Immigrant children represent the fastest growing segment of the U.S. population; one in every four children lives in an immigrant family. Children from immigrant families face a variety of challenges to their health and well-being, including poverty, lack of health insurance, low educational attainment, substandard housing and language barriers.
President Obama's Executive Actions on Immigration
In June of 2016, the Supreme Court announced a 4-4 split decision in the major immigration case, United States v. Texas. Because of the tie, the Court effectively affirmed the Fifth Circuit's ruling, blocking President Obama's 2014 executive actions to expand the Deferred Action for Childhood Arrivals (DACA) program and to create the Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) program. The DACA expansion would have deferred deportations for people who entered the United States as children before January 1, 2010. The current cutoff is June 15, 2007. The DAPA program would have deferred deportation for the undocumented parents of U.S. citizens or legal permanent residents who have been in the U.S. for at least five years. The Court's decision will have a major impact on the lives of millions of immigrant families who live with the fear of deportation and separation from their children, parents and grandparents.
Following the decision, the Academy issued a statement, criticizing the failure of the Court to rule one way or the other on the president's policies and noting the work that remains to fix the country's immigration system.
The Academy was an anchor organization on an amicus brief for the case signed by child health and education organizations, outlining harms to children whose parents face deportation and arguing that lifting the circuit's injunction would provide millions of children with the family stability and security essential to their psychological, physical and emotional well-being.
After the decision of the Supreme Court was announced, the AAP joined 135 national organizations in sending a letter to President Obama asking his administration to provide all individuals granted relief through the original DACA with access to affordable health care to the same extent as other lawfully present people. All forms of deferred action, except for DACA, are considered to be lawfully present for purposes of the ACA, Medicaid, and CHIP. The letter urges President Obama to lift this restriction and provided DACA youth with the opportunity to stay healthy and to succeed.
Access to Counsel for Immigrant Children
The AAP has endorsed the Fair Day in Court for Kids Act of 2016 (S. 2540), legislation that provides unaccompanied children with access to counsel throughout their immigration proceedings. The bill, introduced by Sen. Harry Reid (D-NV) will help ensure that the government appoints counsel to unaccompanied children and other vulnerable individuals, such as those who are victims of abuse, torture, or violence. The legislation also requires the Department of Homeland Security to make legal orientation programs available at all detention centers, so families know their rights and responsibilities under immigration law. It is not uncommon for a child as young as four years of age or younger to represent him-or herself in front of a judge without counsel. Given the percentage of children who are granted lawful status when they have legal representation based on the merits of their case, more must be done to ensure all children have appropriate access to counsel.
Children without counsel are far more likely to be deported, regardless of the merits of their case or the dangers to which they would return. Consistent with AAP's policy statement, Providing Care for Immigrant, Migrant, and Border Children, which states that no child should have to represent him or herself in an immigration proceeding, the AAP has signed on to a letter to Attorney General Loretta Lynch objecting to this practice. AAP has also worked with the American Civil Liberties Union in supporting a petition to President Barack Obama, asking for legal counsel for all children in immigration hearings.
Children Crossing the U.S. Border: Where AAP Stands
In summer 2014, an unprecedented number of unaccompanied children came from Central America into the United States along the southern U.S. border. Pediatricians were deeply concerned about the health and well-being of these children, and the Academy was in regular communication with federal agencies and state AAP chapters to gather information and offer assistance. In addition to ensuring the medical and mental health needs of these children were being met, the AAP urged for steps to be taken to provide for their safety and well-being after the initial assessment and placement. More than 60,000 children were resettled with sponsors in nearly every state. In June 2015, the AAP convened a multidisciplinary meeting of more than 40 service providers to discuss concerns related to health, mental health, legal issues, and education of immigrant children and to develop collaborative strategies for providing services in local communities. Looking ahead, the Academy is working to ensure these children can access the services they need to address their complex health, legal and education needs.
In July 2015, the AAP sent a letter to U.S. Department of Homeland Security Secretary Jeh Johnson to express concerns for the health and well-being of mothers and children who are being held in family detention centers. Also in July 2015, a federal judge in California ruled that the Obama Administration's detention of children and their mothers violates a longstanding court settlement, and that the families should be released as quickly as possible. The federal government has asked the judge to reconsider her ruling, asserting that the ruling "addressed practices and policies that no longer exist." For more information, please see this AAP News article and this ABC News piece.
In October of 2016, the Department of Homeland Security Advisory Committee on Family Residential Centers issued draft recommendations to DHS that call for comprehensive improvements in the quality of care in the family detention facilities, the exploration of alternatives to detention, prevention of inappropriate separation of children from families, and ultimately, an end to the detention of children. AAP President Benard P. Dreyer, MD, FAAP sent a letter on behalf of AAP to DHS voicing support for the recommendations in the Advisory Committee's report.
The Academy will continue to work with the Administration to put more protective policies in place for children.
White House Task Force on New Americans
AAP submitted comments to the White House Task Force on New Americans in response to its request for input on ways to successfully integrate immigrants and refugees into America's communities and economy. The Task Force on New Americans was created by President Obama's executive action on immigration, and its goal is to develop a federal immigrant integration strategy that allows new Americans to contribute to society and strengthen their receiving communities.
The AAP Immigrant Health Special Interest Working Group contributed to the AAP's recommendations to the Task Force, which focus on the need for immigrant families to have access to public benefits, quality health care, and optimal public education.
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