April 01, 2014

Many Uninsured Children Live in Immigrant Families

The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.

More than two-thirds of uninsured children with immigrant parents are U.S. citizens, according to an analysis by Eric E. Seiber, PhD, of The Ohio State University College of Public Health, Columbus. He writes, “Initiatives to expand coverage or increase Medicaid and CHIP uptake will require decision makers to develop new policy and outreach approaches to enroll these children so they do not fall behind.”

Dr. Seiber analyzed data from a U.S. Census Bureau survey for the years 2008 to 2010, including more than 2.8 million households annually. Each year’s data included over 40,000 children living in immigrant families: those who had immigrated themselves or had at least one immigrant parent.

By this definition, nearly one fourth of all U.S. children in 2010 were living in immigrant families. Eighty-six percent of these children were native-born citizens, and another two percent were naturalized citizens. Thus, only 12% of children in immigrant families were noncitizens.

Overall, 42%of uninsured children in the survey lived in an immigrant family. The percentage of uninsured children with immigrant parents ranged from four percent in Maine to 69% in California. “Having an immigrant parent is a defining characteristic of uninsured children,” Dr. Seiber wrote.

After adjusting for other factors, children who were not citizens and those born in Latin America were most likely to be uninsured—by about 11 and seven percentage points, respectively. Language barriers also played a role. For children living in a home where Spanish was the primary language, the chance of being uninsured was two percentage points higher.

While previous studies have shown children living in immigrant families are more likely to be uninsured, less is known about what percentage of uninsured children who are immigrants or have immigrant parents. In 2000, a study reported that 36% of uninsured children live in immigrant families.

The results show that “approaching half” of uninsured children in the United States have immigrant parents, said Dr. Seiber. He added, “Children living in immigrant families are the group most likely to miss key investments in their health and human capital.”

The Affordable Care Act includes efforts to expand health care coverage to uninsured populations. But as the new study points out, many children living in immigrant families are uninsured despite being eligible for Medicaid. “With the future of immigration reform undecided, enrollment groups must provide a safe harbor for citizen children who may have undocumented parents,” according to Dr. Seiber.

He urged new policies and outreach to expand health insurance coverage among children living in immigrant families. “Maine, Hawaii, Massachusetts, New York, and Illinois have been particularly successful in enrolling eligible children with immigrant parents in insurance programs, and are models for the rest of the country,” Dr. Seiber noted.                      

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