Arkansas and Nevada Latest to Eliminate 5-Year Waiting Period for Lawfully Residing Children

Portrait of a smiling family lying on the grass

The Children’s Health Insurance Program Reauthorization Act of 2009 gave states the option to improve Medicaid access by waiving the 5-year waiting period for lawfully residing immigrant children. With Arkansas and Nevada coming on board, this option has now been adopted by 33 states.

Earlier this year, the Arkansas legislature passed a resolution to waive the 5-year Medicaid waiting period for lawfully residing children. Governor Asa Hutchinson signed this resolution in March 2017, and a proposal is currently being prepared to be submitted to federal authorities. The Arkansas Department of Human Services plans to implement the rule by Jan. 1, 2018 if the submission is approved.

Motivating Arkansas, in part, was the large proportion of immigrant children in the northwest part of the state. The region is also home to one of the largest Marshallese populations in the mainland. U.S. Marshallese, as part of a Compact of Free Association, are a unique group of lawfully residing migrants. They have come to the U.S. in increasing numbers over the years due in part to the tragic impacts of the U.S. nuclear testing on the Marshall Islands.

Their unique immigration status for Marshallese, as interpreted by federal and state law, meant that even if they were otherwise eligible, no Marshallese-born children could access ARKids First, the state’s Medicaid and CHIP program. Taking the option –commonly referred to as Immigrant Children’s Health Improvement Act or ICHIA—will resolve this issue because it allows the state to make “lawfully present” children eligible for the program.

In 2014, Nevada had one of the highest rates of uninsured children and the ninth largest number of uninsured Hispanic children in the nation. However, through Medicaid expansion and other coverage options under the ACA, Nevada was able to dramatically decrease their number of uninsured children, cutting the number in half by 2015.

Another important step towards decreasing the number of uninsured children was the adoption of the ICHIA option by the Nevada legislature in June. If the plan is approved by the Centers for Medicare and Medicaid Services, it is estimated to provide coverage to up to 7,500 Nevada children.

Medicaid coverage can have a powerful impact on a child’s life; the Reno-Gazette Journal reported the story of a mother who takes her young children across the border to Mexico to receive affordable medical services. Her children were not eligible for Medicaid even though the children are lawfully residing in Nevada. With the ICHIA adoption, her children can now enroll in Medicaid and receive care close to home.

Nevada and Arkansas, along with Florida and Utah (which opted into ICHIA last year),  represent the strides that states have made in covering uninsured children even in light of federal threats to children’s coverage. Medicaid and CHIP are now more important than ever to the health of immigrant children.

At a time when states like Arkansas and Nevada are moving to increase access and quality of coverage, it is imperative that the Medicaid program and funding structure be kept intact. Any cuts or caps to the program will undermine these efforts and reverse coverage gains for immigrant children. For more information on ICHIA and participating states, please refer to our fact sheet.

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