Michigan Head Start, health programs scramble amid immigration crackdown

• The Trump administration reinterpreted a nearly 30-year-old welfare law to bar many legal and undocumented immigrants from federally backed health centers, Head Start and mental health programs
• Michigan health providers worry the policy will limit access among vulnerable populations, hurting both patient health and the economy
• Michigan and 20 other states are suing to block the rule change

For more than 50 years, Northwest Michigan Health Services has served as a safety net for the uninsured living Up North.

The nonprofit organization was founded to serve the region’s migrant community. It’s a federally qualified health center system, and its four sites are tasked with helping everyone that comes through their doors, regardless of the patient’s ability to pay.

That includes the seasonal farmhands who work the orchards and fields between Traverse City and Shelby, and the summer resort employees in town on foreign visas without access to their regular health care providers.

But a recent change in federal policy has shaken the confidence of workers at Northwest Michigan Health Services and a bevy of other social programs, including Head Start, about whether they can continue to help those in need without first checking their immigration status. 

Earlier this month, the US Department of Health and Human Services effectively barred undocumented immigrants, as well as many lawfully present immigrants, from accessing federal health centers, Head Start programs and various federally funded mental and behavioral health services. In all, 13 programs have been reclassified as “federal public benefits” that fall under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), a welfare reform package passed during the Clinton administration. 

Under the Trump administration’s reinterpretation, only immigrants with  “qualified alien” status, such as green card holders, refugees and people who’ve been granted asylum, are able to access the publicly supported services. 

That means some other immigrants who are in the US legally may lose access, such as international students and seasonal agricultural workers. Others include people who’ve been granted temporary protected status because of civil unrest, violence or natural disasters in their home countries and those with Deferred Action for Childhood Arrivals, or DACA, status, who were brought to the US as children and have temporary protection from deportation. 

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The change will “restore compliance with federal law and ensure that taxpayer-funded program benefits intended for the American people are not diverted to subsidize illegal aliens,” HHS said in a July 10 news release.

At Northwest Michigan Health Services, Heidi Britton, the health center’s CEO, says her clinics see about 8,900 patients a year for medical, dental and mental health services.

She recalls how her team was able to assist a seasonal resort worker when they found a mass on her body during a routine check-up. Providers at the clinic were able to collaborate with physicians in the patient’s home country to address the issue.

“If she had just done nothing during the time that she was up here and didn't have her preventative health care …  we wouldn't have caught it. She wouldn't have caught it,” Britton told Bridge Michigan.

HHS has yet to provide program specific guidance for places like the health clinics, with a department official saying the rule relies on local administration.

While the existing federal statute exempts nonprofits from having to report the immigration status of participants, Britton said it's been “unclear” how the change should be handled on her end.

She worries the decision may limit access to her centers and push people toward emergency rooms after they’ve failed to get preventative care.

“We need community members healthy in order to thrive,” Britton said. “I think there's a huge downstream impact that's going to happen.”

Support systems

Federal health officials lauded the policy shift as a needed correction of a nearly 30-year-old rule that they say redirected funds away from Americans. 

“For too long, the government has diverted hardworking Americans’ tax dollars to incentivize illegal immigration,” said HHS Secretary Robert F. Kennedy, Jr. in a news statement, pledging that the department’s actions would restore “integrity” to federal social programs.

Immigration advocates say the policy reinterpretation is a cutback on critical safety nets for various immigrant communities with legal status.

According to a KFF/LA Times survey, 3 in 10 immigrant adults use federally backed Community Health Centers as their usual source of care, rising to 42% among undocumented immigrants.

Christine Sauvé, a spokesperson for the Michigan Immigrant Rights Center, said the federal government is “excluding individuals that have been relying on these supports for years.”

“It is one more barrier and one more exclusion that immigrant families have to face when they're already facing so many,” she said.

Head Start in crosshairs

Leadership at the Michigan Head Start Association, which advocates on behalf of the state’s $400 million program, believe the new rule will discourage enrollment.

“If these families cannot have safe care for their children, they cannot go to work, and ultimately, that affects our economy,” said executive director Robin Bozek.

HHS estimates that nationwide, the change would push $374 million annually in additional Head Start services toward US citizens and qualified aliens, citing a preliminary analysis.

The state association is advising Michigan’s Head Start programs, which cover more than 28,000 seats for early education and child support systems, to maintain their current enrollment. Bozek said she’s telling members “not to take any action” without specific guidance from the federal office, and said she is focusing her efforts on advocating for fair access to Head Start.

The program has seen an active campaign of “attacks and disruptions,” according to Bozek, including a proposal in Project 2025, a conservative national policy agenda led by the Heritage Foundation, to eliminate Head Start.

Michigan has 13 Head Start centers, a total of 670 seats, for children of migrant and seasonal farm workers. Telamon Michigan, which runs most of the specialized programs, does not verify immigration status as part of its intake process.

Bozek said the decision to accept children and families into Head Start isn’t about country of origin.

“We believe every child deserves the opportunity to be successful, both in school and kindergarten and in life,” she said. “We believe that Head Start gives those children that opportunity.”

Michigan’s immigrant community

There are more than 737,000 foreign-born individuals living in Michigan — just over 7% of the state’s population, including naturalized citizens and other categories. 

Estimates from the American Immigration Council put Michigan’s undocumented population at 110,700 in 2023, in addition to 10,700 DACA-eligible residents and more than 38,000 international students. 

Recent congressional figures show the state has 5,940 individuals with temporary protected status, while thousands travel and are employed in the state with temporary work and tourist visas.

Sauvé with the Michigan Immigrant Rights Center said the policy directive, coupled with increased immigration enforcement and a general feeling of unease about working with government officials, have a “chilling effect” on Michigan immigrants who remain qualified to receive federally backed health services, creating “an underclass of Americans” deprived of basic care and social support.

“We are left with quite a few questions for the state of Michigan as they're evaluating the notices,” she said. “Implementation is a big question mark right now.”

Michigan Attorney General Dana Nesel has joined 20 of her Democratic counterparts in other states in suing the Trump administration to stop the rule change.

“Unlawfully disregarding longstanding precedent on a whim puts these vital programs at risk, not only for those without formal documentation but for the entire community. It forces providers to comply with sudden, arbitrary changes or lose federal funding,” Nessel said in a statement announcing the lawsuit.

The lawsuit claims the decision has sowed “chaos,” with federal agencies failing to provide proper notice procedures before implementation, burdening the states with developing costly screening systems for eligibility.

“Many programs cannot realistically conduct verification at the door, such as 24/7 crisis hotlines, emergency services for individuals suffering an overdose, and homeless shelters,” the lawsuit continues. “Even if some programs could implement such verification with time and resources, vulnerable people lack government identification when accessing these services for myriad reasons.”