Health Coverage for Immigrant Children and Families? Two New Studies Support Moving Forward

Two new studies published in Health Affairs support state efforts to expand coverage for immigrant children and families.

Coverage for immigrant kids and pregnant women

In 2009, the Children’s Health Insurance Program Reauthorization Act provided a new opportunity for states to receive federal funding to cover lawfully present low-income kids and pregnant women in Medicaid and CHIP. A new study shows that in the 20 states and DC states that took up this option as of 2011, children had improved access to health coverage and health care services. A few key findings:

  • Children in states that expanded eligibility for immigrant children experienced a 14.9 percentage point increase in the probability of children having insurance.  Most of this (11.8 percent) was due to greater enrollment in Medicaid and CHIP.
  • Coverage expansions for immigrant children were associated with a substantial decrease (13.7 percentage points) in the probability of immigrant children experiencing unmet need.  These expansions also improved access to a personal doctor or nurse; a usual source of care; well child visits; preventive dental visits; and receipt of specialist care if needed.
  • Increased public coverage for immigrant children was not associated with reductions in private coverage or “crowd out.”  This is likely because low-income immigrant families have more limited access to private health insurance than nonimmigrant families.

Coverage for unauthorized immigrants

The Affordable Care Act excluded undocumented immigrants not only from premium subsidies in the marketplace, but also from buying coverage at full cost in the marketplace.  A new study shows that undocumented immigrants, and especially the uninsured among them, do not use more health care services than other immigrants and citizens.  In fact, undocumented immigrants use was lower or similar to that of other groups.

  • The mean number of doctor visits in the past year was significantly lower for undocumented children (2.3) and undocumented adults (1.7) than for US-born children (2.8) and US-born adults (3.2).
  • Undocumented adults had significantly lower usage of the emergency room (11 percent) than US born adults (20 percent).
  • When considering only the uninsured population and adjusting for other factors, fewer undocumented children (73 percent) had a doctor visit in the past year than naturalized citizens (89 percent) and children who were legal permanent residents or had another type of documentation (84 percent).

As additional states consider providing coverage options for immigrant children and families, both these studies could come in handy.

Interested in learning more?  I also recommend reading a blog post by Randy Capps at the Migration Policy Institute about immigration and the Affordable Care Act.