and ethnicity, it maps the immigrant part of the story. when we see disparities for latinx or api or black communities, it can be instructive to point out that one third of latinx people, two thirds of aapi people and 1/10 of black people were born outside the u.s. and many more are second-generation with a parent born outside the u.s.
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that realization can enhance our perspective on what that disparity looks like and what policy or practice measures might be needed to make a difference and mitigate it. i think the intersection is important to think about. >> we are grateful to both of you for helping us think about those questions and more. it is wonderful to have you with us. thank you for your great work. to our audience, think you for being with us, we look forward to seeing you soon. be well and be safe. [captions copyright national cable satellite corp. 2021] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit] >> c-span is your unfiltered view of government, created by america's cable television companies in 1979. we are brought to you by these companies to provide c-span2 viewers as a public service.
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