Immigrant children face health challenges even after obtaining citizenship


According to a new study, children living in the United States without citizenship status are four times more likely to be uninsured and more than twice as likely to receive delayed care from a sibling who obtains citizenship.

These children are even more likely to have relatively worse health outcomes and lower wages later in life, research in Health published Tuesday shows. Despite this, 69% of those who become citizens at the age of 30 and more than 80% of them obtain citizenship at the age of 50.

More so than income, area or race, citizenship is the biggest indicator of whether a child will not be insured.

Children with citizenship were 85% more likely to be covered by the Children’s Health Insurance program than their non-citizen siblings in mixed-status families.

Comparing the gap between this subgroup of citizen and noncitizen children in mixed-status families and those children of variable status in a larger population, the gap between mixed-status families is up to 79% greater.

“Seeing those wide disparities is really alarming, even if it’s not necessarily surprising,” said Kelly Whitener, Associate Professor at the Center for Children and Families at Georgetown McCourt University School of Public Policy. “Having access to Medicaid is part of the puzzle.”

In a 2018 survey of more than 250,000 citizen children and 8,000 non-citizen children, Hispanic children were almost six times more likely to be noncitizens than black, non-Hispanic children, and four times more likely to be non-Hispanic white children.


Noncitizen siblings were even more likely to live in poverty (53%) and receive delayed care due to high costs (7%), according to the study.

Whitener said it would be helpful if Medicaid learned that among noncitizen groups they are eligible for coverage and learn to reach out.

But among immigrant communities, there is a widespread fear that access to public benefits would deport family members or jeopardize permanent status, Whitener said.

The CHIP eligibility restrictions imposed in 1996 create a five-year waiting period for children who are not citizens before they can enroll. About 35 states have used waivers to repeal the rule for non-citizen Medicaid users and 24 have done so for CHIP. Federal legislation has given states the possibility to cover legal immigrant children and pregnant women without a waiting period in 2009. Undocumented children were excluded.

There is progress in states such as Pennsylvania, Delaware and Connecticut toward the use of state funds to raise the waiting period for legally residing children and undocumented children, according to Whitener. But he said there needs to be leadership at the federal level.]

House Representatives in the Progressive Caucus plan to reintroduce health equity and access under the Immigrant Family Act 2021 before Congress ends later this week. Proponents say previous introductions have been halted due to a lack of appetite to cut the waiting period into more benefit programs, but are optimistic.

Co-sponsored by Rep.Pramila Jayapal (D-Wash.), The bill eliminates the five-year public waiting period and supports the Affordable Care Act tax credit for children of immigrants born in the States. United

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