Complicated eligibility rules, burdensome enrollment processes, and concerns about mistreatment during interactions with staff keep many people from enrolling in safety net programs such as Medicaid and the Children’s Health Insurance Program (CHIP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Supplemental Nutrition Assistance Program. But research finds that immigrants face additional barriers to enrollment, including lack of language access and fears of immigration-related consequences, on top of eligibility restrictions that prohibit many from qualifying. Given states’ roles in financing and delivering many safety net programs, state- and local-level policies and practices can contribute to how well programs meet the needs of state populations, including immigrants and people who live in families with immigrants. In this report, we assess barriers to immigrant families’ enrollment in safety net programs in North Carolina and strategies for state- and county-level improvements to promote access and inclusion. These findings are based on 42 interviews with stakeholders at the state level and in four counties across the state, as well as four focus groups (in Spanish, Swahili, and Hmong) with members of immigrant families who have experience with safety net programs in the state.
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