Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation

"Chilling effects" are a popular explanation for low program take-up rates among immigrants, but the effects of an icy policy climate are inherently hard to measure. This paper finds robust evidence that heightened federal immigration enforcement reduces Medicaid participation among children of noncitizens, even when children are themselves citizens. The decline in immigrant Medicaid participation around the time of welfare reform is largely explained by a contemporaneous spike in enforcement activity. The results imply that safety net participation is influenced not only by program design, but also by a broader set of seemingly unrelated policy choices.