Community Health Centers See Declines in Medicaid Enrollment Among Immigrant Patients

Health center directors believe the declines may be owing to confusion over the Trump administration's public charge rule.

Community health centers across the nation are reporting that many immigrant patients are not enrolling in Medicaid, possibly because of fears and confusion surrounding recent immigration policy changes that could jeopardize their status as legal residents, a new survey shows.

The Kaiser Family Foundation survey found that 47% of community health centers said that many or some immigrant patients didn't sign up for in Medicaid in the past year, and that 32% of CHCs said patients dropped or didn't renew their coverage.

The enrollment declines come as the Trump administration has attempted to tighten eligibility requirements for Medicaid under the public charge rules, leading some health center staff respondents to the survey to suggest that fear and confusion over the policy shift may be the reason, KFF said.

Late last week, federal judges in California, New York, and Washington State issued temporary injunctions against the policy shift, which would have allowed the federal government to withhold green cards and for immigrants who enroll in Medicaid or seek other public assistance, such as food stamps and housing subsidies.     

The survey and interviews also found some changes in healthcare utilization, with 28% of health centers reporting drops among adult immigrant patients in seeking healthcare in the past year, including pregnant women and people with chronic illness, KFF said.

In addition, 22% of centers reported reductions in healthcare use among children in immigrant families.

Health center directors told KFF they're training clinical staff to answer questions about the public charge rule.   

There are 1,362 health centers across the United States, providing care for about 28 million patients in medically underserved rural and urban areas.   

The survey of community health centers and phone interviews with health center directors and senior staff was conducted from May to July 2019 by researchers at KFF and the Geiger Gibson Program in Community Health Policy at the George Washington University.