Immigrant Children’s Medicaid and CHIP Access and Participation: A Data Profile
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Highlights
In 2019, 40 percent of income-eligible immigrant children were barred from Medicaid and CHIP, and even eligible children enrolled at much lower rates.
- Of 2.3 million income-eligible immigrant children in 2019, 909,000 were federally ineligible for Medicaid or CHIP because of immigration status; Latino children were most affected, with 53 percent ineligible versus 22 - 27 percent of other groups.
- Even federally eligible immigrant children enrolled at lower rates than U.S.-born peers (74 percent versus 92 percent); CHIPRA states had higher immigrant participation than non-CHIPRA states.
- Federally ineligible immigrant children had a 43 percent uninsured rate—more than seven times the 6 percent rate for U.S.-born children—while eligible immigrant children still had an 18 percent uninsured rate.
- As of June 2022, only six states and the District of Columbia funded coverage for unauthorized immigrant children; confusion about the federal public-charge rule contributed to enrollment drops in some states.
A child’s access to health care can have a long-term impact, with poor health in childhood linked to health complications and higher medical costs in adulthood. Many immigrant children in the United States face additional hurdles to staying healthy, including a higher likelihood of being in a low-income household and limits on their access to comprehensive health insurance through Medicaid and the companion Children’s Health Insurance Program (CHIP)—programs that help many U.S. children in low-income families access care.
Under federal law, certain noncitizen children are ineligible for federally funded nonemergency Medicaid and CHIP. This includes all unauthorized immigrants, many with a temporary status, and most lawful permanent residents (also known as green-card holders) during their first five years in that status.
This policy brief presents U.S. and state-level estimates of the number of immigrant children (ages 0 to 18) whose families have incomes low enough to qualify them for Medicaid and CHIP, and among them, the number who are either federally eligible or ineligible due to their immigration status. The brief also describes Medicaid and CHIP participation and uninsured rates among U.S.-born and federally eligible immigrant children. This analysis highlights trends across racial/ethnic groups and states that have and have not chosen to expand access to public health insurance for immigrant children.
Table of Contents
1 Introduction
CHIPRA Option and State Discretion
2 Federal Eligibility of Income-Eligible Children
A. Race and Ethnicity of Income-Eligible Immigrant Children
B. State-by-State Estimates of Income-Eligible Immigrant Children
3 Medicaid and CHIP Participation Rates
A. Participation Rates by Race and Ethnicity
B. State-by-State Participation Rates
4 Uninsured Rates among Income-Eligible Children
5 Conclusion
About the Human Services Initiative
The Initiative produced work focusing on U.S. federal, state, and local policies on immigration issues affecting children, families, and health and human services.
About the National Center on Immigrant Integration Policy
The Center is a national hub connecting policymakers, educators, community leaders, and service providers with evidence-informed policy research, technical assistance, and data to advance effective immigrant integration at U.S., state, and local levels.
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