Immigrant Social Policy in the American States: Race Politics and State TANF and Medicaid Eligibility Rules for Legal Permanent Residents

TL;DR: This paper examined differences in the drivers of state Temporary Assistance for Needy Families (TANF) and Medicaid immigrant eligibility policies, determined in the wake of the 1996 Welfare Reform, and found that differences in incentive structures of the two programs may affect the way race politics influence each.

Abstract: This article examines differences in the drivers of state Temporary Assistance for Needy Families (TANF) and Medicaid immigrant eligibility policies, determined in the wake of the 1996 Welfare Reform. The findings show that differences in the incentive structures of the two programs may affect the way race politics influence each. Specifically, race is a strong negative correlate for TANF inclusion of immigrants as states with large African American populations were more likely to exclude legal permanent residents from the program. In the case of Medicaid, the size of the immigrant population is a strong positive correlate for inclusion. The effect of the size of the black population, although negative, is small and not significant. The study confirms extant research findings that ideological factors play an important role in the formation of both policies.

Summary

Introduction

• Since the formation of the United States, race politics has been at the heart of both immigration and social welfare policies at the federal and the state levels.
• 1996) , states in fact produced varied responses: some states chose to incorporate almost all LPRs into their public benefits and healthcare programs; other states were far more selective and restrictive in terms of eligibility and inclusion.
• This is a major omission because, as will be discussed, not only does the incentive structure for state governments differ by program, but the two policy areas are politicized and racialized very differently in the public discourse.

II. PRWORA and the Devolution of Immigrant Social Policy

• The Welfare Act represented a substantial shift in American welfare and immigration federalism and a rather unique quasi-experiment for American politics.
• PRWORA dismantled the AFDC entitlement program, and replaced it with the TANF block grant.
• With PRWORA, welfare reform and devolution was tied to immigration reform and devolution.
• According to PRWORA, states could choose to include or exclude from TANF and/or Medicaid any or all of the three groups of immigrants that the law created.
• If states chose to incorporate immigrants in their programs, Washington matched funds only for pre-enactment immigrants and those who had been in LPR status for more than five years.

III. Immigration, Social Policy and the Politics of Race

• Both immigration and social welfare policies have been theorized as the result of Americans' understandings and evaluations of social and racial categories.
• Racial classifications and their associated tropes have led to racially-based assumptions of who deserves access to privileges and who does not.
• The nexus between immigration, welfare and race is multidimensional.
• Concerns over welfare, or the likelihood that an immigrant may become a "public charge," serve as the basis for exclusion from immigration to the U.S as well as a limitation for naturalization.
• At the same time, since PRWORA, immigration status serves as the basis for exclusion from welfare programs.

a. Race and Immigration Policy

• Alone among areas of law, immigration policy is not subject to the same strict scrutiny that the Supreme Court has applied to cases involving race and minorities (Neuman, 1996; Chin, 1998) .
• Most notably, such policies precluded the arrival of specific undesirables who threatened to disturb the racial and ethnic distribution of the American population and unsettle the system of privilege constructed around whiteness (Zolberg, 2006; Haney Lopez, 2006; Daniels, 2004; Ngai, 2004; Tichenor, 2002; King, 2002) .
• In the 1930s states and localities used public benefits as a guise in the "repatriation" of more than half a million Mexican immigrants and Mexican-Americans.
• The federal government can and does continue to use race as a factor in its immigration policy decision-making (Chin, 1998) .
• In general, public charge exclusions, which tie directly to the fear that immigrants will become "dependent" on the American welfare system, have had a disproportionate impact on minority applicants for permanent residence (Johnson, 1998) .

