Interagency Dynamics in Matters of Health and Immigration

Posted: 27 May 2022

See all articles by Medha D. Makhlouf

Medha D. Makhlouf

Pennsylvania State University, Dickinson Law

Date Written: May 7, 2022


When Congress delegates authority on issues to more than one executive agency, it tells us something important about the expertise that Congress wishes to harness in policymaking on those issues. In the legal literature on interagency dynamics and cooperation, issues at the nexus of health and immigration are largely understudied. This Article extends that literature by examining how delegations of authority on issues at the intersection of health and immigration influence policymaking. In an analysis of how agency coordination theory applies to three topics in the shared regulatory space of the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS), I demonstrate that HHS’s ability to leverage its expertise on topics under the agencies’ joint purview is compromised by a culture of capitulation to DHS—or to an administration’s immigration policy preferences, generally. This, in turn, intensifies the subordination of health-related expertise to immigration policy concerns, which contravenes Congress’s purpose in establishing related or overlapping jurisdictional assignments to HHS and DHS. It reveals a need to achieve a better balance in matters of health and immigration. A deeper understanding of how institutional design affects policymaking in this space can help Congress or the agencies themselves make better use of available tools to disseminate health-related expertise throughout the federal bureaucracy.

Keywords: interagency cooperation, interagency collaboration, health policy, immigration policy, shared regulatory space

JEL Classification: K32, K37, K23, I1, I18

Suggested Citation

Makhlouf, Medha, Interagency Dynamics in Matters of Health and Immigration (May 7, 2022). Boston University Law Review, Vol. 103, Forthcoming 2023, Available at SSRN:

Medha Makhlouf (Contact Author)

Pennsylvania State University, Dickinson Law ( email )

150 S College St
Carlisle, PA 17013
United States

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