The Academy’s advocacy to support immigrant child health is multifaceted. One aspect of this work is focused on ensuring immigrant children and families have access to appropriate care and services that support their overall health and well-being regardless of immigration status.
At the federal level, the AAP is pursuing several advocacy priorities to bring attention to the unique health needs of immigrant children.
Notably, this advocacy is playing out against the backdrop of the end of Title 42, an AAP-opposed policy that was used to expel immigrants at the border during the public health emergency, as well as new restrictions on families seeking asylum in the U.S., which the AAP also has spoken out against.
Here is a snapshot of the Academy’s recent efforts to ensure the health and safety of immigrant children in federal custody after they arrive at the border and as they proceed through the immigration process.
Addressing children’s unique health needs
The AAP continues to elevate and emphasize its longstanding recommendations to federal agencies responsible for the care and custody of children who arrive at the country’s border either alone or in a family unit.
Following the deaths of an 8-year-old girl and a 17-year-old boy in the custody of U.S. Customs and Border Protection (CBP) in May, the AAP continues to call for changes to CBP facilities to keep children safe. These recommendations include increasing the number of caregivers at all CBP facilities, hiring licensed child welfare workers, increasing pediatric medical expertise and using a trauma-informed approach for facilities, and training staff to meet the needs of children and families better.
Additionally, the Academy is calling for pediatrician representation in leadership roles at the U.S. Department of Homeland Security so the unique health needs of immigrant children are considered and prioritized in policy and staffing decisions.
Ongoing support for unaccompanied children
Another component of this advocacy is focused on ensuring that unaccompanied children can receive appropriate medical and mental health services after they leave federal custody and transition into a community.
The AAP issued a joint report with the Migration Policy Institute looking at the barriers that unaccompanied children often face in getting medical and mental health care after they have been placed with families (https://bit.ly/3AkgVF2). Among the report’s detailed recommendations are improving the Office of Refugee Resettlement’s information-sharing about children’s health conditions with those caring for them upon their release and providing medical and mental health case management for all children following release for at least a year.
Ensuring access to health care coverage
The Academy also is commenting on a rule proposed by the Biden administration that would expand health care coverage to Deferred Action for Childhood Arrivals (DACA) program recipients, an AAP priority. Recipients are immigrants who were brought to the United States as children and have protection from deportation and work authorization.
From the inception of DACA under President Barack Obama, recipients were ineligible for Medicaid, the Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA) marketplaces.
The proposed rule would eliminate these exclusions, making DACA recipients and other categories of immigrant children eligible for coverage either through the ACA marketplace or, in some states, Medicaid and CHIP.
At press time, the fate of the DACA program remained uncertain, with a court set to rule on its future.
The Academy will continue elevating the unique needs of immigrant children to policymakers and will keep members updated on the latest developments on these and several other issues.
Leading physician groups discuss health care barriers on Capitol Hill
AAP President Sandy L. Chung, M.D., FAAP, joined leaders from five other physician organizations on Capitol Hill in May to discuss the need to address barriers to health coverage and care, including ensuring adequate physician payment in Medicaid and Medicare, and the importance of supporting the physician workforce.
From left: Iffath Abbasi Hoskins, M.D., FACOG, president of the American College of Obstetricians and Gynecologists; Omar Atiq, M.D., FACP, president of the American College of Physicians; Petros Levounis, M.A., M.D., president-elect of the American Psychiatric Association; Dr. Chung; Ernest Gelb, D.O., FACOFP, president of the American Osteopathic Association; and Tochi Iroku-Malize, M.D., M.P.H., M.B.A., FAAFP, president of the American Academy of Family Physicians.
AAP advocacy resources
Check out the Academy’s new digital advocacy guide, which includes tools, resources and information for pediatricians on how to be effective child health advocates. AAP members can access the guide at AAP.org/AdvocacyGuide. To contact your lawmakers on the latest federal advocacy action opportunities, visit https://federaladvocacy.aap.org (AAP login required for both websites).