Medicaid Health Coverage for Legal Immigrants

Due to advances in Medicaid and the creation of the State Children’s Health Insurance Program (SCHIP), there was a major reduction in the number of uninsured children in the past decade. Although this is a significant health policy success, the percentage of low-income immigrant children who do not have health coverage has increased since 1996. This was when federal legislation limited the eligibility of legal immigrants for Medicaid and SCHIP only on their first five years in the United States.  The difference in health insurance between citizen and immigrant children has increased significantly, and now almost half of low-income immigrant children are uninsured. This has even made it harder for immigrant children to get medical care and put their health at risk.  Other adversities, such as food insecurity, have added up to these problems that immigrant children often encounter.

SCHIP reauthorization addresses these health insurance coverage disparities faced by legal immigrants.  Congress has included a provision giving states the option to provide Medicaid and SCHIP coverage to legal immigrant children and pregnant women during their first five years in the USA.  This proposal was supported by the many organizations and the National Governors Association (NGA).

This also created a chance to enhance health coverage for legal immigrant children and pregnant women.  Bipartisan legislation that restored state government’s option to give Medicaid and SCHIP coverage to legal immigrant children and pregnant women was introduced in the House by then Representatives Lincoln Diaz-Balart and Henry Waxman and in the Senate by Senators Hillary Clinton and Olympia Snowe.  This was also incorporated in other children’s health bills presented in Congress, and Senators Jay Rockefeller and Olympia Snowe included these provisions in the SCHIP reauthorization legislation.

The SCHIP reauthorization offered a new federal funding option that helped both legal immigrants and health care providers who give uncompensated care to uninsured immigrants in states that do not cover legal immigrant children and pregnant women but have growing immigrant populations.  For states that already provided Medicaid and SCHIP coverage to legal immigrant children or pregnant women the legislation gave immediate fiscal assistance. The legislation, known as The Legal Immigrant Children’s Health Improvement Act, or ICHIA improved health insurance coverage for legal immigrant children and pregnant women, and helped states financially as well.

The ICHIA was supported by the National Governors Association, the National Conference of State Legislatures, and hundreds of national and state organizations. These also included the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the National Council of La Raza.  The NGA called on the federal government to pick up its share of costs for immigrant Medicaid health coverage since the federal government arranges immigration policy.

Legal immigrant families work very hard and pay their share of taxes. Nearly all immigrant children will grow up to be U.S. citizens.  The ICHIA was passed at a time when there was much interest in greatly reducing the number of uninsured children and improving health care and coverage given to them. Efforts to widen coverage to this group of children and pregnant women merited a lot of consideration from legislators.