Micromotives and Macro Mayhem: A blog

This page summarizes my non-academic writing on policy issues at the intersection between health and poverty.

Proposed Change to the “Public Charge” Rule Likely Reduced Social Safety Net Access

by Jeremy Barofsky, Allison Yates-Berg, and Ariadna Vargas

Update: On January 27, 2020, the U.S. Supreme Court overruled the injunction blocking implementation of the public charge rule. The Department of Homeland Security announced the rule will go into effect as of February 24, 2020.

The Trump Administration’s expanded “public charge” rule was set to begin on October 15th 2019 before being temporarily blocked by a federal judge only days before going into effect. If implemented, the rule would withhold green cards from immigrants who use common social safety net programs such as Medicaid, which provides health insurance to low-income families, and the Supplemental Nutrition Assistance Program (SNAP), which provides food assistance. Even though there are differences in how safety net programs are affected by the proposed change (e.g., using nutritional assistance for pregnant mothers and young children through the Special Supplemental Nutrition Program for Women, Infants, and Children [WIC] is exempt), a tremendous lack of transparency, confusion, and fear have already led one in seven adults in immigrant families to avoid safety net programs all together. This public charge rule is designed to discourage immigration by making the prospect of life in America as hassle-filled and intimidating as possible, and is consistent with the current administration’s overall approach. It’s a vivid example of a sludge: changing the choice environment, in this case by increasing fear, uncertainty, and stigma around safety net programs to reduce social welfare.

Read the full post here.

Earlier Blog Posts for the Brookings Institution:

Can rapid urbanization in Africa reduce poverty? Causes, opportunities, and policy recommendations 9/7/2016

by Jeremy Barofsky, Eyerusalem Siba, and Jonathan Grabinsky

Sub-Saharan Africa is urbanizing rapidly, but remains mostly rural. Already, cities such as Lagos and Kinshasa constitute urban agglomerations of over 10 million residents (“megacities”), while Dar-es-Salaam, Johannesburg, and Luanda are projected to reach that size by 2030. This rapid city growth in sub-Saharan Africa reflects trends….

Read the full post here.

The impact of not expanding Medicaid 2/2/20/2015

Thoughts on the impact for states that decided not to expand Medicaid on the Brookings Institution’s Health360 blog: Here

Keeping up with the expansionists 3/9/2015

Latest action on Medicaid expansion (with Rio Hart) on the Brookings Institution’s Health360 Blog: Here

U.S. funding for HIV treatment linked with employment gains in sub-Saharan Africa 6/16/2015

Our new paper in Health Affairs on how the U.S. HIV treatment program PEPFAR affects employment in sub-Saharan Africa. Blog and full article.

Investment in health for poverty reduction: New evidence and data challenges 10/9/15

Blog post on the growing evidence that investment in treating HIV and malaria can improve economic outcomes, while highlighting how continuing data challenges make this research more challenging. Joint with Waseem Nosair Blog.

Having your cake and eating it, too: The long-term economic effects of malaria eradication in southwestern Uganda 10/16/15

Blog and full article.