b. Race and Social Welfare Policy for Immigrants

• Many have posited that the presence of large numbers of racial and ethnic minorities among welfare beneficiaries has led those in the dominant white group to object to social programs on the basis that they are racially driven and preferential in nature (Soss, Schram, Vartanian and O'Brien, 2003; Hero and Tolbert, 1996; Taylor, 1998) .
• Recent findings on immigration indicate that the growth of immigration when combined with a salient national discourse that depicts immigrants as a threat can lead to the introduction of restrictive legislation at the local level (Hopkins, 2010).
• A number of studies have documented social and political conflict between blacks and Latinos (Bobo and Masagli, 2001; Vaca, 2004) .
• On the other hand, Hero and Preuhs (2007) found no statistically significant relationship between the overall size of the Latino, immigrant, or black population and eligibility rules.

c. Race and Healthcare Policy for Immigrants: Does the Majority/Minority Conflict Hypothesis Apply?

• Access to health services, health insurance and resultant health outcomes are all correlated with race.
• Studies of health insurance coverage show the existence of significant racial differences between whites and blacks going back to the 1950s and persisting to the current time (Olson, 2010; Thomasson, 2006) .
• Over the next two decades, the scope of Medicaid was expanded to include a variety of non-AFDC eligible low-income populations.
• The immediate result of PRWORA was a substantial decline in the rates of public health insurance coverage among immigrants either because of ineligibility or out of fear and misinformation (Kandula et.al., 2004; Hagan et.al., 2003) .
• Furthermore, healthcare policy in recent decades has tended to be framed around issues of cost, access and public health rather than "deservedness" (Vilardich, 2009) .

IV. Data and Methods

• As explained in section II, the federal government created three new categories of LPRs through PRWORA and enabled states to determine which of these groups, if any, they wish to include in their TANF and Medicaid programs.
• I also tested interaction terms for these variables with each other and with public opinion liberalism.
• The population data were derived from U.S. Census sources.
• These are Erickson, Wright and McIver's (1993) measure of public opinion liberalism, and Rom, Peterson and Scheve's (1999) measure of Democratic party control updated to include data from 1996-1997.
• Also included are two lagged measures of the state's economic conditions, unemployment and percent of population under poverty.

[TABLE 2-HERE]

• Table 3 presents the results of the multivariate regressions for TANF and for Medicaid immigrant inclusion.
• The standard errors for each terms is included in parentheses below the relevant coefficient.

[TABLE3 -HERE]

• It can be seen that the two models resolve very different proportions of variance.
• In both models, the liberalism variable is a strong correlate (standardized b=0.375 for the TANF model; β=0.500 for the Medicaid model) and significant at the p < 0.01 level.
• There are, however some differences between the two models: the percentage of African American population is a negative correlate in the TANF model and a positive (but not significant) in the Medicaid model.
• I will discuss these findings in detail in the following Section.

V. Discussion

• As expected given earlier research findings, estimates indicate that public opinion liberalism played a similar and significant role in the development of the immigrant eligibility rules for both programs, a finding consistent with previous research in immigration policy and in state politics writ large (Graefe, et.al., 2008; Hero and Preuhs, 2007; Erikson, Wright and McIver, 1993) .
• This hypothesis posits that in states where blacks had some political power compared to immigrants and Latinos, black legislators may have supported immigrant welfare exclusion in order to maintain a larger portion of a rapidly shrinking pie for their constituents.
• States with a lower percentage of the population under poverty were more likely to include immigrants in their TANF programs than were states with a higher percentage of the population under the poverty line.
• The federal requirement that all noncitizens have a right to emergency healthcare meant that exclusion from Medicaid could lead more immigrants to the emergency room (ER).

VI. Conclusion

• Racial factors have played important roles in the shaping of public policy towards vulnerable minority populations, but the centrality of racial considerations differs by policy area.
• The story of immigrant eligibility for TANF and Medicaid shows that the debate over welfare/TANF policy in the 1990s was more racialized along the traditional black/white divide.
• Traditionally, the discourse over healthcare has focused on cost and public health issues with a lesser emphasis on deservedness.
• By contrast, welfare policy has never enjoyed the support of such powerful and wellorganized constituencies.
• The focus here is with LPRs in the context of TANF and Medicaid.