Will ending birthright citizenship incur the plagues of Egypt?
Trump has signed an executive order to end birthright citizenship for certain children of immigrants. But an unprecedented policy experiment in the Dominican Republic shows it could turn him into an inverted Pharaoh. Egypt was plagued for keeping the House of Israel in. Ending birthright citizenship could bring plagues for trying to keep immigrants out.
Many Western Hemisphere countries grant birthright citizenship, or jus soli - citizenship to those born in the country's territory. While some European countries offer jus soli, it's encumbered with other restrictions. There might be additional residency requirements, or perhaps the parents must be in the country legally (which is the requirement that Trump's EO adds). Because of their history of migration, most of the Americas had unrestricted jus soli. Anyone born in the country, regardless of parents' immigration status, automatically received citizenship.
While the majority of Americans can trace their own citizenship to an ancestor who received jus soli, it's not always a popular policy. In the United States, some want greater control over immigration, but jus soli revokes a portion of that control. America's legal immigration system prioritizes family members of citizens. If undocumented immigrants can have a kid on U.S. soil, then they just got placed in the Disney Lightning Lane to citizenship. The privileges granted to these children have led to the derogatory nickname anchor babies, or Colbert's satirical extreme of grappling hook babies.
Fifteen years ago, the Dominican Republic was having a similar policy discussion. Yet there's went a step beyond.
In 2010, the DR amended its constitution to end unrestricted birthright citizenship. As far as I can tell, the amendment was prompted by general discontent with Haitian immigration, though it was coincidentally adopted just weeks after the 2010 earthquake devastated Haiti. The amendment introduced common restrictions on birthright citizenship, removing the privilege for the children of undocumented immigrants. Similar reforms have happened in European
But the unprecedented change came in 2013. A Dominican woman of Haitian descent applied for a national ID card in 2008. Even though she had been born in the country in 1984, her application was denied because her parents were Haitian migrants. When she challenged the denial in court, the decision took an unexpected direction. In 2013, the court retroactively removed citizenship from any Dominican born to foreign parents since 1929.
This affected hundreds of thousands of Dominicans. The government started mass deportations, sending people to Haiti who had never seen the country. And it may have led to more hardships for Haitian migrants.
A new paper argues that the policy came back and affected the public health system.
The Plague
This paper by Fabiola Alba Vivar, Eduardo Campillo Bentancourt, and Jose Flor Toro was presented at the 2024 Northeastern University Development Consortium (NEUDC). It's a work in progress, but I'll report the results they presented.
While this policy change seems unrelated to public health, but it affects both the demand for and supply of healthcare. On the supply side, imagine you have a health issue and ideally you would get examined by a doctors. If you need identification documents to get treatment, then Dominicans of Haitian descent, who just lost their legal status, no longer get access to healthcare. Furthermore, clinics may be less likely to treat anyone of Haitian descent for fear of the legal consequences (or maybe because discrimination has been normalized). On the demand side, if you are Haitian, you might worry that being in the healthcare system increases your risk of deportation. Both effects push towards less healthcare.
If fewer people are getting healthcare, this could be a problem for communicable diseases. This leads to the paper.
The authors use public health reports to examine what happened to communicable diseases in areas with high Haitian populations. They show that areas with the highest Haitian ancestry populations (top quartile) saw a 16% increase in dengue, a highly contagious disease. While this is high, it's probably an underestimate because this is cases among those who have access to healthcare. We're probably missing diagnoses from the individuals directly affected by the policy.
I'll discuss the implications for America, but I don't want to present this paper uncritically. The main issue I have with it is that the policy exposure variable is measured through the population share of recent Haitian immigrants. But the end of birthright citizenship was applied to Dominicans who had been in the country for generations. This doesn't dispute their results, but it does dispute the mechanism. For this policy to be working directly through those who lost their citizenship, it must be that the recent immigrants and the Dominicans of Haitian descent are located in the same places. But I'm not sure if that's the case, since a Dominican whose grandparent migrated from Haiti might not stay near the frontier. Since it uses recent immigrant as exposure, my interpretation is that the policy is working more through the anti-immigrant mechanism than the loss-of-citizenship mechanism.
Implications for America
What does this say for America? Fortunately, the US isn't implementing as extreme of a policy. The Dominican Republic revoked citizenship for hundreds of thousands of people who had been in the country for generations. Trump is just trying to remove birthright citizenship for those yet to be born. The consequences should be much more muted.
But since I think the DR effect is coming through anti-immigrant sentiment, a similar effect could be awaiting the US. I doubt the birthright citizenship executive order will survive the judicial challenge. But it's a symptom of a greater theme. Another symptom is Trump's threat of mass deportations. If these anti-immigrant policies scare our immigrants like they do the DR's, maybe we'll get similar public health issues.
Yet, we shouldn't just focus on the public health consequences. The biggest takeaway for me is that targeted policies have societal consequences. While you would think that you could contain the effects of revoking citizenship to just those directly affected, you can't. Dominicans are bearing the cost. And that's just in public health. There are other areas, such as the labor market or the demand for local services, where these effects will be harder to measure but are just as real.
Why are we committing these unforced errors?