Institute for the Study of I nternational M igration, Georgetown University Centre on M igration, Polic y and Society, Oxford University Funded by Barrow Cadbur y Trust and Carnegie Corporation of New York
Undocumented Children and Access to Education, Healthcare and Livelihoods in the United Kingdom and United States Susan Martin, Institute for the Study of International Migration Elzbieta M. Gozdziak, Institute for the Study of International Migration Nando Sigona, Centre on Migration, Policy and Society Vanessa Hughes, Centre on Migration, Policy and Society
Photo Credit: Istvรกn Benedek
Acknowledgements This paper is part of a larger project on undocumented children and their access to education, health care and employment opportunities carried out with the generous support of the Barrow Cadbury Trust and the Carnegie Corporation of New York. The authors wish to thank: the Institute for the Study of International Migration of Georgetown University, the Center for Research on Immigration, Population and Public Policy at UC-Irvine, the Population Research Institute of Pennsylvania State University, and the Russell Sage Foundation for research support. Heartfelt appreciation to the numerous policy makers, service providers, school administrators, community leaders and immigrant youth advocates for giving generously of their time and expertise to provide information and share their opinions. Many thanks to the immigrant children and families for sharing their migration experiences and integration challenges and successes.
Project Reports Mexican-American Educational Incorporation: The Size and Meaning of Unauthorized Migrationâ€™s Legacy Frank D. Bean, Susan K. Brown, Mark A. Leach, James D. Bachmeier and Rosaura Tafoya-Estrada To Dream or Not to Dream: The Effects of Immigration Status, Discrimination, and Parental Influence on Latino Childrenâ€™s Access to Education Elzbieta M. Gozdziak Unauthorized Latino Children. Access to Education, Health Care and Livelihoods: Selected Bibliography Elzbieta M. Gozdziak and Nina Laufbahn Children Affected by Unauthorized Migration: An Overview of Applicable Legal Frameworks for Accessing Education, Health Care and the Labor Market in the United States Sanjula Weerasinghe, Elzbieta M. Gozdziak and Nina Laufbahn No Way Out, No Way In: Irregular Migrant Children and Families in the UK Nando Sigona Being Children and Undocumented in the U.K.: A Background Paper Nando Sigona and Vanessa Hughes
I. Introduction The United States and the United Kingdom saw record levels of unauthorized migration during the economic boom of the late 1990s and early 2000s.1 Although the economic crisis of the late 2000s reduced these levels, one of their legacies has been the growth in the number of children (that is, younger than 18) who are themselves in unauthorized status or who are, in the U.S., the citizen children of undocumented parents. Recent estimates in the United States, for example, indicate that approximately 1 million unauthorized immigrants are children (Taylor et al., 2011). An additional 4.5 million children were born in the U.S. to at least one unauthorized immigrant parent (Taylor et al., 2011). The population of U.K.born children of irregular migrant parents is in the tens of thousands (Sigona and Hughes, 2012). Adding children who migrated independently and children who travelled with or joined their close family and reside in the U.K. irregularly, the figure grows to more than a hundred thousand minors (Sigona and Hughes, 2012).
This comparative report pulls together the findings from a three-year research project undertaken by the Centre for Migration Policy and Society (COMPAS) at the University of Oxford and the Institute for the Study of International Migration (ISIM) at Georgetown University. The project has focused on how two countries are addressing these challenges – the United Kingdom and the United States. Comparing the situation in Britain and America helps highlight issues that are of broad concern while focusing on the advantages and disadvantages of more specific policy options. The project fills gaps in knowledge in both countries of the experiences and everyday lives of migrant children who, through a range of different routes and circumstances, happen to reside in the U.K. and U.S. without legal residence status. In the United States, the project also examined the impact of parental status on citizen children.2 It aimed to show the multiple ways in which the lack of legal status affects the lives of young migrants both directly or through their parents, shaping their social worlds and more importantly their chances for the future. Moreover, through the exploration of services and resources available to them, in particular in relation to healthcare and education, the report sheds light on migrant children’s encounter with public services and the complexities and idiosyncrasies of the immigration system at a time of economic downturn and radical reform of public services. Although there are many differences between the two countries, particularly in citizenship, healthcare and policies to regularize the status of children, the comparison finds many similarities in the challenges faced by irregular migrant children, their families and the communities in which they reside.
As migrants and as children, this multi-faceted group stands at the crossroads of different and to some extent conflicting policy agendas. As this report shows, the unresolved tension between commitments to protect children and children’s rights, on the one hand, and curbing unauthorized immigration and securing borders, on the other hand, shapes their everyday lives in Britain and America. The Platform for International Cooperation on Undocumented Minors (PICUM) has pointed out that these children are: “in a position of triple vulnerability: as children above all, as migrants, and as undocumented migrants” (PICUM, 2008: 7). Moreover, many are also visible minorities and face challenges of racial, ethnic and religious discrimination, not only from the white majority but also from native-born minorities.
II. Methodology Research design and sampling strategies were informed by review studies (Sigona and Hughes, 2010; Weerasinghe, 2010; Weerasinghe et al., 2012) that provided the research team with insights into the legal status as well as different forms and demography of child migration and the complex policy framework governing it. The review studies also highlighted the importance to consider the specificities of migration histories, community formation and settlement patterns in understanding the experiences of irregular migrants.
client group and rationale for granting access, and the frontline experiences of engaging with this variegated group of young migrants. Over the period of fieldwork, the study teams also established collaborative links with a number of grassroots support and community organizations, and the research teams worked in close cooperation with them throughout the fieldwork. In the United Kingdom, interviewers sought out families from Afghanistan, Brazil, China, Kurdistan, Jamaica and Nigeria who were living in Birmingham and London. The countries of origin selected for inclusion in the study provided variation in terms of economic development; historical and colonial ties to the U.K.; and histories and motivations for migration to Britain. People from Jamaica, Nigeria and China have long histories of migration to Britain and have established community networks, while migration from Brazil and Afghanistan is more recent, and there are fewer community networks to help shape migrants’ experiences.
In order to capture variations and commonalities in the experiences of irregular migrant children and their families, the study used a purposive snowball-sampling frame to gain information about migrant children and/or families who had no legal status at the time of interview. Interviews with healthcare and education professionals, national and local politicians, civil servants and support organizations were conducted in parallel to the fieldwork with migrants. The main aim was to gather insights into the situation of irregular migrant children and explore issues such as entitlement and access to services, working definition of
The U.S. interviews were with families of mostly Mexican and Latin American origin who lived in the Washington,
In this report, the terms “irregular”, “unauthorized” and “undocumented” are used interchangeably to describe individuals who enter without the legal permission of the country of destination or who enter legally but overstay their permission to remain. 2 Under the 14th Amendment to the U.S. Constitution, children born on the territory of the United States are automatically U.S. citizens, regardless of the legal status of their parents. A similar provision does not apply in the United Kingdom so the children of undocumented parents born in the U.K. are themselves in irregular status. 1
D.C.-metropolitan area although additional information was collected in Colorado and New Mexico to provide a comparative perspective. The research included one year of continued ethnographic fieldwork in three different neighborhoods in the Washington. D.C.-metropolitan area: Chirilagua, V.A., a neighborhood on the border of Alexandria and Arlington also known as “Arlandria”; Langley Park, M.D.; and Columbia Heights, D.C.. Respondents were from El Salvador, Guatemala, Mexico, Bolivia and Colombia. Secondary analysis was also done of a survey in Los Angeles that included substantial data on undocumented children and children of undocumented parents. In order to gain the confidence of the migrants, we did not ask direct questions
about legal status but most of our respondents volunteered that information. Interviews were analyzed with the support of software for qualitative data analysis (NVivo 8) which facilitated the cross-examinations of data along different dimensions (e.g. country of origin, entry route, location, gender, household type, length of stay). Additional information about sampling strategy and methodology may be found in Sigona and Hughes (2012) and Gozdziak (2012).
III. Counting the Uncountable Increased interest in research on irregular migration is partly based on the premise that Western Europe and North America have seen a significant increase in the numbers of migrants residing in these countries “illegally” or using “illegal” entry channels. Significant numbers of these kinds of migrants can be expected to be individuals under 18.
