It’s hard to believe that the next open enrollment period is only 5 months away.  As the federal marketplace and states work to fix enrollment challenges, it’s important to consider what groups are most likely to be uninsured and smooth their pathway to coverage.

A study recently came out that makes it clear that enrollment system fixes for immigrant families should be on the top of the list. The findings were eye-opening: almost half of uninsured children live in immigrant families.  In other words, if we could reach and enroll children in immigrant families, we could cut the number of uninsured children in half (prior studies had looked at how many children in immigrant families are uninsured).  Here are a few other key facts from the study:

• Almost half (42%) of uninsured children in the US live in immigrant families in 2010.  A decade ago this number was close to one third, so that percentage is growing.
• Two thirds (69%) of these uninsured children in immigrant families are US citizens.

The first open enrollment period was acutely difficult for lawfully present immigrants with incomes low enough to qualify for the ACA’s premium tax credits.  As my colleague, Tricia Brooks, mentioned in her recent Health Affairs article, Open Enrollment, Take Two, the federal and state marketplaces can address the most significant challenges faced by immigrant families (including families with a mix of members who are immigrants and citizens) with just two main fixes:

• Developing applications in additional languages other than just English and Spanish;
• Improving the electronic and alternative processes for verifying identity and qualified immigration status

When immigrant parents can’t apply for coverage, their children also lose out on enrolling in coverage. There are other simple but important ways that Medicaid, CHIP and the marketplace can support the enrollment of immigrant families:

• Providing resources for community groups to provide enrollment assistance.
• Training call center and consumer assistance staff about the nuances of immigrant eligibility rules, and the specific barriers—like language access, providing SSN, verification of identity and immigration status—that prevent immigrants from applying and how to overcome them (these are all discussed in a blog series by my colleague Dinah Wiley).

With so many uninsured kids in immigrant families and so little time until November, it makes sense to put enrollment system fixes for immigrant families at the top of the list.