Non-citizens are less likely to have health insurance than U.S. citizens. Many who work in low-wage jobs are not offered employer-based health insurance – and, although they may be income-eligible for Medicaid or CHIP, certain eligibility and coverage restrictions may limit access to full Medicaid coverage. For example, many lawfully present immigrants are generally required to wait five years from the date they were granted their immigration status before they can qualify for full Medicaid or CHIP.
States have the option to remove the five-year waiting period and cover lawfully residing children and/or pregnant women in Medicaid or CHIP. Twenty-nine states, the District of Columbia and the Commonwealth of the Northern Mariana Islands have chosen this option, made available under the Children's Health Insurance Program Reauthorization Act (CHIPRA) in 2009.
A recent study found that between 2007 and 2011-12, the health coverage for low-income immigrant children increased 24.5% in states that expanded coverage through the eligibility option described above, largely due to having greater access to public health coverage. In states that did not pick up the option, coverage for immigrant children increased by only 4%. By 2011-12, 61.5% of immigrant children in states that extended eligibility had Medicaid or CHIP coverage, compared to 21.2% in states that did not. Among children who got coverage, access to health care improved, with a larger percentage of children reporting a usual source of care and having had a well-child visit or a preventive dental visit in the past year and a smaller percentage reporting unmet health care needs.
Immigrants who are otherwise eligible for Medicaid in their state, but do not meet the citizenship and immigration status requirements, may be able to get Medicaid coverage for treatment of an emergency medical condition.
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