Table 1: Updated estimate on the undocumented migrant population at end-2007
Central Estimate 430,000
Lower Estimate 310,000
Higher Estimate 570,000
Gordon et al. (2009)
Children have always been part of migration flows. However, data on children in families, whether documented or not, has been particularly limited. Children’s movements are often not recorded separately from their parents. The mobility of unaccompanied or separated children, instead, despite being a smaller group, has attracted significantly more attention from policy makers, support and advocacy groups, academics and the broader public. In the United Kingdom, estimating the numbers of irregular migrants is difficult, and rarely includes disaggregated data on children. The methods used are also much debated (LU.K.es et al., 2009; Vollmer, 2008). Problems arise in particular from the very nature of the target population that is hidden and mostly wants to remain as such (Bloch et al., 2007). The different definitions of “illegality” adopted in the studies also pose a significant challenge to the comparability of the data. Elaborating on Gordon et al.’s (2009) estimate, we have calculated an estimate of the irregular migrant children population in the U.K. at end-2007 (Sigona and Hughes, 2010) (See Table 1). Taking the central estimate as a reference, of a total of 155,000 migrant children, over 85,000 are estimated to be U.K.-born. The remaining 70,000 migrant children entered the country either as dependents (for example, of asylum seeking parents who had their application rejected) or independently (for example, overstaying student or visitor visas). It can be expected that among independent migrant children, asylum is likely to be less signiﬁcant as a route into irregular status than among adults
(incl. 85,000 U.K.-born)
(incl. 44,000 U.K.-born)
(incl. 144,000 U.K.-born)
Estimation of the unauthorized migrant population in the United States has a longer history than in the U.K. (Seigal et al., 1980). Generally, a residual method is used. Annual census and labor force surveys are adjusted upward to take into account the likely undercount of undocumented persons (calculated based on special surveys) and then the known number of births, deaths, legal admissions and estimated number of return migrants are subtracted to determine the likely number of unauthorized migrants. Passel and Cohn (2011) estimated the unauthorized population to be 11.2 million in 2010. Using socio-economic characteristics of the migrant population derived from various surveys to estimate age, Passel and Cohn conclude: Among children of unauthorized immigrants, an estimated 4.5 million are U.S.-born; 1 million are foreignborn and therefore unauthorized. The number of unauthorized children has declined from a peak of 1.6 million in 2005. The number of U.S.-born children has more than doubled from 2.1 million in 2000 (2011: 3). The estimates further indicate: “among children with at least one unauthorized immigrant parent, 70% have parents from Mexico, 17% from other Latin American countries, 7% from Asia, 2% from Europe and Canada, and 3% from Africa and other nations” (Passel and Cohn, 2011).
IV. Unauthorized Migrant Children, Law and Public Policy According to international law, all people are holders of rights, including irregular migrants. A number of civil, political, social and economic rights apply to individuals irrespective of their legal or administrative status, which are formally guaranteed under legal instruments such as the European Convention on Human Rights, the Universal Declaration of Human Rights or the International Covenant of Economic, Social and Cultural Rights. Children’s rights in particular are internationally enshrined in the Convention
on the Rights of the Child (UN, 1989). The CRC refers to a wide range of civil, economic, political and social rights. Article 3 of the Convention contains a principle that dictates the manner in which all the other rights in the Convention should be applied as well as providing an overarching substantive right. In particular, Article 3.1 states that: In all actions concerning children, whether undertaken by
public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interests of the child shall be a primary consideration.
duty under Section 13 of the Education Act 1996 to provide a school place to every child between the ages of 4 and 16 who is residing on a temporary or permanent basis in their geographic area. There is also no obligation for an education authority or school to ask for proof of a child’s immigration status or inform the U.K. Border Agency of any such status if it is disclosed. Therefore, even if a parent is an illegal entrant or an overstayer, his or her children are entitled to attend publicly funded schools. However, the Young People’s Learning Agency/Skills Funding Agency: Agency Funding Guidance 2010/11 Learner Eligibility Guidance (Version 1a, 19 March 2010) states that a learner must be lawfully resident in the United Kingdom to be able to obtain a free place in further education and that a person subject to a deportation order will ordinarily be ineligible for funding until his or her situation has been resolved.4
International instruments, such as the CRC, formally offer considerable protection to migrant children regardless of their legal status (CRC General Comment No. 6: UN, 1989). However, the enforcement of such international instruments depends significantly on their incorporation into domestic law. In the U.K., the CRC was ratified in 1991 but it has not yet been fully incorporated into national law. The U.S. has not ratified the CRC, although it has ratified other conventions that include provisions similar to those encompassed in the CRC. Moreover, the U.S. Constitution provides significant protections that apply to all children, including those who are without authorization, including the right to a primary and secondary education.
Article 24.1 of the CRC recognizes: “the right of the child to the enjoyment of the highest attainable standard of health,” and commits States parties: “to ensure that no child is deprived of his or her right of access to such health care services.” At present, irregular migrant children have access free of charges only to primary and emergency care. Anyone needing primary care can approach his or her local GP (General Practitioner) or Primary Care Trust, and GPs have a discretion to take anyone on as a patient on a temporary or permanent basis, irrespective of their immigration status. If they choose not to exercise this discretion, the Primary Care Trust must then locate a GP who is willing to take the patient on to their temporary or permanent list. Difficulties arise if the patient needs to be referred for hospital treatment, as an irregular migrant child may not qualify for free hospital treatment under the National Health Services (Treatment of Overseas Visitors) (Amendment) Regulations 2004 SI 2004/614.5 Prior to 2004, anyone who had lived in the U.K. for more than a year qualified, but now they have to show that this period of residence was lawful.
Perhaps the most striking legal difference between the U.S. and the U.K. pertains to children born to unauthorized migrants. All children born on U.S. territory to irregular migrants automatically are U.S. citizens, with all rights and responsibilities that citizenship provides. By contrast, children of irregular migrant parents who are born in the U.K. are labeled “illegal migrants”. This effectively excludes many of them from citizenship, forced into a limbo from which there are few ways out.3 It is important to keep in mind, however, that the legal differences do not always result in practical improvements in access to education and healthcare. In both countries, the irregular status of parents often impedes access even when the children face no legal barriers (Yoshikawa, 2011). United Kingdon. The U.K. Government’s strategy for children is set out in the Children Acts 1989 and 2004 and the Every Child Matters (ECM) framework which, over the last decade, have considerably transformed child welfare policies in the U.K., marking a change in the way local and national government and other organizations work with children and families. Section 11 of the Children Act 2004 has introduced the duty of regard for the welfare of children to almost all state agencies. It has also set out a statutory framework for local cooperation to protect children. According to the ECM framework, all organizations with responsibility for services to children must take steps to ensure that in discharging their functions they safeguard and promote the welfare of children. Safeguarding and promoting the welfare of children is primarily the responsibility of the local authority, working in partnership with other public agencies, the voluntary sector, children and young people, parents and caregivers and the wider community. Several of the CRC provisions address issues in this report. Article 28 of the CRC recognizes that every child has a right to education but only commits States to making primary education compulsory and free. The United Kingdom is providing educational services that presently exceed those required by the CRC, as all local education authorities have a
Overall, evidence suggests that children in the immigration system are treated firstly as migrants, similarly to adult migrants if independent or as extensions of their parents if accompanied, and secondly as children with particular rights and needs (see Crawley, 2006; Sawyer, 2006). A code of practice for safeguarding the welfare of children in the immigration system has been developed but treatment of irregular migrant children remains largely separated and different from the treatment of all children, producing a hierarchy of more or less deserving children in the country. Against this background, the local level plays a crucial role. Under the Section 17 (1) of the Children Act 1989, local authorities have a general duty to promote the welfare of children “in need” in their area and to enable children to be brought up by their families by providing a range of support services to the child and his/her family irrespective of immigration status.6 To this end, they are also responsible for coordinating other local service providers. It is important
It should be noted, however, that Section 1(4) British Nationality Act 1981, which provides the possibility to apply for citizenship after 10 years of residence for U.K.-born children irrespective of legal status, provides an important if not well understood route to regularization. 4 Under the Points Based System now operating within the Immigration Rules, an irregular migrant child would not qualify as a Tier 4 (General) Student Migrant due to having previously breached immigration law and would therefore not be able to secure a place on a Higher Education course (Finch, 2011). 5 The guidelines were update in October 2012 (see Guidance On Implementing the Overseas Visitors Hospital Charging Regulations) so that HIV treatment is no longer chargeable to overseas visitors. 6 In general, the statutory duties owed by a local authority and other public authorities to irregular migrant children arise from the fact that he or she is a child and the reasons for his or her irregular immigration status are not of direct relevance. Restrictions on entitlement largely depend on the current immigration status held by an irregular migrant child and not on how he or she became irregular. However, particular duties and powers arise when a child is unaccompanied under Section 20 of the Children Act 1989 or is born in the United Kingdom. Children of failed asylum seekers also have some additional entitlements for example under Section 4 of the Immigration and Asylum Act 1999 (Finch, 2011). 3
Local authorities, together with schools, healthcare professionals and other local agencies have the difficult task in their everyday practices to mediate between conflicting policy agendas and interests. They are left to manage the micro-social costs of immigration policy and, increasingly, are asked by the central government to perform tasks of immigration control traditionally assigned to the Home Office and the U.K. Border Agency (U.K.B.A). This is illustrated by the attempt to place a responsibility on healthcare professionals to establish a patient’s immigration status, by asking schools to cooperate with the U.K.B.A. and apply more stringent control during the enrolment phase as well as by the duty on local authorities (including social services) to supply information in respect of a person where it is reasonably suspected that the person has committed specified immigration offences under Section 129 of the Nationality, Immigration and Asylum Act 2002. Evidence suggest that lack of access to social rights and services is often due to a confusion among the service providers on what the rights of irregular migrants are (Hewett et al., 2005). This confusion is partly the result of conflicting legislation and frequent change of policies. As a result, service providers take decisions based on outdated information and are in constant need of retraining. Additionally, policy announcements and consultations anticipating future’s policy changes blur the boundaries between current and anticipated law. United States. In summer 2012, the Department of Homeland Security announced a new program, Deferred Action for Childhood Arrivals (DACA), for undocumented children and youth who had arrived in the United States before their sixteenth birthday and were not yet 30 years of age. If they were in or had completed high school or served in the U.S. military and had not been convicted of a felony or serious misdemeanor or did not pose a threat to national security, these undocumented children would be granted deferred action – meaning that they would not be placed in removal hearings – for two years. With deferred action, they will be eligible for a work permit. At the end of two years (assuming the policy is continued), they will be able to apply for renewal of deferred action. The status does not give them the right to stay permanently in the United States, but it does protect them from deportation. The administrative act responded to lobbying by immigrant advocates for legislation called the Dream Act that would have put these children on a path to citizenship. Congress had failed to take action on the legislation, leading the administration to use its more limited authority to give the youth a breathing space of at least two years. The Dream Act and DACA emanate from what has become a more general policy framework in the United States – that children should not be punished for the acts of their parents.
The Supreme Court applied this concept in a seminal decision in 1982, Plyler v. Doe, which held that children in the United States, irrespective of their immigration status, have a constitutional right to free public elementary and secondary education. In Plyler, the Supreme Court held that the state of Texas violated the Equal Protection Clause of the Fourteenth Amendment to the U.S. Constitution by denying unauthorized school-age children a free public education. The Plyler Court recognized the importance of access to education by noting: “it is doubtful that any child may reasonably be expected to succeed in life if he is denied the opportunity of an education,” and acknowledged that education is a child’s only path to becoming a “self-reliant and self-sufficient participant in society.” Notwithstanding criticism of Plyler (Hutchinson, 1982; Kurland and Hutchinson, 1983; Perry, 1983), over the intervening years, the core constitutional guarantee of K-12 educational access has remained intact (Olivas, 2010), even in the face of direct legislative challenges. Whilst Plyler addressed the right to education in the K-12 context, it was silent on whether the relevant protections extended to the college setting. In this regard, even though federal law does not expressly prohibit the admission of unauthorized students to U.S. colleges (Gonzales, 2009), upon graduation from high school and application to colleges, the limitations associated with unauthorized status become more acute and barriers multiply (Gonzales, 2007, 2010; Diaz-Strong et al., 2010). The passage of the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) (U.S. Congress, 1996) and the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA) have further engendered this controversy (Salinas, 2006). The PRWORA prohibited states from providing federal post-secondary grant, loan and work-study assistance to unauthorized students; states wishing to provide financial aid to unauthorized students were mandated to pass affirmative legislation addressing eligibility (Chacón, 2008). Since that time, a number of states have passed laws that offer instate tuition to undocumented migrants who finish high school in those states and are otherwise admissible to local colleges and universities. Other states have taken exactly the opposite stance and specifically barred undocumented migrant youth from enrolling in publicly funded colleges and universities. A piece of bipartisan federal legislation which moves beyond access and impacts the quality of education provided at public elementary and secondary schools is the No Child Left Behind (NCLB) Act of 2001 (U.S. Congress, 2002). This law aims to improve the academic performance of students and to eliminate the achievement gap among students from different backgrounds (Ryan, 2004) by fundamentally changing the way students are taught and evaluated (Murray et al., 2007). More specifically, the law holds schools accountable for the academic performance of all students, including limited English proficient (LEP) students (Consentino de Cohen, 2005). Although the law does not single out unauthorized students as a protected subgroup, many LEP students are immigrants or children of immigrants (Capps et al., 2005; Consentino de Cohen, 2005). Moreover, such children also often fall into other protected groups
to note that the duty is triggered by an assessment of need, which is a quantifiable concept and not by any notion of vulnerability. An irregular migrant child may have been rendered “vulnerable” by his or her past experiences or the deprivations which arise from being without regular immigration status, but assistance will only be provided under Section 17 in response to a need for accommodation or other forms of tangible support.
such as “major racial and ethnic groups” (Hispanics, Asians), low-income students and students in special education programs (Capps et al., 2005).
1997, federal coverage of health care services for children was further extended through CHIP (U.S. Congress, 1997; Wysent et al., 2003; Fremstad and Cox, 2004). It provides health coverage to uninsured, low-income children whose family income is too high to qualify for Medicaid but too low to reasonably afford private health coverage (National Immigration Law Center, 2003; Wysen et al., 2003; Fremstad and Cox, 2004).
The NCLB Act also affected bilingual education. The Act consolidated grants under the Bilingual Education Act and under the Emergency Immigrant Education Act into a single population-based formula grant (U.S. Congress, 1965). The new system allocates funding according to the population of LEPs (80%) and according to the population of recently arrived immigrants (20%) (CRS Report for Congress, 2007).
Under Medicaid and CHIP, unauthorized migrants, including children, are ineligible for non-emergency services. Citizen children (including citizen children of unauthorized parents) are eligible to access a broad range of health care services provided they meet relevant income and other eligibility criteria (Costich, 2001/2002; Lessard and Ku, 2003; Fremstad and Cox, 2004; Ku, 2007). States are permitted to use federal funds to provide pre-natal health services to women regardless of immigration status (National Immigration Law Center, 2003; Fremstad and Cox, 2004). It is the fetus rather than the pregnant woman who is the recipient of the CHIP-funded services and accordingly, the scope of services available to the pregnant woman is limited to those directly related to the fetus ( National Immigration Law Center, 2003; Aguilar, 2005). However, as discussed below, eligibility does not always lead to health insurance coverage and even many citizen children of unauthorized parents are not enrolled in Medicaid or CHIP (Lessard and Ku, 2003; Fremstad and Cox, 2004). Citizen children (as well as citizen adults) applying for or renewing Medicaid coverage are required to present satisfactory documentary evidence of citizenship (Ku, 2006; Sommers, 2010).
