
Title 42: Impact on Families and Communities
In 2022, nearly half of all migrant encounters at the border fell under Title 42 authority. A Title 42 expulsion refers to the U.S. government's action of deporting individuals who have recently been in areas affected by communicable diseases. This provision, enacted during the COVID-19 pandemic, allowed for the rapid expulsion of individuals apprehended at the border without the standard immigration processing procedures. Among these encounters, a striking 89% were expulsions of single adults, who then faced immediate removal from the United States without the opportunity to present asylum claims or seek legal recourse.
​
Moreover, research has shed light on the detrimental impact of Title 42 expulsions, particularly on the health and well-being of migrant families. Families subjected to these expulsions often endure heightened stress, uncertainty, and exposure to dangerous conditions, exacerbating vulnerabilities already present in their migratory journey. The abrupt and often chaotic nature of these expulsions disrupts familial units, leading to emotional distress and trauma, especially among children.
​
Furthermore, the lack of adequate screening and access to essential services during expulsions poses significant health risks to migrants, such as exposure to COVID-19 and other communicable diseases. The absence of proper medical care and support systems further compounds the challenges faced by migrant families, leaving them vulnerable to exploitation, abuse, and other forms of harm.
​
Thus, the widespread use of Title 42 authority not only raises humanitarian concerns, but also underscores the need for comprehensive immigration policies that prioritize the protection and dignity of all individuals, regardless of their immigration status. Efforts to address the root causes of migration, improve access to legal pathways for asylum, and uphold international human rights standards are essential to fostering a more humane and equitable approach to border management and immigration enforcement.
​
Title 42 works in conjunction with many immigration policies — for example, the DACA program, established in June 2012 via Presidential Executive Order, safeguards certain undocumented immigrants who arrived in the U.S. as children from deportation and grants them authorization to work for renewable two-year periods. To qualify, individuals must have arrived before turning 16 and prior to June 15, 2007, be under 31 as of June 15, 2012, be enrolled in school, have completed high school or its equivalent, or be a veteran, and have had no lawful status as of June 15, 2012. Over 900,000 immigrants have benefited from DACA, allowing them to remain in the U.S., pursue education, and contribute economically. As of September 30, 2022, there were over 589,000 DACA recipients in the U.S., with a majority residing in California, Texas, Illinois, New York, and Florida. Most recipients are female, and the majority are between 21 and 30 years old. Although DACA shields individuals from deportation temporarily, it doesn't confer lawful status or offer a pathway to citizenship, and recipients are ineligible for federally-funded health coverage.
​
While DACA recipients can work, they face limited options for health insurance as they remain ineligible for many federal programs, including Medicaid, CHIP, and ACA Marketplaces. The Biden Administration's Final Rule, published in 2022, aimed to codify DACA, but its implementation is constrained due to ongoing legal battles. This followed the Trump Administration's attempt to rescind DACA in 2017, a move deemed unlawful by the Supreme Court in 2020. Despite the Biden Administration's efforts, court rulings have affected the processing of DACA applications. Even if first-time DACA applications were reinstated, the pool of eligible individuals is shrinking over time. The DREAM Act of 2021, if passed, would offer a pathway to lawful permanent resident status and eventual citizenship for undocumented immigrants brought to the U.S. as children.
​
However, such legislation has faced hurdles in Congress, with no clear path to enactment. If the district court reviewing the current case deems the DACA program unlawful and no further legislative or administrative actions are taken, individuals will lose their deferred status. Consequently, they'll lose work authorization and might face deportation. This would likely lead to job terminations by employers due to the loss of work authorization, resulting in unemployment and loss of employer-based health coverage.
​
Without access to employer-based coverage, many individuals could become uninsured as they aren't eligible for Medicaid, CHIP, or Marketplace coverage. The employment and coverage losses would exacerbate financial strain and diminish access to care for affected individuals and their families, including citizen children.
​
Regarding the Public Charge Rule, as of December 23, 2022, the Biden Administration's new regulations have come into effect. Ongoing outreach and education efforts will be crucial for alleviating fears among immigrant families about enrolling in health coverage and other assistance programs. Traditionally, federal officials could deny entry to the U.S. or adjustment to LPR status based on the determination of being a public charge. In 2021, the Biden Administration ceased applying the public charge regulations introduced by the Trump Administration in 2019, which had included the use of noncash assistance programs, like Medicaid, in public charge considerations.
​
Instead, the Biden Administration reverted to using the 1999 field guidance, which excludes the consideration of noncash benefits such as Medicaid coverage, except for cases of long-term institutionalization, when making public charge determinations. In 2022, it introduced new regulations that largely formalized this field guidance. One of the primary goals of the 2022 public charge rule is to counteract the chilling effects of the 2019 rule, which discouraged many immigrant families, including citizen children within those families, from seeking assistance, including health coverage and care, for which they were eligible.
​
The Final Public Charge Rule was officially published on September 9, 2022, and took effect on December 23, 2022. However, families may still refrain from participating in assistance programs due to concerns about potential adverse consequences on their or their family members' immigration status. According to a 2021 survey by KFF of Hispanic adults, 1 in 4 potentially undocumented Hispanic adults and over 1 in 10 lawful permanent resident Hispanic adults reported that they or a family member avoided participating in a government assistance program in the past three years due to immigration-related fears. Despite the implementation of the new rule, addressing these fears will likely necessitate outreach efforts from trusted community-based sources. Overcoming these fears is crucial for closing the significant gaps in health coverage for immigrants and citizen children in immigrant families.
​
In conclusion, the intersection of Title 42 and DACA presents a complex landscape with significant implications for both immigrant communities and broader society. The potential termination of DACA, coupled with the continuation of Title 42 expulsions, creates a precarious situation for DREAMers and other undocumented individuals. The loss of DACA protection could result in individuals facing deportation, while the ongoing enforcement of Title 42 exacerbates the challenges they face in seeking refuge or asylum in the United States. This combination of policies not only threatens the well-being and livelihoods of affected individuals but also undermines efforts to promote compassion, fairness, and human rights in immigration policy. As discussions and legal battles unfold, it becomes increasingly urgent to address the systemic issues that perpetuate these challenges and seek solutions that uphold the rights of all individuals, regardless of immigration status.