Health Insurance Coverage of Children in Mixed-Status Immigrant Families

Public health insurance coverage increased—and rates of uninsurance decreased—between 1999 and 2002 among two groups of low-income, U.S. citizen children: those with parents who are native or naturalized U.S. citizens and those with at least one immigrant parent who is not a U.S. citizen (referred to as mixed-status families). The improvements followed efforts on the part of the states and the federal government to expand coverage of children under Medicaid and the State Children’s Health Insurance Program (SCHIP) and the introduction of policies directed at improving Medicaid and SCHIP access for immigrant and non-Englishspeaking families. Nonetheless, more than one in five citizen children in lowincome mixed-status families remained uninsured in 2002—a rate 74 percent higher than that of children with citizen parents. This Snapshot uses data from the 1999 and 2002 National Survey of America’s Families (NSAF) to examine the health insurance coverage of lowincome citizen children. (In 2002, 72 percent of all children with noncitizen parents were themselves citizens and thus qualified for benefits on the same terms as citizen children with citizen parents.) The Snapshot also looks at differences in health insurance coverage between children whose parents or other caregivers responded to the survey in English and those whose family responded in Spanish. Limited English skills—like lack of citizenship—may prevent parents from applying for public benefits for their children (Holcomb et al. 2003).