Neither the U.S. Constitution, nor the common law, recognizes an affirmative right to health care in the United States (Gunnar, 2006). Unlike many other industrialized countries, the existing U.S. system of health care is not a national system of health care access (Calvo, 2008). Rather, it is a system, which relies predominantly on health insurance from employers for workers and their families (Furrow, 2007). However, a proportion of health insurance programs offered by employers do not cover part-time employees or dependents of employees, let alone unauthorized workers. In this regard, unauthorized immigrants represent a significant proportion of the uninsured population in the United States. The Patient Protection and Affordable Health Care Act of 2010 (ACA) (commonly referred to as the Affordable Care Act, Healthcare Reform or Health Insurance Reform) (U.S. Congress, 2010) aims to expand coverage, control health care costs and improve health care system delivery. Yet, its programs aimed at assisting the uninsured obtain coverage specifically exclude unauthorized immigrants (Zuckerman et al., 2011), although citizen children of unauthorized parents are not necessarily excluded (National Immigration Law Center, 2010).
All unauthorized migrants, including children, are eligible for emergency Medicaid provided they meet other eligibility criteria and are faced with an emergency medical condition. The definition of an emergency medical condition for Medicaid eligibility corresponds with the definition7 under the Emergency Medical Treatment and Active Labor (EMTAL) Act, which was enacted in 1986 to guarantee emergency health care to all individuals. This Act aims to ensure that all persons have equal access to emergency medical care by requiring any hospital with an emergency room to provide emergency care (examination, treatment and stabilization) regardless of insurance coverage, immigration status, ability to pay or any other criteria (Gunnar, 2006; Cohen, 2007; Clarke, 2008). Under the Act, hospitals or physicians that fail to meet appropriate standards of patient care are penalized (Gunnar, 2006).
Supplementing the U.S. system of health insurance provision by employers are a variety of federal, state and local government programs for individuals who cannot obtain private health insurance (Calvo, 2008). In this context, the Medicaid and the State Children’s Health Insurance Program (CHIP) are of particular relevance to children. Since 1965, the federal Medicaid program (which was created under Title XIX of the Social Security Act of 1965) (U.S. Congress, 2000) has provided funding and a means tested, need-based entitlement framework for the provision of a comprehensive set of health services for specific categories of low-income individuals, including children (Wysen et al., 2003). In
V. Policy in Practice Children without authorized residence in the U.K. and U.S. encounter public services on a daily basis. Seldom are services specifically geared to this population, but restrictions that apply to irregular migrants are often waived on a humanitarian basis for children. The majority of services focuses in the first instance on emergency provisions, such as help with food, clothing, basic healthcare and housing, which is followed by more long-term support involving immigration advice, welfare, immigration and benefit advice, advocacy on behalf of clients and sign-posting.
In most cases, the children fall under a category, such as Limited English Proficient or destitute, which allows service providers to assist all children without regard to legal status. Such services provide some degree of access and protection, but they also vary in quality, are subject to different interpretations and local circumstances, and ultimately may exclude a significant number of children who face barriers related to their own legal status or that of their families. The campaign led by the Heart of Birmingham PCT to reduce
An emergency medical condition is defined as a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in (A) placing the patient’s health in serious jeopardy, (B) serious impairment to bodily functions, or (C) serious dysfunction of any bodily organ or part. (Costich, 2001/2002) 7
infant mortality among “new immigrant communities” in its catchment area provides a valid example of how public services can reach irregular migrant children and families by proxy. A senior civil servant in Birmingham explains: Any trick in the book is useful to try to establish services when more straightforward ways would simply not be accepted…It is under the general umbrella of that indicator of infant mortality that we were able to look at the position of say, pregnant women in marginal migrant communities, and provide money to ensure that the children are safe, and the mothers are safe and that adequate care is provided. Agencies are also creative in categorizing the form of aid that is provided. A community organization in the Washington, D.C.-metropolitan area enabled undocumented children to participate in summer programs, despite their ineligibility for work permits, by raising funds from private donors for summer stipends, rather than salaries. Private funds are important for helping unauthorized migrants gain access to U.S. health care services as well. Community leaders working with Latino immigrant families in D.C. said that while access issues persist for some children, long-standing advocacy efforts have resulted in a robust network of free or fairly affordable health clinics. The same networks work with immigrant communities to reassure them that beneficiaries will not be reported to immigration authorities. Some Primary Care Trusts in the U.K. have opted to commission specialist services in the form of a GP practice. This means that in these areas, irregular migrants are able to access primary healthcare without any problems, and their staff is trained and knowledgeable about the specific problems of their clients, often extending beyond healthcare needs. Urgent care centers/walk-in clinics have been set up as another alternative to deal with a mobile population without legal status to use services that are more formal.
Reporting requirements regarding migrant children have been controversial in the United States as well. Federal rules exempt non-profit charitable organizations from “requirements to determine, verify, or otherwise require proof of alien eligibility or status.”8 Public agencies that administer cash assistance and public housing programs are required to report persons they know are unlawfully in the U.S to immigration authorities. Under current interpretations of the Supreme Court’s Plyler decision, schools are barred, however, from asking any questions that would have a “chilling effect” on the willingness of undocumented students to enroll. Several U.S. states have attempted to implement legislation that would require schools to ascertain the legal status of students or their parents. The most far-reaching, enacted in Alabama, required schools to determine upon enrollment whether the enrolling child “was born outside the jurisdiction of the United States or is the child of an alien not lawfully present in the United States.” The provision would have applied to U.S. citizen children of unauthorized migrants. As of this writing, the provision has been blocked by the U.S. Court of Appeals for the 11th Circuit that held it: “imposes a substantial burden on the right of undocumented school children to receive an education.”9
There are limits to this approach however. As the coordinator of a service for destitute people in the U.K. pointed out, irregular migrant children and families are particularly vulnerable as there is no strategy to support them once they have fallen out of the system, and there is, conveniently, no record to show how many people are in that situation. When children age out of eligibility for services, for example, there may be few alternatives. Many of the interviewed children found themselves in what researchers in the U.S. call “suspended illegality” through late adolescence. In kindergarten, primary and even middle schools, they did not have to face full on the consequences of their immigration status. However, once they entered high school, particularly during their final year, when their peers were applying to college unauthorized children started realizing the effects of their immigration status on their future after high school: The social parenthesis the moratorium affords them gives way in late adolescence to a time of deep disorientation, of shock, of not knowing who they are or where they belong, and of anger at their parents for putting them in this situation (Suarez-Orozco et al., 2011: 453).
In the U.K. as well, the services that are available or provided specifically for irregular migrant children and their families vary significantly between different localities and over time, subject to funding availability as well as the broader political and economic context. A striking example of this diversity on the ground is provided by a London-based interviewee
Despite efforts to protect the identity of their clients, the ability of service providers to ensure that information will not be used for immigration enforcement purposes provides 8 9
constraints as well. Ensuring protection of such information is often essential to building trust with clients. Some U.S. health care providers said that a mere threat of deportation prevents many unauthorized parents from taking their children to the doctor. Fear of exposing immigration status, and consequent repercussions, contributes to confusion regarding eligibility rules (Costich, 2001/2001; Lessard and Ku, 2003; Gunnar, 2006; Calvo, 2008). Researchers indicate that this situation raises serious public health and moral concerns (Berk and Schur, 2001). Requirements to collect information and provide it to immigration authorities are especially problematic. Stakeholders find themselves caught in between their commitment to the best interest of the child and increasing demands by the government for them to contribute to the task of controlling migration. A senior manager at a Further Education college in London captures this sentiment: “It is now my duty to check that new students hold valid passports and visas. But I work in a school. I don’t work for U.K.B,A, That’s not the job I applied for.” Also among healthcare professionals working in close contact with irregular migrants there was a sense of discomfort for the demands coming from the central government that seek to turn them into “mini-immigration officers”: We’ve always adopted the stance that we’re healthcare providers and the sort of policing and the immigration thing, that’s other people’s business and if they want to sort it out then they can sort that out (laughs) but that’s not our job to sort that out for them (General Practitioner, East London).
