Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117555

Lisa Cacari Stone, PhD, Department of Family and Community Medicine, Masters of Public Health Program, University of New Mexico, 2400 Tucker North East, Albuquerque, NM 87131-5267, 505-577-3540, Lcacari-stone@salud.unm.edu, Dan M. Reyna, MPA, New Mexico Department of Health, Director, Border Health Office, 1170 N. Solano Dr. Suite L, Las Cruces, NM 88001, and Alice Salcido, MPH, New Mexico Department of Health, Office of Border Health, 1170 N. Solano Dr. Suite L, Las Cruces, NM 88001.

This presentation will include findings from a 2004 study in New Mexico which analyzed the local consequences of the implementation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (welfare reform) on the funding and provision of health services to immigrants in New Mexico. Primary data were collected from five demographically and politically distinct counties in New Mexico. Semi-structured interviews (n=55) with government officials, providers and health advocates served as the main data collection method augmented by documents collection and field observation.

Results show that economic and political factors were influential in shaping variable county responses to the federal policy changes that restrict Medicaid eligibility and benefits for legal immigrants arriving after 1996. Scarce resources and anti-immigrant sentiment fuel public resentment towards Mexican immigrants by current residents of New Mexico, especially by native-born Hispanics. Despite a reported lack of political will to publicly dialogue and address on-going public health issues related to immigration, sporadic advocacy efforts have influenced programmatic and incremental policy changes at the local level. Furthermore, the majority of respondents confirmed that complicated welfare reform policies and regulations have created a climate of chronic confusion and ambiguity that has increased front-line discretion in determining immigrant eligibility for public benefits. Finally, New Mexico is similar to other border states (Arizona, California, and Texas) in struggling with the legal ambiguity that the welfare reform has created with respect to services to immigrants who are lawfully in the country, but do not qualify for Medicaid.

Learning Objectives: At the conclusion of the session, the participant will be able to

(
• Understand the policy changes of the 1996 welfare reform and how those changes have impacted the financing and delivery of health care by a border state and its localities. (
• Describe how the state, counties and safety net in New Mexico has responded to the 1996 policy changes. (
• Discuss alternative policy options and program changes that ensure access to health care for immigrants regardless of citizenship status and language.

Keywords: Immigration, Public Policy

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation