Medicaid/CHIP Coverage for Immigrants During Pregnancy, Childhood, and Adulthood: A Discussion of Relevant Policies and Evidence.

Abstract

Context: Despite major expansions in public health insurance under Medicaid and CHIP over the last 60 years, many immigrants remain ineligible for coverage.

Methods: We discuss the existing federal and state policies that extend public health eligibility to low-income pregnant immigrants, children, and nonelderly adults. We also conduct a literature review and summarize quasi-experimental evidence examining the impact of public health insurance eligibility expansions on insurance coverage, healthcare use, and health outcomes among immigrants.

Findings: Public health insurance eligibility for immigrants varies widely across states due to the implementation of different federal and state policy options. Previous studies on expanded eligibility identified positive effects on insurance coverage and healthcare utilization among pregnant and child immigrants, as well as some evidence indicating improved health outcomes. Further research is required to understand the longer-term impacts of expanded coverage, as well as to examine impacts of recent state expansions for adults.

Conclusions: A complicated patchwork of federal and states policies leads to major differences in immigrant access to publicly-funded insurance coverage across states and population groups. These policies likely have important implications for immigrant access to healthcare and health.