who explains how difficult it can be to register a newborn with a GP in some areas of London: “It’s just unfortunate that if you’re a baby that’s born in West London you have… pretty much no chance of registering whereas if you’re born here in the East you can register like this (snaps fingers), it’s, it’s a huge injustice.” Interviewees pointed out that registering with GPs has become much harder even though there have been no changes in the law. Some GPs have implemented increased checks, but it is unclear whether that is out of choice or pressure. There are government officials responsible for recovering fees for those who are not eligible and uncovering fraud, raising questions about the voluntariness of these processes. The consultation launched by the government (26 February 2010) did not lead to any formal change yet many felt that there were real changes and ground-level access was in fact restricted. A common complaint regarding the difficulties in gaining access to GPs in the U.K. was the barrier that receptionists and other administrative staff, such as practice managers, often posed. This meant that many irregular migrants were only able to register with a GP after several attempts with different practices. At the same time, it seemed that, in their experience, a significant number, maybe even most, were able to register with a GP in the end. Another major problem is the clients’ fear to move from one GP to another, particularly those who registered when they were legally resident and are keeping their registration by inertia even after their circumstances have changed. A serious problem for those who did receive secondary healthcare was the subsequent charge that was requested from them and often forcefully chased. The payment of these often high bills to people who are often destitute or near destitute could cause huge stress. Although access to primary and secondary education posed no legal and few practical challenges (discussed below), education beyond primary and secondary is problematic
in both countries. Some institutions of higher education try to help unauthorized migrant youth who wish to enroll. This means that they will accept papers that are given to them, try and be as flexible as possible regarding the type of documents they are presented with without getting themselves into trouble, all the while seeing the well-being of the student as their priority. As one member of staff at a London college reported: I wouldn’t know what a forged Italian passport, or a Portuguese, or a forged Spanish document would look like, it’s not my job, you know, all I do is to say ‘What is your nationality’ they then have to show that documentation to the enrolment officer and they photocopy it as evidence.” In other cases, however, it has been reported that schools check visas. Where the money comes from as well as its level has an impact on what kind of services can be provided and how explicit organizations can be about the target users of their services. Charities and NGOs with independent sources of funding are better placed to adapt their services to the specific needs of their clients in both countries. Some municipalities used their own revenues to expand access of undocumented children even when national authorities prohibited use of their funds. In both countries, however, the downturn in the economy and general funding cuts mean that more organizations are competing for less money overall. Migrant support organizations feel that they are often not seen as a priority, that they are at the bottom end of the ladder and will get cut first. For most community-based organizations, funding remains an issue of ongoing insecurity and needs to be sought constantly. Funding is often given per project on a short-term basis. This also affects the way work is planned and delivered. The project cycle is so short that there is very little time where it “just works”. The subsequent lack of continuity and uncertainty affect the quality of care that irregular migrant children receive.
V.A. Migrant Experiences with the Education System Overall, parents of undocumented children in both countries value education highly and see it as a primary pathway to social mobility. Yet, educational outcomes for unauthorized migrant children do not necessarily match these beliefs. In the United States, for example, 40 per cent of unauthorized young adults, ages 18 to 24, have not completed high school. Unauthorized children who arrive in the United States before the age of 14 do slightly better – 72 per cent finish high school (Passel and Cohn, 2009). Some of these students can be termed “drop-outs”, having started school but not completed it, but others never “drop-in” to school. They come, often as teenagers, with the intent to work, not to study. Some eventually do obtain a high school degree but many others remain in the labor force, never to complete their education. A Guatemalan youth is a case in point: “Once you grow older, you realize the value of studies.” It never occurred to him to enroll in school in the United States, because he was already working in Guatemala. He came to the U.S. to work, not to go to school. Immigration status is but one of a range of barriers that undocumented children face in the education system. Despite the overall positive attitude towards education
and schooling, a number of parents and children reported difficulty in combining the continuity of education with the uncertainty of their lives. In the U.K., most of the interviewed minors who were not attending school had consciously decided not to enroll because they had no documents, despite expressing a desire to learn. Insecurity of residency was another problem. A Chinese mother explains: “We don’t have a fixed place to live. This will cause a lot of problems for our child if she wants to go to school. This is the thing that causes us the biggest headache.” Parents also pointed out that access to education and especially the enrollment process have become harsher and tougher over recent years. This coincided with worries of parents around the issue of collaboration between schools and the U.K. Border Agency or Home Office: Some schools didn’t really care back then…you know...I think they are getting fewer now, that don’t care about [immigration status]…I read on the internet, [that] the Border Agency is tightening up even in schools...whereby all the schools must ask for documents of the parents… so even if the child has right to education, if the parents do not have the legal status to stay in the country...they might as well say the child does not have the right to
education in the country (Nigerian mother).
of friends and family.
Some were turned away from schools. Noteworthy, parents in the U.K. mentioned that it was not always the first school that accepted their children and that the search of place could be time consuming, resulting in children missing school and having to start school in a class younger than their age cohort. Parental attitudes in both countries showed variation in the assessment of education despite the general appreciation of its benefits. Many parents felt that schools were better in the destination than in their countries of origin although the sentiment was not universal. They also appreciated that education was free. Attendance was considered important and missing school days an exception. However, as the U.K. interviews showed, not merely the value of education but also worries about legal status and being reported to local authority’s social services contributed to the priority given attendance.
Lack of immigration status affects children’s life at school in many ways. In the U.K., because of the lack of legal status, children are not entitled to benefits such as school meals, financial support for uniforms or transport to and from school. School trips abroad illuminated another dimension of how the lack of immigration status was felt by the children and their parents. Although limited money was also an issue, the lack of a passport or visa was usually the main reason for children not joining such trips and would sometimes play a role in the disclosure of the immigration status by parents to their children: “My daughter said that they have a France trip coming up and it’s about education next year...I don’t think she’ll be able to go.” Serious obstacles were experienced by young people who wanted to change school (e.g. due to moving house) or go to college or university. This often had a seriously negative impact on the youth, as most were not able to see a way out of this situation. In addition, access to precompulsory education is difficult. Parents struggle to gain access to nurseries or pre-school childcare, and most relied on arranging childcare privately. This could either mean accepting less income as one parent would stay at home or, for single-mothers, having to rely a lot on personal networks
More tensions were identified in the U.S. interviews. Schools were not necessarily seen as safe places for the undocumented children. Fistfights and physical violence experienced by many of the interviewed as well as gang violence discourage Latino students from attending school; many skipped school often or dropped out altogether. One Latino immigrant student reported being: “kicked in the chest by a big girl [on his first day of school]. She seemed so big, maybe 6 feet tall. She was black.” He did not report the incident: “No, I did not do anything. I did not know where to go. I told my friend and he told me ‘Man, there is nothing you can do’ so I just sat there on a swing.” Descriptions of good relationships between immigrant children and other students were sometimes belied by the largely segregated social patterns that emerged in observations. In some cases, the migrant children are excluded and in others, they self-segregate. As one U.S. stakeholder described: It is difficult for immigrant children to communicate with peers who do not speak Spanish. These limitations often lead Mexicans to self-segregate. Migrant children make friends within their migrant network, creating an insulated cultural and language bubble. Indigenous Indian students and Black Latinos we spoke with experienced discrimination from within the Latino community as well. Recounting being teased and bullied in high school, one student said: “It was just like in Guatemala. They judged me by my clothing. I didn’t have a lot of friends.” Difficulties in relationships with other classmates occurred in the U.K. as well when direct comparisons were made. A crucial issue was lack of money, which meant the children could not keep up with their friends’ clothes and gadgets and so on. Some young people also compared themselves to others in terms of their status. A young Jamaican, for example, noted: I’m thinking they don’t know how privileged they are, ‘cause they don’t...Obviously they are not in the situation so they don’t have to think about it. So therefore they don’t know how privileged they are, how they can go, get jobs, quit whenever they want and do all of these things, all these sorts of things. Particularly pernicious in the U.S. interviews were the
Depending on their own educational experiences, parents differed as to what constituted an appropriate level of education for their children. All seemed to want their children’s education to exceed their own. Some undocumented migrants who had professional degrees in their own countries expressed their willingness to do low wage work in the U.S. or U.K. precisely because they hoped for a better life for their children. Some parents with very low levels of education saw a secondary education as a major achievement and gave their children little encouragement to go to college. In some cases, their earnings were needed to supplement the family’s income and to send remittances to relatives in the home country. In the U.S., parents were also reluctant to see their children incur large debts to pursue a college education. Certainly, worries about their children’s lack of legal immigration status played a role but the reluctance to encourage higher education sometimes extended to citizen children as well.
