ALL CHILDREN ARE NOT CREATED EQUAL: PRWORA'S UNCONSTITUTIONAL RESTRICTION ON IMMIGRANT CHILDREN'S ACCESS TO FEDERAL HEALTH CARE PROGRAMS

• Published date: 01 July 2006
• Date: 01 July 2006
• DOI: http://doi.org/10.1111/j.1744-1617.2006.00101.x
• Author: Hyejung Janet Shin

FAMILY COURT REVIEW, Vol. 44 No. 3, July 2006 484–497

© 2006 Association of Family and Conciliation Courts

Blackwell Publishing, Ltd.Oxford, UKFCREFamily Court Review1531-2445© 2006 Association of Family and Conciliation CourtsJuly 2006443Student Note

FAMILY COURT REVIEWShin/XXXXX

ALL CHILDREN ARE NOT CREATED EQUAL:

PRWORA’S UNCONSTITUTIONAL RESTRICTION ON

IMMIGRANT CHILDREN’S ACCESS TO FEDERAL HEALTH

CARE PROGRAMS

Hyejung Janet Shin

The lack of health insurance for children is a serious problem in the United States, especially for those children

in families that earn too little to get private health insurance and too much to qualify for Medicare. Even within

this subclass of children, immigrant children are particularly vulnerable to the problems faced by lack of health

care. Nevertheless, with the passage of the Personal Responsibility and Work Reconciliation Act (PRWORA) by

Congress, equality interests of low-income immigrant children are undermined when immigrant children are

denied federal benefits for the first 5 years of residency in the United States. The first part of this Note examines

the importance of child health care and the long-term problems with uninsured children, especially with unin-

sured immigrant children and pregnant women. The next part introduces Medicaid as well as State Children’s

Health Insurance Program, a supplemental federal program designed to increase health care coverage to all chil-

dren, while contrasting these programs in light of the restrictive anti-immigrant PRWORA provisions. The third

part explains the passage of PRWORA, its anti-immigrant provisions, and how these provisions prevent needy

immigrant children from receiving federally funded health care. Then, the fourth part uses both the Equal

Protection Clause of the Fourteenth Amendment and the Due Process Clause of the Fifth Amendment to argue

the unconstitutionality of the anti-immigrant provisions. Finally, the last part lays out the recommendation to

amend the Social Security Act so that the PRWORA barriers can be removed and recent immigrant children can

receive federally funded health care.

Keywords:

State Children’s Health Insurance Program

;

health insurance

;

Personal Responsibility and Work

Reconciliation Act of 1996

;

Equal Protection Clause

;

Due Process Clause

;

immigrant children

INTRODUCTION

At the base of the Statute of Liberty, there is an inscription that reads, “Give me your

tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your

teeming shore. Send these, the homeless, tempest-tossed to me, I lift my lamp beside the

golden door.”

1

This quotation suggests a spirit of openness reflected in some of the immi-

gration laws and policies of the United States. However, in 1996, with the passage of the

Personal Responsibility and Work Reconciliation Act (PRWORA)

2

, the federal government

effectively put an end to federal benefits for precisely these needy immigrants that the

inscription meant to welcome into this country.

3

In particular, some provisions of PRWORA

implemented strict residency requirements on all legal immigrants before being allowed to

receive federal assistance.

4

Most importantly, this restriction effectively harms immigrant

children and pregnant women who face significant barriers in receiving any type of health

care and places them in an especially vulnerable position of having to live in the United

States without the protection of any quality medical care.

Correspondence: hshin1@pride.hofstra.edu