Living in an Immigrant Family in America: How Fear and Toxic Stress are Affecting Daily Life, Well-Being, & Health

Appendix 1: Recent Changes in Immigration Policy, 2017

Executive Order: “Protecting the Nation from Foreign Terrorist Entry into the U.S.,” January 2017: Suspends entry of nationals from seven Muslim-majority countries — Iraq, Iran, Libya, Somalia, Sudan, Syria, and Yemen—into the U.S. for 90 days as well as all refugees for 120 days (and an indefinite ban on Syrian refugees), with an exception for religious minorities. States and other groups challenged the order, resulting in a temporary restraining order against enforcement of the ban. In March 2017, the Administration revised the order, removing the ban on nationals from Iraq, the indefinite ban on Syrian refugees, and the exception for religious minorities. In June 2017, the Supreme Court permitted a limited version of the revised ban to take effect, but ultimately dismissed legal challenges to the ban before ruling on its merits in October 2017, after the ban expired. In September 2017, the Administration released a new ban targeting primarily Muslim-majority countries—keeping Iran, Libya, Somalia, Syria and Yemen on the list, removing Sudan, and adding Chad as well North Korea and Venezuela. This version of the ban suspended entry of most nationals from these countries indefinitely (except Venezuela, where it is limited to government officials and their family) and enhanced screening and vetting requirements. On December 4, 2017 the Supreme Court, while not ruling on the merits, allowed this ban to go fully into effect while it continues to be challenged in the Fourth and Ninth Circuits and makes its way before the Supreme Court. A fourth ban was issued on October 24, 2017, requiring refugees from 11 Muslim-majority countries—Egypt, Iran, Iraq, Libya, Mali, North Korea, Somalia, Sudan, South Sudan, Syria, and Yemen—to undergo extreme vetting before entering the U.S. and preventing family members of refugees from joining them in the U.S. This ban is also being challenged in federal courts.

Executive Order: “Enhancing Public Safety in the Interior of the US,” January 2017: Expands the category of individuals classified as “priorities for removal,” prioritizing undocumented immigrants who have committed, been charged, or been convicted of a criminal offense, as well as those who have “committed acts that constitute a chargeable offense,” even if they are never convicted of an offense. Also disqualifies “sanctuary cities,” or jurisdictions that limit their role in civil immigration enforcement, from receiving federal grants. Cities are challenging the restriction of federal grants, including law enforcement funding, to “sanctuary cities” in the courts. The U.S. District Court permanently blocked the “sanctuary cities” provision. The Administration later narrowed the scope of the provision, but cities continue to challenge the new conditions on federal grants.

Executive Order: “Buy American Hire American,” April 2017: Encourages employers to verify all new hires through e-verify and calls for reforms to the H1B visa program that allows employers to find workers with highly specialized knowledge outside of the US.

Executive Order to Rescind Deferred Action for Childhood Arrivals (DACA) Program, September 2017: Rescinds DACA, which allowed for certain undocumented youth who came to the U.S. as children to be granted permission to stay in the U.S. and work for temporary renewable periods. DACA has protected nearly 800,000¹ undocumented children over the past five years and currently protects nearly 690,000 immigrants.² The Administration rescinded DACA in September 2017, and is no longer accepting applications for or renewals of DACA.³ Individuals’ DACA and work permits (employment authorization documents) remain valid until their expiration date.

Termination of Temporary Protected Status (TPS) Designation for Sudan, September 2017: Terminates TPS designation for Sudan effective November 2, 2018. Individuals currently residing in the U.S. under this TPS status must obtain an alternative lawful immigration status to remain in the U.S.⁴

Termination of TPS Designation for Nicaragua, November 2017: Terminates TPS designation for Nicaragua effective January 5, 2019. Individuals currently residing in the U.S. under this TPS status must obtain an alternative lawful immigration status to remain in the U.S.⁵

Termination of Central American Minors (CAM) refugee program, November 2017: Applications for CAM stopped being accepted November 9, 2017, and interviews for CAM cases will end January 31, 2018.⁶

Termination of TPS Designation for Haiti, November 2017: Terminates TPS designation for Haiti effective July 22, 2019. Individuals currently residing in the U.S. under this TPS status must obtain an alternative lawful immigration status to remain in the U.S. Haitians with TPS will be required to reapply for Employment Authorization Documents to legally work in the U.S. until the termination date.⁷

Appendix 2: Immigration Statuses and Eligibility for Health Coverage

Immigration Statuses

Lawfully present immigrants are non-citizens who are lawfully residing in the U.S. This group includes:

• Lawful permanent residents (LPRs or “green card” holders): Individuals who have been granted permission to permanently reside and work in the U.S. Individuals may be granted lawful permanent residence while overseas or adjust to permanent status within the U.S.⁸
• Refugees: Individuals who are at risk of or have been subject to persecution in their home countries and are unable to return because they fear serious harm.⁹ Individuals may be granted refugee status from outside the U.S.; those who flee to the US may seek asylum or withholding of removal once in the U.S.
• Asylees: Individuals who meet the same definition of refugees but are already in the U.S. or are seeking admission at a port of entry.¹⁰
• Other individuals who are authorized to live in the U.S. temporarily or permanently.

Undocumented immigrants are foreign-born individuals residing in the U.S. without authorization. This group includes individuals who entered the country without authorization as well as individuals who entered the country lawfully and stayed after their visa or status expired.

The Deferred Action for Childhood Arrivals (DACA) program, which was established in 2012, allowed for certain undocumented youth who came to the U.S. as children to be granted permission to stay in the U.S. for temporary renewable periods. The Administration rescinded DACA in September 2017 and is no longer accepting applications for or renewals of DACA.¹¹

Eligibility for Health Coverage Programs

Lawfully present immigrants may qualify for Medicaid and CHIP subject to certain restrictions. In general, lawfully present immigrants must have a “qualified” immigration status to be eligible for Medicaid or CHIP and many, including most LPRs or green card holders, must wait five years after obtaining qualified status before they may enroll. Some immigrants, such as those with temporary protected status, are lawfully present but do not have a qualified status and are not eligible. Some immigrants, such as refugees and asylees, do not have to wait five years before enrolling. For children and pregnant women, states can opt to eliminate the five-year wait and extend coverage to lawfully present immigrants without a qualified status.

Lawfully present immigrants can purchase coverage through the Affordable Care Act (ACA) Marketplaces and may receive subsidies for this coverage. These subsidies are available to people with incomes from 100% to 400% FPL who are not eligible for other coverage. In addition, lawfully present immigrants with incomes below 100% FPL may receive subsidies if they are ineligible for Medicaid based on immigration status. This group includes lawfully present immigrants who are not eligible for Medicaid or CHIP because they are in the five year waiting period or because they do not have a “qualified” status.

Undocumented immigrants and individuals granted DACA are not eligible to enroll in Medicaid or CHIP or to purchase coverage through the ACA Marketplaces.