A major difference in the U.S. and U.K. findings pertained to relationships between undocumented students and other students. Before starting school, a Brazilian child was worried about how he would be treated by the other children in the U.K. To his own surprise, he had a good experience: I thought in the beginning that they were going to treat me differently because I’m from Brazil but there in the school there are many people from other countries, here in London there are many people from other countries and I also thought that the English kids my age would treat me differently because I am from Brazil, but no they treated me like a brother. Others reported similar experiences, and usually the children’s school friends were from a variety of national backgrounds. However, many children would not often meet up with school friends outside of school.
assumptions of teachers and administrators about immigrant students. Often, counselors assumed that Latino students were undocumented and could not go on to higher education. Such assumptions were not only unwarranted, since many children of undocumented parents are U.S. citizens, but also they undermined the aspirations of all Latino students. Ethnic and racial stereotyping often led Latino students to be overlooked, excluded or negatively tracked and resulted in unequal educational opportunities. An expert on bilingual education remarked that Latino students are marginalized within the school system in Washington, D.C.: “In a school system where the majority of students are African Americans – with their own set of educational challenges – it is virtually impossible to get anyone focused on the Latino kids.” Although reluctant to talk about overt discrimination, he nevertheless wondered, “where neglect ends and discrimination begins.” Parents often found it difficult to counter the problems faced by their children. Lack of English language knowledge in both countries was common among parents, especially among those who did not know English from their countries of origin. Such language difficulties affected them in their dealings with their children’s school in several ways and often required complicated arrangements for translations. Once enrolled, difficulties often continued for parents in communicating with the school. These included talking to teachers about their child’s progress at parents’ evenings as well as discussing and agreeing simple arrangements of when to pick up their children. Most of the time parents would find a friend or acquaintance to accompany them to the school in order to translate. Some students or their parents reported that the school and teachers had been helpful in involving the children. In the U.K., a lot reported that the school used a “buddies” system, where a “new” child was paired with a child that had been at the school for some time, to help them get settled. In some instances, the “buddies” even spoke their native language. Those who migrate while still young found it easy to learn English in the school setting. Sometimes, however, children would pair up with co-nationals, or other children who spoke the same native language, which would inhibit them from improving in English. The U.K. interviews revealed some differences between young unaccompanied people who often attend ESOL or similar English language classes before entering the mainstream education system, whereas children in families tend to enroll in schools straight away, regardless of the children’s language skills. The irregular status of parents affects their children’s experiences in both direct and indirect ways. A couple of U.S.-born Latino high school seniors stated that they did not realize how much their parents or siblings’ unauthorized status affected their ability to be successful in applying to college until they wrote their college essays. One remarked: I have the grades to get to a good college, but I don’t have any extracurricular activities to brag about in my essay. My friends are writing about trips abroad, community service, sports achievements and I have nothing! All I ever did during high school was study. My mom told me to lay low, because she was afraid that someone would tell immigration authorities that both she and my older brother are here without papers.
The fear of possible deportation of family members overshadowed days in school. Several community leaders told us: “[the] issue of immigration status just hangs there,” both for unauthorized children and for those living with unauthorized family members. Many Latino children feel pressure not to be noticed and not to discuss their or their family’s status with peers. A director of youth leadership program in the District of Columbia talked about the constant fear and the psychological effects of immigration status on Latino youth: Even if they are here legally, they hear every day about someone having been deported or someone having been shot at – or worse, having died – while crossing the border. It’s difficult to shake it off. A long-time immigrant children advocate in Washington, D.C. spoke about the effects of parents’ undocumented status on young Latino children born in the United States: The number one problem is not undocumented status anymore – relatively few [unauthorized] kids come these days [to Washington, DC] – but the indirect effect of the undocumented status of immigrant parents, particularly those who came in as children or teens, and resulting lack of security and feelings of abandonment affect their parenting skills and ability to raise and educate their children well. The status of parents affected children in the U.K. as well. For an undocumented migrant parent bringing up a child can be “at times overwhelming,” in the words of a Nigerian father. The precariousness of legal status means living in continuous fear of deportation and relying on volatile income for the everyday survival. Many interviewees felt unable to do anything “normal” with their children and struggled to protect them from the pressure they were experiencing because of their situation. While they may be unaware of the subtleties of the immigration system, nonetheless children understand parents’ anxieties and are affected by economic hardship and, if possible, try to help. Another significant intersection of immigration status and parenthood is the case of transnational migrant families, where lack of status and the rigidity of immigration control lock irregular migrants in the place of residence forcing separated families to stay apart, an issue particularly relevant among Chinese interviewees in the U.K. who had left children behind. Even when family reunion eventually happens, the enforced separation may produce lasting consequences. A Kurdish father was separated from his daughter for five years; when he finally managed to have her in England, he discovered that the rapport he once had was no longer there. Letting children know about their legal status is difficult and parents address the issue differently. In some cases, the disclosure is the result of events outside parental control, and they can only minimize the damages. Age plays an important role. The older the children get, the more aware they become of their circumstances. One father summarized the position taken by others. He noted that he prefers his children not to know about the lack of legal status for the security of his family.
V.B. Undocumented Migrant Children’s Health and Well-Being The combination of precarious immigration status and financial hardship often has serious effects on migrants’ physical and mental health, often resulting in chronic conditions such as asthma, migraines and depression. A Jamaican mother in the U.K. explains how her immigration status affects her: “Mentally, it’s really bad. We’re just sitting here, staring, wondering where the next meal is going to come from, when the next bill is going to be paid.” The precarious situation, in which many of the interviewees live, has often meant that any change in their situation or negative experience easily lead to a downward spiral. Talking about her father’s funeral in Jamaica, one mother in the U.K. said: “Everyone was like going over, I couldn’t go… my sisters, brothers, they all went over. I was the only child that wasn’t there. I couldn’t eat, couldn’t do nothing.” In the U.S., one interviewee noted: Many parents escaped wars and civil unrest, children experience the effects of family separation and feel abandoned by their parents. Undocumented status contributes to this trauma; people change names very often and the feeling of constantly hiding does not help build a better life in the U.S. A common theme was that interviewees saw a strong connection between their chronic physical ailments and their emotional/psychological stresses. Signs of stress, exhaustion, anxiety and other impacts on health due to financial and immigration status insecurities could be detected in most interviews. The majority of the interviewees that explicitly talked about their mental health problems were parents and a number of them were being treated with either or both anti-depressants and counseling. Reasons given for feeling depressed or “low” included fear of being deported or detained, not knowing what will happen in both the near and the distant future, not being able to talk about their problems, losing support networks or not having any in the first instance thus feeling lonely and isolated and in inadequate accommodation arrangements. Of particular concern was the well-being of children who had experienced detention and deportation. In the U.S., parents, children and stakeholders raised issues related to gang violence, domestic violence and teenage pregnancy as public health concerns that affected the entire community. Obesity is also a problem that affects children of unauthorized parents, as it does many young Americans. The differences in the U.S. and U.K. healthcare systems were apparent in the access of children to primary care. Most of those interviewed in the U.K. were registered with a GP and able to access primary care. Where parents were interviewed, this applied to both parents and children. Children who were born in the U.K. were usually referred to a GP by hospital staff and registered with their birth certificate without problems. Migrant children who were in the U.K. with their family were more likely to be registered with a GP and felt that going to the GP was normal and safe. Independent minors were more likely to feel apprehensive about going to a GP, or they would not even try to register. Several mothers made a distinction when accessing healthcare for adults and for children under 16 (“under-16s”), which they felt was much easier. Furthermore, many thought that for children under 10
