How Are Immigrants Faring After Welfare Reform?. Immigrants' Understanding about Program Eligibility


As shown in Table 1.1, a modest proportion of all immigrants were post-enactment LPRs(23), the main group of immigrants who lost eligibility for many programs under PRWORA (though many pre-enactment immigrants also lost eligibility for the Food Stamp Program). The drop-off in immigrants' use of benefits since 1996 suggests that many of those who exited the programs were still eligible, including immigrants who entered the country before 1996 and citizen children in immigrant families. The survey data indicate that some of these people may have dropped off or failed to participate because of fears and confusion regarding the new legislation. Many immigrants believe, for instance, that getting benefits might endanger their immigration status or prevent them from getting green cards, reentering the country, or becoming citizens. Further, many families were confused by the complex changes in immigration and welfare law that occurred in 1996 and may have believed that all immigrants were disqualified.

To examine immigrants' perceptions and understanding, we probed respondents' knowledge of program rules. They were asked to assess whether the following statements were true or false or if they did not know the answer:

  1. If someone who isn't a citizen receives Medicaid [or Medi-Cal] he will probably have to pay it back to become a citizen. [correct answer is false]
  2. An immigrant who receives a welfare check from the government cannot become a citizen. [correct answer is false]
  3. Think about the case in which immigrant parents have children who were born in the United States. If these children get Medicaid [or Medi-Cal] then their parents cannot get green cards. [correct answer is false]

As seen in Tables 1.3 and 1.4, in 1999-2000 there was still substantial confusion among immigrants about eligibility for public benefits, and many believed that getting benefits like Medicaid might have adverse consequences. In general, at least half of the respondents knew the correct answer to a single question, but only 30 percent in Los Angles and 37 percent in New York knew all three answers. For each question, wrong answers and "Don't Know" answers were roughly evenly divided. The question that was the least likely to be answered correctly concerned repayment of Medicaid benefits.

Table 1.3.
Immigrant Understanding of Program Eligibility Rules and Consequences
(Individual Items in LANYCIS Survey)


Share of respondents (in both cities) answering question Share with wrong or "don't know" answers
Los Angeles New York City
Correctly Incorrectly "Don't know" All Respondents Low-income* Noncitizens All Respondents Low-income* Noncitizens

1. "Immigrants might have to pay back Medicaid benefits." (Correct answer is false)

47.8% 27.0% 25.2% 55.0% 62.0% 48.9% 61.1%

2. "Immigrants who get welfare cannot become citizens." (Correct answer is false)

61.3% 18.5% 20.2% 41.6% 51.5% 35.2% 47.9%

3. "If citizen children get Medicaid, then immigrant parents can't get green cards." (Correct answer is false)

63.9% 16.6% 19.4% 34.7% 39.0% 37.7% 44.8%
Table 1.4.
Immigrant Understanding of Program Eligibility Rules and Consequences (Composite Score on Items in LANYCIS Survey)

Composite responses

Share of respondents Los Angeles New York City
Both cities, all respondents All Respondents Low-income* Noncitizens All Respondents Low-income* Noncitizens

All answers correct

33.1% 30.0% 21.0% 36.8% 24.5%

2 answers correct

26.9% 27.9% 27.9% 25.7% 24.6%

1 answer correct

19.9% 22.8% 28.7% 16.4% 23.5%

All answers wrong or don't know

20.1% 19.2% 22.3% 21.1% 27.4%

* Low-income noncitizens live in families with incomes below 200 percent of the federal poverty level.
Source: Urban Institute, LANYCIS

We considered the possibility that low-income noncitizens might have more accurate responses, since they were more likely to be eligible for benefits. Contrary to this expectation, this group was slightly less likely to answer correctly or know the answer. That is, the people for whom the eligibility distinctions are most important were slightly more confused about the rules or worried about how they might be affected adversely. For instance, over 60 percent of low-income noncitizens in each city believed that they would have to repay Medicaid benefits.

It is important to note that LANYCIS was conducted from late 1999 through mid-2000, after the INS issued a policy guidance in May 1999 that the receipt of food stamps, SCHIP, or Medicaid (except for long-term care) would not be used in the determination of public charge status. Nonetheless, at the time of the survey, a high level of misunderstanding and concern about adverse consequences persisted in immigrant communities. In Los Angeles, the county Department of Social Services, health care providers, and community groups worked together with the Spanish-language news media to conduct outreach to let the public know that getting Medicaid was "safe" for immigrant families. Community education efforts also occurred in New York, albeit fewer of them (Ku and Freilich, forthcoming). The survey data do not mean that the community education efforts were fruitless, however; they may have incrementally improved understanding. Indeed, our case studies suggested that public charge concerns and confusion were greater initially in Los Angeles than New York, but that the additional community outreach in southern California may have helped bring levels of understanding up to those comparable to New York.

There have been a number of anecdotal and case study/focus group reports about immigrants' confusion concerning participation in public benefit programs (Schlosberg and Wiley 1998; Maloy et al. 2000; Feld and Power 2000). To the best of our knowledge, this analysis of LANYCIS is the first to systematically document that such confusion and concerns remained a year after the INS clarified its policies regarding public charge status.

In some ways, it is not surprising that many respondents do not understand program requirements; the rules are complicated and change from time to time. Earlier research has found that, in general low-income people often do not understand eligibility rules and that this can be a serious impediment to participation (Shuptrine and McKenzie 1996; Perry et al. 2000). However, the survey data reveal that, in addition to not understanding certain rules, many immigrants also worry that they might actually be affected adversely  be unable to get residency or citizenship, or be forced to repay Medicaid benefits  if they participated in programs.

LANYCIS does not provide unambiguous evidence regarding whether immigrants who misunderstand program rules or the consequences of program participation are less likely to receive benefits. On the one hand, there appears to be a correlation between Medicaid use and proper understanding of eligibility and immigration consequences. Figure 1.3 shows that poor immigrant adults who had one or more answers right were more likely to participate in Medicaid than those with no answers correct and the probability of participation was highest for those who answered two out of three questions correctly. One explanation for this finding is that those who participated in Medicaid were inherently likely to understand program rules, since they had managed to enroll.

Figure 1.3.
Relationship of Understanding of Program Rules to Medicaid Participation Rates for Noncitizen Poor Adults

Figure 1.3. Relationship of Understanding of Program Rules to Medicaid Participation Rates for Noncitizen Poor Adults

On the other hand, the correlation between understanding of program rules and receipt of food stamps is more tenuous, as shown in Figure 1.4. When compared to the number of correct responses to these questions, there is not much variation in FSP participation during the year prior to the survey. Participation was 14 percent among families with respondents answering no questions correctly, compared to 17 percent among those answering all questions correctly. Responses to in-depth surveys offer some reasons why. In one example, an undocumented respondent feared that food stamp receipt could prevent him and his wife from obtaining legal status. Yet, when they both lost their jobs, their financial crisis was serious enough for them to apply for food stamps for their children. As soon as they got back on their feet, they stopped their food stamp benefits. In another case, a respondent feared that food stamp receipt would influence his wife's citizenship application. Since both adults were employed, they were able to avoid applying for TANF or food stamps. Some respondents did complain about social service agency staff incorrectly telling them that benefits receipt would prevent them from legalizing or naturalizing. Still, it appears that many immigrant families apply for food stamps when they face a serious financial or economic crisis.

Figure 1.4.
Relationship of Understanding of Program Rules to Food Stamp Receipt in the Year Prior to the Survey
Figure 1.4. Relationship of Understanding of Program Rules to Food Stamp Receipt in the Year Prior to the Survey

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