Access to quality healthcare is essential to everyone's ability to achieve and maintain good health—and is not possible without affordable, quality health insurance coverage.
Removing barriers that exist for noncitizens and citizens alike is crucial to advancing health equity.
Although national uninsured rates have reached an all-time low, there are still an estimated 27 million people who remain uninsured—which means they are missing out on preventative care, assistance with managing chronic conditions like heart disease and diabetes and timely diagnosis of diseases.
A person's immigration status alone can prevent them from being eligible for health coverage. The deep-rooted racism in the United States, outdated immigration policies, and an individual's immigration status are all connected. Even those who are eligible also fear discriminatory and uneven immigration enforcement practices, which prevent them from enrolling in services—even when eligible.
Noncitizens in the United States are four times as likely to be uninsured compared to individuals who are citizens (39.2% versus 9.8%). This is due to eligibility restrictions for Medicaid, Children's Health Insurance Program (CHIP), and Marketplace coverage, as well as limited employer-sponsored coverage.
The current state of healthcare coverage for immigrants affects us all. Policymakers cannot advance health equity in this country without prioritizing immigrant health coverage. Now is the time to break down barriers to improve healthcare for all.
Opportunities to Expand Health Coverage for Immigrants
There are pathways to coverage for noncitizens living in the United States. The pathways available vary by immigration status, with lawfully present immigrants eligible for more options and undocumented immigrants eligible for fewer. Below are opportunities at the federal and state level:
The Biden administration announced a plan to extend coverage to Deferred Action for Childhood Arrivals (DACA) recipients previously excluded from federal health programs, including Medicaid and marketplace premium assistance. Finalizing this rule is a necessary first step towards closing the healthcare gap among immigrant populations.
Expanding Medicaid could offer coverage to many more people, including lawfully present residents and others with immigration statuses eligible for Medicaid.
Use of State-Only Funds to Provide Coverage or Subsidies
State leaders can utilize state-only funds to extend coverage to low-income residents currently ineligible for Medicaid/CHIP or subsidized health insurance under the ACA, regardless of immigration status.
Extensions of Coverage Under CHIP
While many immigrants remain ineligible for federally funded health benefits, Congress has provided states various opportunities to extend CHIP coverage in certain situations. Many states have exercised these options, but many others have not.
Innovative Policy Elements to Advance Equity
Addressing concerns that enrollment can lead to adverse immigration-related outcomes, considering affordability for those who exceed income eligibility, and conducting community outreach to eligible undocumented immigrants so they understand how to access benefits can help more immigrants access health coverage.
To achieve health equity, we must identify where racism has shaped our nation’s governance, social structures, and policies perpetuating inequities. We must consider longer-term solutions that could transform several of our nation’s systems, policies, and practices built on a legacy of exclusion to ensure a future where everyone’s children and grandchildren can achieve their best health and wellbeing.
The Health Coverage of Noncitizens in the U.S.
Information on the sources of health insurance coverage of noncitizens, and further details on the characteristics of uninsured noncitizens, is critical if policies are to be designed to achieve near-universal coverage in the U.S.
Health Equity and Affordable Health Coverage for Immigrant Populations
Briefs highlight strategies for states to expand affordable health coverage to immigrant populations in the United States.
Coverage for Recipients of DACA and Other Lawfully Present Immigrants
Comments regarding eligibility for federal health insurance coverage for recipients of Deferred Action for Childhood Arrivals and other lawfully present immigrants.
From the Blog
Advancing Health Equity for Immigrants
Civic engagement and equity-centered data foster a society that advances health and wellbeing for immigrants.