16, health care was automatically free, whereas they were not always clear about the adults’ entitlements to healthcare. Although the initial picture that emerged looked positive in terms of access to primary healthcare, it is important to look at how and which GPs were accessed. In the majority of cases, individuals registered very soon after their arrival in the U.K. while having some form of residence status, either as a visitor, a student or an asylum-seeker. A number of interviewees were not able to register with the first GP they approached, and it often took several attempts with different GPs before registration was successful. Once registered, interviewees tended to remain with the same GP, regardless of changes in their situation, such as moving to a different area. This would usually mean long travel times to get to the GP, further complicating access to healthcare. Retaining the same GP was often a conscious decision because they were worried they would not be able to re-register with a new GP. Overall, migrants in the U.K. seemed to have good relationships with their GPs. Sometimes the relationships were so good and trustworthy that interviewees openly discussed their immigration situation with the GP, who became the first port of call for advice. Several interviewees told us that their GPs had written letters of support to the Home Office. The main problem reported around accessing and receiving good healthcare by interviewees were issues around language. Such problems could be particularly distressing in emergencies. Problems in describing and explaining one’s health needs were common and often resulted in confusion. Arranging for an interpreter remained complicated (Gill et al., 2011). Some resorted to seeking help from a friend to interpret, and, in some instances, children interpreted for the parents. A number of interviewees were also able to find health professionals that spoke their native language. Furthermore, many preferred to speak English to their physicians to practice the language and said that that staff were mostly patient with them if they had difficulties expressing themselves. However, if the illness was serious, an interpreter would commonly be requested. In the U.S., no system of healthcare corresponds to what is available in Britain. As discussed above, the U.S. citizen children interviewed are eligible for CHIPS and Medicaid. Access for the undocumented children depends on whether the parents have employer-provided private health insurance. Few employers of low-wage workers offer such coverage to their employees. As a result, levels of uninsurance are extremely high among immigrant families in general and undocumented in particular. A 2004 study found that 51 per cent of recent immigrants (those in the U.S. for less than six years) were uninsured, as compared to 15 per cent of natives.10 For unauthorized children in the D.C., Maryland and Virginia areas, there are some options for free healthcare. For example, Mary’s Center in Columbia Heights has a health clinic that vows to assist patients regardless of their ability to pay. In Virginia and Maryland, there are similar programs, such as the Arlandria Clinic and the Arlington Free Clinic,
both of which cater to uninsured, low-income patients. There is a fee schedule based on income and number of family members in the household, but the payments are nominal (some as low as 5 dollars). The DC Healthcare Alliance Card is another option for low-income families that are not eligible for Medicare or Medicaid. The Alliance card cannot be used by unauthorized children or their family members, however, as it requires documentation of permanent residence status, refugee or asylum status, victimization in a domestic violence or trafficking situation or other extenuating circumstance. Applications are made at hospitals and health clinics in the city. Hospital coverage is more problematic, even for those who find low-cost clinics for primary care. Although all hospitals must provide emergency care, there are differences as to what constitutes an emergency. Moreover, the uninsured interviewees mentioned receiving large bills from hospitals (e.g. $15,000 for surgery) which they were unable to pay. Although the hospitals may not try to collect the money, the migrants were unsure what was expected of them. At least one mother reported that she would no longer bring her children to a hospital having had this experience. Even when children are eligible for coverage, their parents may not understand the requirements or they may fear revealing their own undocumented status. As one interviewee stated, “<any immigrants just ‘pray for their children so they don’t
get sick.’” Prenatal care is a particular problem for undocumented migrants. Although federal legislation permits states to provide pregnant women with prenatal care, regardless of legal status, coverage is still limited. The women often do not understand the value of prenatal care, which was not readily available in their home countries. They often do not have the funds to pay for the costs of the care itself or the transportation to get to clinics. Teen pregnancy is an issue that many of the stakeholders and immigrants mentioned as a problem. Respondents noted that teenage girls are often impregnated by older men. Sex may be a rite of passage into gangs or an escape from bad conditions at home. Some schools seek to combine education and health care for pregnant girls and young mothers. One Virginia program is targeted to pregnant teens and fathers. It meets twice a month with the goal of teaching healthy lifestyles to these teens and preventing repeat pregnancies (25 minutes of content). The program provides free baby clothing and books. Students are taught hand washing, how to take care of sick children, breast-feeding, setting boundaries and healthy eating. Representatives come from city departments to provide resources. The program brings health professionals and teens together to help ensure better access to prenatal and postnatal care for mothers and children.
V.C. Livelihoods Finding the money to pay the rent, bills, food, clothing and, most importantly, to provide for their children is a prevalent theme running through the narratives of parents in both countries. In the U.K., most parents have some form of employment, mainly informal and cash-in-hand, but are often insecure. Employment is also common among undocumented families in the United States. The forms of employment range from day labor, an informal job, to positions in the formal economy, which pay at or above minimum wage. The money earned through these jobs varied from allowing for a relatively comfortable life to providing only just enough to survive. Often, the condition of employment were reported to be insecure, unreliable and in constant flux. In the U.K., interviewees related this insecurity, which they felt was increasing, to the current economic climate and the U.K. Border Agency’s introduction of tougher employer sanctions. Most of the independent minors in the U.K. who were not in receipt of social services support were working irregularly, mainly in construction, refurbishment, shops and restaurants. Pay was usually low, and working hours long and irregular. Independent minors who were able to secure some kind of support from social services were usually given accommodation and a weekly allowance that could range from £35 to £50. One of the respondents in the U.S. reported he had come when he was 13 years old and worked in order to pay for his own rent and food while in school. He continued to be entirely financially independent until his schoolteachers realized his situation and he was put in foster care at age 17. An 18-year-old day laborer interviewed in D.C. had been working in the U.S. for 4 years and lived with his brother. The siblings supported each other and sent money back home to Guatemala when they could.
Undocumented minors in families were less likely to be working, particularly if they were in school. In the U.S., children and adolescents who attended school sometimes held summer jobs, but they did not work during school year except for helping in the family business – mainly restaurants and stores – or taking care of younger siblings while their parents held multiple jobs. Brazilian households in the U.K. reported that both parents worked and older children held the occasional part-time job. The most common job among Brazilian adult interviewees was cleaning in private households and businesses. Children often helped their parents during the school holidays, and some of the girls were earning some extra money by babysitting. Many unauthorized youth simply found their legal status to be too strong a barrier to employment, in spite of the fact that their parents worked for cash or with forged paperwork. One interviewee in the U.S. said that he had always wanted to work when growing up but that he had been unable to find jobs due to his legal status, and so had dedicated himself to academics instead. Another said that her father forbade her from working because he did not want her to use forged documents. He wanted his children to follow the law as best as they can, she said, in spite of the fact that they are unauthorized. Her biggest aggravation was how her peers who did work viewed her. She said, “People think I am a pampered princess because I am not working and my dad is paying for everything. But it isn’t that I don’t want to work!” In these cases, parents responded to the legal employment barriers by wanting their children to focus on education. By contrast, older adolescents and young adults who come to the United States – usually after years of being separated
from their parents – in their late teens, never “droppedin” to a school in the U.S. and entered the labor market immediately to repay the money the family paid a smuggler to bring them across the border. For this group, the need to work is a burden that limits their freedom and brings them to the stresses of the adult life at an earlier stage. Therefore, in spite of legal barriers to labor market access, these youth have to find some way to aid in supporting their family. Yet, several service providers, community advocates and local employers suggested that the economic crises has adversely affected immigrant youth, as they compete for jobs with adult immigrants, often their own parents. One interviewee who arrived in the U.S. in 2007 reported seeing the effects of the economic crisis in drastically reduced employment opportunities soon after he arrived. The American Dream of endless employment opportunities was no longer true, and he has found life here much more of a struggle than he had thought it would be. Ways of finding jobs varied significantly. In the U.K., one route was a pro-active approach of asking in shops or looking for vacancies in shop windows, newspapers and the internet. Another common route was finding a job through the network of friends and family. For the majority of interviewees finding paid work was a daily priority, as they were all too aware that they are not allowed to access any benefits. In the U.S., network hiring was also common. One youth obtained employment as a cashier in a local bakery via the recommendation of a friend from her church; the employer did not require her to file much in the way of paperwork. Another interviewee worked as a receptionist in a small non-profit and was paid in cash. He had looked for some time for waged employment with no success before a community leader connected him with the job. Employers had some idea that the youth did not have the immigration status to work legally but were willing to overlook this barrier due to personal connections. They also often ignored immigration status due to the altruistic desire to help these young people access better opportunities and financial resources. While such employers could be considered “benevolent” in the sense that they offer employment to young people without paperwork requirements, such jobs can also leave unauthorized youth vulnerable to various forms of exploitation. This is the case for youth who work as day laborers and are paid in cash at the end of the day. In such cases, workers often suffer wage theft. They complete a day’s work and the employer refuses to pay, knowing that the laborers will not use legal recourse to obtain their wages. In the U.K., Chinese parents reported particularly poor working conditions and instances of exploitation. However, due to their lack of status most felt powerless to speak out or take action in order to right this situation out of fear of being detected and losing the job they nonetheless depended on. Several undocumented youth interviewed in the U.S. mentioned that they could not work because they did not have social security numbers. A few reported using fraudulent documents to obtain employment. Typically, they were unclear about exactly how such documentation has been obtained or processed. One interviewee said that he simply paid someone that another immigrant had recommended. That person then filled out the employment
forms for him and the interviewee submitted them. With these forms, he was able to work at a sandwich shop and later a restaurant. Another youth said that his aunt and uncle had taken care of the forms, and he was unsure of how he overcame the legal barrier to employment. In these cases of false documentation, the youth in these interviews did not appear that they were being coy or unwilling to reveal the process they had undergone, only that they were not aware of the intricacies of obtaining false documentation and that someone else had taken care of the process for them. Beyond these more typical channels for securing employment, some highly innovative unauthorized youth, through their own initiative, have created businesses. Often, these enterprises are insufficient in and of themselves financially to support the youth, but they do help with overall expenses. One interviewee produced works of art when not working his job, which he would sell either from special requests or simply on the street. Such entrepreneurship is a sign of the creativity and determination of many unauthorized youth who look for different ways to earn a living in spite of legal barriers. Yet these instances were rare among our interviewees. Families in the U.K. were more likely than were those in the U.S. to report applying for social services as a source of support. Yet, often, despite trying, parents were unable to access any form of support through social services, even straight after giving birth, which left mothers and their children in destitution. Interviewees, who were or had been in contact with social services, reported a number of negative experiences. These experiences ranged from having support withdrawn unexpectedly, being refused any assistance in securing support and being threatened with taking the child into care. In order for families to have access to help from statutory agencies, it is often required that families have some kind of pending application for regularizing their position or that they are in the process (sometimes this term is used rather loosely) of putting together an application. For many interviewees in both countries, networks of friends, family, faith and community organizations were important means of support, making up for the lack of formal, institutional support. These were largely used to provide the essentials: a place to sleep or money for rent, food, clothes and travel, but also for help with childcare arrangements. Many found it either difficult to ask for money or were no longer able to ask friends or family for support. Often this was because of a feeling that they would not be able to pay the money back or because friends and family believed they would never get the money back. Living in or near destitution has had serious consequences on some of the interviewees. Being in constant need of donations from friends, financial or otherwise, the constant stress of worrying about where the next meal is going to come from and always having less than others, has put a significant strain on social relations. Especially for young people who go to school and have friends and classmates in better economic situation, the wealth differential may cause self-exclusion and lack of confidence. Destitution also affects general health status, where respiratory problems are common due to poor housing conditions and clothing, and children’s educational achievements. Furthermore, the
constant borrowing of money and dependence on donations from friends and family often leads to indebtedness and asymmetric relationships, sometimes to exploitation. Differences in how interviewees spent their income emerged along the lines of whether they were parents or young people and if minors dependent or independent. In the U.K., the dependent migrant minors and independent minors who were accommodated by social services largely did not have to take care of their basic needs, such as accommodation, bills, travel and food. Money that they earned or received as an allowance was then to a certain extent “extra” money from which they bought toiletries, clothes, mobile phones and credit, school materials, called their families and went out with friends, sometimes to cafes or parks.
In contrast, parents mostly spent their income on the essentials of the households, such as rent, bills, food and travel. Any money left after those were paid tended to be used to buy clothes, games, toys and other things for the children. Although most interviewees in the U.K. expressed the wish or the intention to send remittances to their families in their country of origin, their own financial situations usually meant that they were unable to send any money “home”, especially in regular installments. Such a wish was often linked to an expectation of the family at “home” and in some instances was related to paying back debts incurred for the journey. Having children further complicated sending money “home”, as financial resources became more strained and the focus of life had shifted towards the United Kingdom.
VI. Conclusions Irregular migrant children are a sizeable population in both the United States and the United Kingdom. In the U.S., they have recently become a subject of political debate with the implementation of the Deferred Action for Childhood Arrivals (DACA) program. Through an administrative act, the Executive Branch has halted efforts to remove undocumented children and youth who arrived in the United States prior to their 16th birthday. Although not a permanent solution, DACA provides for work authorization and some security from deportation. DACA has become an issue in the U.S. [residential race since the Republican nominee, Mitt Romney, has been opposed to the DREAM Act and has not indicated if he will continue the program if he is elected. At the same time, some states and localities have passed or interrupted laws to make it more difficult for unauthorized migrants, including minors, while others have adopted provisions that would improve their situation (for example, by allowing them to pay lower in-state tuitions at public universities). By contrast, undocumented children have been mostly outside the radar of current political debate in the United Kingdom. They are a composite and diverse group, mostly made up of dependent children who are either born in the U.K. to irregular migrant parents or migrated to the U.K. at an early age. Either way they are likely to have spent a significant part of their childhood in the U.K. being educated in British schools and speaking English as their main language. Irrespective of their immigration status and of the circumstances that led to it, as children, they are bearers of rights and powers enshrined in international law and the American and British legal systems. Both systems guarantee, for example, their access to compulsory education and to primary and emergency healthcare. Both legal systems also create a duty on public authorities to act in the best interest of children in ensuring their safety and security. Nevertheless, in both countries, undocumented children find it difficult to exercise these rights. The tension between immigration policy and the best interest of the child erodes access to education, health care and the opportunity to live in safe and secure environments. In both countries, officials are increasingly being asked to check the legal status of those who apply for services of all sorts. In the U.K., not having legal status can mean that the child either does not
go to school or cannot participate fully in school activities. In the U.S., federal courts have held that schools cannot ask for documentation that may have a chilling effect on undocumented children accessing education, but a growing number of state governments have passed legislation that would require all students to show their own or their parents’ legal status. Although the most egregious requirements are on hold, the message is clear in many jurisdictions – undocumented children are not welcome. Even where the legal rights of the child are not at risk, parents with irregular status fear coming forward to obtain services for their children who are eligible for the assistance. In the U.S., this extends to the U.S. citizen children of undocumented parents. As a result, undocumented children and the children of undocumented parents are marginalized and denied the possibility to contribute fully to the society in which they live. It also means that the child’s physical and mental wellbeing cannot be adequately protected. The voices presented in this report compose a story of everyday resistance, adjustment, adaptation and resilience. They offer a portrait of a group of migrants navigating through the economic downturn and widespread antimigrant rhetoric in both countries. It offers a vivid account of the everyday struggle of children and families to create and maintain some sense of normality despite a situation of extreme precariousness and uncertainty in terms of livelihoods as well as loss of control of one’s own life. Drawing on the accounts of irregular migrants, this study shed light on the multiple ways in which illegality is “woven into the patterns of life” (Das. 2010: 141) of irregular migrants and the agency they need to maintain the fragile fabric of everyday life. It has revealed how “illegality”, especially for children, is not a single and homogeneous (non-) status rather it is a constellation of positions vis-à-vis the state that are the product of tensions and ambiguities existing in the legal framework. This comparative report is also an account of two different policy frameworks for addressing the situation of undocumented children. In the U.S., the problem is one generational since the children born to irregular migrants in the United States are automatically U.S. citizens. Although, as shown, the problems of their parents affect their lives in many ways, they do not face the same level of marginalization and
fear of deportation that is common in the United Kingdom. Moreover, the Deferred Action for Childhood Arrivals program gives new hope to undocumented youth that they will eventually be able to regularize their status in the United States. By contrast, the U.K. does not appear to be exploring ways to help resolve the status of undocumented children, even those who were born in the country. Yet, the length of residence in the U.K. makes these children in many cases de
facto non-deportable. It is certainly not in the interest of children or of the nation to put up barriers to undocumented minors’ access to education or healthcare, or to consign them to lives of irregular and exploitative employment and poverty. In sum, regularization is smart for the children as well as the broader community.
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This synthesis paper is part of a larger project on undocumented children and their access to education, health care and employmentopportuni...
Published on Dec 19, 2012
This synthesis paper is part of a larger project on undocumented children and their access to education, health care and employmentopportuni...